0686 Cognitive Behavioral Therapy for Insomnia to Reduce Cannabis Use: Results from a Pilot Randomized Controlled Trial

Abstract

Introduction: Cannabis use, including use for insomnia, has increased significantly in the United States over the past decade. Cannabis use disorders and/or heavy cannabis use have been linked to numerous negative outcomes, including poor work performance, other substance use, increased risk of psychosis, and neurocognitive deficits. In a pilot randomized controlled trial, we compared telemedicine‐delivered CBT for insomnia tailored to individuals regularly using cannabis for sleep (CBT‐CB‐TM) to sleep hygiene education (SHE‐TM) for improving sleep and daytime functioning and for reducing cannabis use. Methods: Adults with chronic insomnia who reported using cannabis for sleep at least three times weekly were recruited through advertisements and at local cannabis dispensaries and screened for disqualifying sleep, medical, and mental health disorders. Fiftyseven eligible participants (43 women, mean age 37.6 ± 12.8 years) were randomized to 6 sessions of CBT‐CB‐TM (n=30) or SHE‐TM (n=27). Participants completed self‐reported measures of insomnia (Insomnia Severity Index, primary outcome), daytime functioning (sleep beliefs, depression, and overall functioning) and cannabis use before and after treatment and at 8‐week follow‐up. Results: Mixed models showed that scores improved more on the Insomnia Severity Index (β=‐2.83, se=0.62, p