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Cognitive-behavioural therapy for insomnia in adults to decrease cannabis use: study protocol for a randomised
Cecilia Bolling1, M Elizabeth Cardoni1, Deirdre A Conroy1
1Sleep and Circadian Research Laboratory, Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
BMJ Open
|June 17, 2026
Summary
Cognitive-behavioural therapy for insomnia (CBTi-CB) may reduce frequent cannabis use and improve sleep in adults. This study compares CBTi-CB to sleep hygiene education (SHE) to assess treatment efficacy and effects on sleep mechanisms.
Area of Science:
- Sleep Medicine
- Behavioral Science
- Clinical Psychology
Background:
- Cannabis use is prevalent in the USA and linked to sleep disturbances.
- Insomnia is a common issue that may be exacerbated by cannabis use.
- Evidence-based treatments for insomnia could potentially reduce cannabis consumption.
Purpose of the Study:
- To compare telemedicine-delivered cognitive-behavioural therapy for insomnia for adults with frequent cannabis use (CBTi-CB) against sleep hygiene education (SHE).
- To evaluate the impact of CBTi-CB on insomnia, daytime functioning, and cannabis use frequency.
- To investigate the effects of treatment on sleep mechanisms, including electroencephalogram delta activity.
Main Methods:
- A single-site randomized controlled trial (RCT) involving 200 adults with chronic insomnia and frequent cannabis use.
- Participants were randomized 1:1 to receive six sessions of CBTi-CB or SHE.
- Clinical assessments and overnight polysomnography (PSG) were conducted at multiple time points.
Main Results:
- Primary outcomes include improvements in insomnia severity, mental health (SF-12 MCS), and reduced cannabis use frequency (Timeline Follow Back).
- The study will assess changes in electroencephalogram delta activity from PSG as a measure of sleep homeostasis.
- Data will be analyzed to determine the association between sleep mechanisms and clinical outcomes.
Conclusions:
- Telemedicine-delivered CBTi-CB shows promise as a treatment for insomnia in frequent cannabis users.
- This approach may offer a dual benefit of improving sleep and reducing cannabis consumption.
- Findings will contribute to understanding sleep mechanisms and informing clinical interventions.
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