Cognitive Behavioral Therapy for Insomnia in Substance Use Disorders

Completed · Not applicable

Conditions studied: Substance Use Disorders, Insomnia

In brief

Substance Use Disorders (SUDs) and insomnia are major public health concerns, and each are independently linked to reduced quality of life, disability, and high healthcare costs. Insomnia, characterized by difficulty initiating or maintaining sleep, or nonrestorative sleep, is prevalent in 10% of the general population and is co-morbid in 70% of patients with SUDs. Primary insomnia and SUDs are chronic, unremitting diseases and have a complex bidirectional relationship. Insomnia symptoms may predate the onset of SUDs and may explain high prevalence of self-treatment. Insomnia may also be a direct effect of intoxication, withdrawal, or abstinence from the substance of abuse. Subjective and objective measures of sleep disruption have been shown in various stages of abuse and recovery. Insomnia is the most well documented predictor of substance use relapse. Treatment specifically targeting chronic insomnia is essential for improved clinical outcomes. Although, chronic insomnia is a well-established, modifiable risk factor, to our knowledge, there are no interdisciplinary residential treatment programs that specifically treat chronic insomnia during acute SUDs treatment. We propose that improved treatment of insomnia as part of a comprehensive reinforcement-based outpatient treatment program will provide an efficient and cost effective opportunity to improve standard outpatient SUD. Converging evidence suggests that prophylactic CBT-I during SUD treatment may have short and long-term efficacy for sleep, and improve attrition. In the proposed study, patients with co-morbid SUDs and insomnia will engage in an 8-week group CBT-I (gCBT-I) program in addition to receiving treatment as usual for SUDs. This study may provide new hope to effectively treat insomnia in SUD and lead to a new standardization of outpatient care. We hypothesize that a CBT-I intervention can be implemented as part of an evidence-based SUD treatment program within a residential facility.

Key facts

Study ID

NCT03208855

Run by

Johns Hopkins University

People needed

28

Starts

2017-07-31

Expected to finish

2020-10-13

Last updated by the study team

2022-02-01

Who can join

Age: 18 and older. Sex: male. Healthy volunteers: not accepted.

You may qualify if…

• Males > 18 years of age
• Active substance use disorder of any type
• Enrolled in the Cornerstone at Helping Up Mission clinic for less than 3 weeks
• ISI > 8
• Report either latency to sleep onset > 30 minutes or > 2 awakenings/night or > 15 min duration or wake after sleep onset (WASO) time > 30 minutes
• Insomnia symptom frequency self-reported as > 3 night/week for > 1 month

You may not qualify if…

• Self-report of Bipolar Disorder
• Self-report of Epilepsy or seizure disorder
• Suicidal ideation
• Acute Alcohol Withdrawal requiring medical attention

Where it is running

• Cornerstone at Helping Up Mission Clinic — Baltimore, Maryland, United States

Full record on ClinicalTrials.gov

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