CBT improved sleep, reduced cannabis use in those with chronic insomnia

CHARLOTTE, N.C. — Cognitive behavioral therapy for insomnia is a “feasible and acceptable” treatment for people regularly using cannabis to help with sleep, J. Todd Arnedt, PhD, said at the SLEEP 2022 meeting.

“Cannabis use has increased significantly in the past decade,” Arnedt, co-director of the Sleep and Circadian Research Laboratory and director of the behavioral sleep medicine program at Michigan Medicine’s department of psychiatry, said. “We think insomnia has been associated with early onset of cannabis use, development of cannabis use disorder and relapse after cannabis cessation attempts.”

Arnedt and colleagues recruited participants from medical cannabis clinics, online advertising and local cannabis dispensaries for a pilot, randomized controlled trial. Researchers sought adults with chronic insomnia who reported using cannabis at least three times a week. He noted that people misusing cannabis are typically not included in clinical trials.

Fifty-seven participants (43 women; mean age, 37.6 ± 12.8 years) were randomized to receive six sessions of cognitive behavioral therapy or sleep hygiene education (SHE-TM) via telemedicine. They self-reported insomnia, daytime functioning and cannabis use before and after treatment and at the 8-week follow-up.

Arnedt noted that the cognitive behavioral intervention (CBI) did not address cannabis use.

“CBI improved insomnia more than active control condition SHE,” he said. “Daytime functioning improved, and cannabis use frequently declined in both treatment groups. We didn’t see any increase in use of other substances.”

Arnedt concluded that CBT is a feasible and acceptable treatment for those using cannabis for insomnia.