NCT03964974

Brief Summary

As medical cannabis use becomes more common in the United States, it is essential to understand the ways in which adults who use medical cannabis perceive the benefits of cannabis use and to identify effective strategies to help them cope with these problems. Emerging data indicate that insomnia and/or use of cannabis for sleep are very common in medical cannabis patients. The present study will adapt and gather pilot data on the impact of a Cognitive Behavioral Therapy for insomnia (CBTi-CB) intervention on sleep- and cannabis-related outcomes in adults who use medical cannabis.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
57

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Feb 2020

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 17, 2019

Completed
11 days until next milestone

First Posted

Study publicly available on registry

May 28, 2019

Completed
9 months until next milestone

Study Start

First participant enrolled

February 10, 2020

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 13, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 13, 2021

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

September 14, 2022

Completed
Last Updated

September 14, 2022

Status Verified

August 1, 2022

Enrollment Period

1.4 years

First QC Date

May 17, 2019

Results QC Date

July 7, 2022

Last Update Submit

August 22, 2022

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change From Baseline Insomnia Severity Index Score at Study Completion

    The Insomnia Severity Index (ISI) is a brief self-report instrument measuring the patient's perception of both nocturnal and diurnal symptoms of insomnia. The ISI comprises seven items assessing the perceived severity of difficulties initiating sleep, staying asleep, and early morning awakenings, satisfaction with current sleep pattern, interference with daily functioning, noticeability of impairment attributed to the sleep problem, and degree of distress or concern caused by the sleep problem. The range of the ISI is 0 to 28, with 28 corresponding to maximum severity.

    16 Weeks

Study Arms (2)

Cognitive Behavioral Therapy for Insomnia in Cannabis Users (CBTi-CB)

EXPERIMENTAL
Behavioral: Cognitive Behavioral Therapy for Insomnia in Cannabis Users (CBTi-CB)

Sleep Hygiene Education (SHE)

PLACEBO COMPARATOR
Behavioral: Sleep Hygiene Education (SHE)

Interventions

Each CBTi-CB therapy session will review the previous week of sleep/wake diaries and summarize key sleep parameters with participants. The treatment will address cannabis use by increasing use of appropriate coping strategies and improving self-efficacy to manage insomnia and next-day consequences. The content includes: (1) Sleep Scheduling Strategies to consolidate sleep using behavioral strategies that increase the drive for sleep and stabilize the circadian timing system; (2) Sleep Hygiene to discuss behaviors, substances, and environmental conditions that can help or hinder sleep; (3) Cognitive Therapy aims to identify and alter dysfunctional beliefs about sleep and functioning that contribute to insomnia; (4) Counter-Arousal Strategies address ruminative thoughts and increased body tension interfering with ability to fall or return to sleep; (5) Relapse Prevention for Insomnia reviews treatment gains and the behavioral and cognitive strategies that were most helpful.

Also known as: Cognitive Behavioral Therapy
Cognitive Behavioral Therapy for Insomnia in Cannabis Users (CBTi-CB)

The SHE condition will be matched to the CBTi-CB condition in terms of level of attention and the non-specific aspects of receiving social support from a study therapist, without providing individualized recommendations. The current content includes: (1) Insomnia History of the participant, including triggers that initiated the problem, duration, severity, and frequency, premorbid sleep characteristics, and previous sleep treatments; (2) Sleep Education about why we sleep, sleep stages, sleep regulation at night, and sleep changes across lifespan; (3) Substance Use and Sleep and the effects of cannabis and other licit and illicit substances on sleep; (4) Environmental Factors that contribute to a sleep-conducive environment; (5) Lifestyle Factors like the effects of diet, exercise, and napping on sleep; (6) Sleep Maintenance Strategies to review treatment gains from the participant's perspective and emphasize the principles covered to maintain sleep improvements.

Sleep Hygiene Education (SHE)

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 21 years or older
  • Insomnia Severity Index (ISI) score greater than 10 (indicating mild insomnia),
  • Use of cannabis on average three times a week for the past three months,
  • Self-reported use of cannabis to manage insomnia at least once a week over the past month,
  • Positive drug screen for Tetrahydrocannabinol (THC),
  • Consistent access to a telephone, smart phone, laptop, or tablet

You may not qualify if:

  • Individuals who do not understand English,
  • Individuals judged unable to provide informed consent (e.g. intoxication, mental incompetence),
  • Diagnosis or high suspicion of a sleep disorder based on validated self-report questionnaires,
  • Self-reported cancer,
  • Self-reported pregnancy,
  • Self-reported rotating or night (3rd) shift work.
  • Participants taking medications for sleep will be included if they meet study criteria for insomnia, medications have been stable for at least 8 weeks, and they agree to maintain the same regimen throughout the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Bloom City Club

Ann Arbor, Michigan, 48103, United States

Location

Om of Medicine

Ann Arbor, Michigan, 48104, United States

Location

Related Publications (5)

  • Arnedt JT, Conroy DA, Armitage R, Brower KJ. Cognitive-behavioral therapy for insomnia in alcohol dependent patients: a randomized controlled pilot trial. Behav Res Ther. 2011 Apr;49(4):227-33. doi: 10.1016/j.brat.2011.02.003. Epub 2011 Feb 15.

    PMID: 21377144BACKGROUND
  • Ilgen MA, Bohnert K, Kleinberg F, Jannausch M, Bohnert AS, Walton M, Blow FC. Characteristics of adults seeking medical marijuana certification. Drug Alcohol Depend. 2013 Oct 1;132(3):654-9. doi: 10.1016/j.drugalcdep.2013.04.019. Epub 2013 May 15.

    PMID: 23683791BACKGROUND
  • Ashrafioun L, Bohnert KM, Jannausch M, Ilgen MA. Characteristics of substance use disorder treatment patients using medical cannabis for pain. Addict Behav. 2015 Mar;42:185-8. doi: 10.1016/j.addbeh.2014.11.024. Epub 2014 Nov 26.

    PMID: 25481452BACKGROUND
  • Cranford JA, Arnedt JT, Conroy DA, Bohnert KM, Bourque C, Blow FC, Ilgen M. Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain. Drug Alcohol Depend. 2017 Nov 1;180:227-233. doi: 10.1016/j.drugalcdep.2017.08.017. Epub 2017 Sep 9.

    PMID: 28926791BACKGROUND
  • Arnedt JT, Cuddihy L, Swanson LM, Pickett S, Aikens J, Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. Sleep. 2013 Mar 1;36(3):353-62. doi: 10.5665/sleep.2448.

    PMID: 23450712BACKGROUND

Related Links

MeSH Terms

Conditions

Sleep Initiation and Maintenance Disorders

Interventions

Cognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Sleep Disorders, IntrinsicDyssomniasSleep Wake DisordersNervous System DiseasesMental Disorders

Intervention Hierarchy (Ancestors)

Behavior TherapyPsychotherapyBehavioral Disciplines and Activities

Results Point of Contact

Title
Mark Ilgen
Organization
University of Michigan

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor of Psychiatry

Study Record Dates

First Submitted

May 17, 2019

First Posted

May 28, 2019

Study Start

February 10, 2020

Primary Completion

July 13, 2021

Study Completion

July 13, 2021

Last Updated

September 14, 2022

Results First Posted

September 14, 2022

Record last verified: 2022-08

Data Sharing

IPD Sharing
Will not share

Locations