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Sleep Treatment for Addiction Recovery

Not Applicable
Conditions
Alcohol Use Disorder
Insomnia
Substance Use Disorders
Interventions
Behavioral: CBT-I
Registration Number
NCT04198311
Lead Sponsor
University of Missouri-Columbia
Brief Summary

Project STAR aims to examine the feasibility, acceptability, and initial efficacy of a CBT-I supplement to outpatient alcohol and substance use treatment.

Detailed Description

Among those who receive treatment for alcohol use disorder (AUD), one in three relapses to problematic drinking within one year of treatment. Thus, additional treatment strategies are needed. Notably, up to 74% of individuals seeking treatment for AUD report co-occurring symptoms of insomnia, while 85% of those seeking SUD treatment report insomnia symptoms. Given the negative impact of insomnia on attention and emotion regulation, insomnia symptoms may decrease patients' abilities to attend to treatment for substance use and manage negative emotions that lead to craving and relapse. This project aims to examine the feasibility, acceptability, and initial efficacy of a CBT-I supplement to substance use treatment. Forty adults who meet diagnostic criteria for AUD or SUD and Insomnia Disorder will receive Cognitive Behavioral Therapy for Insomnia (CBT-I). In order to generate hypotheses regarding the efficacy of CBT-I for individuals who are and are not engaged in substance use treatment, we aim to recruit 20 participants who are engaged in substance use treatment through the community at baseline and 20 participants who are not. Outcomes will be assessed at the end of the active intervention period (6 weeks) and at 6 weeks post-intervention

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Participation in alcohol or substance use treatment in the Columbia, MO area
  • DSM-5 criteria for moderate to severe Alcohol Use Disorder of Substance Use Disorder
  • DSM-5 episodic criterion (duration at least 1 month) for Insomnia Disorder
Exclusion Criteria
  • unable to provide informed consent
  • cognitive impairment
  • continuous sobriety for 2+ months at baseline
  • untreated sleep disorder requiring more than behavioral treatment for insomnia
  • severe psychiatric disorder that requires immediate clinical attention
  • initiation of a sleep medication in the past six (6) weeks

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Cognitive-Behavioral Therapy for Insomnia (CBT-I)CBT-IIndividual Cognitive Behavioral Therapy for Insomnia (CBT-I) delivered once a week for five (5) weeks
Primary Outcome Measures
NameTimeMethod
RecruitmentAssessed at Post-Treatment (week 6)

The number of participants who complete baseline.

RetentionAssessed at Post-Treatment (week 6)

The number of participants who complete all treatment sessions

Treatment SatisfactionAssessed at Post-Treatment (week 6)

The satisfaction rating participants give the treatment.Assessed using the Client Satisfaction Questionnaire; The Client Satisfaction Questionnaire is an 8-item measure of satisfaction with treatment that has been validated in substance use treatment settings. Items are scores from 1 to 4, with higher scores indicating greater satisfaction with treatment.

Secondary Outcome Measures
NameTimeMethod
Insomnia severityChange from baseline to post-treatment (week 6) to follow-up (week 12)

Assessed using the Insomnia Severity Index (ISI); ISI will be used as a 7-item measure of insomnia severity in the past two weeks. Items assess difficulty falling or staying asleep, satisfaction with current sleep pattern, interference with daily functioning, the extent to which others notice their sleep problems, and worry/distress related to sleep problems. Response options range from 0 (not at all worried) to 4 (very much worried), with possible total scores ranging from 0 to 28. Participants scoring 10 or higher will be classified as screening positive for insomnia (Morin et al., 2011).114 Notably, self-report is the recommended method of assessment for symptoms of insomnia in adults (Schutte-Rodin et al., 2008).

Heavy-Drinking DaysChange from baseline to post-treatment (week 6) to follow-up (week 12)

The percentage of days during the past 6 weeks that the participant engages in heavy drinking (\>4/5 drinks/day for women/men). Assessed using the Timeline Followback (TLFB) for alcohol; TLFB allows participants to trace their alcohol use back 42 days.

Substance Use DaysChange from baseline to post-treatment (week 6) to follow-up (week 12)

The percentage of days during the past 6 weeks that the participant engages in drug/substance use. Assessed using the Timeline Followback (TLFB) ; TLFB allows participants to trace their drug/substance use back 42 days.

AbstinenceChange from baseline to post-treatment (week 6) to follow-up (week 12)

The percentage of days during the past 6 weeks that the participant is abstinent from their drug of choice (alcohol or other substance). Assessed using the Timeline Followback (TLFB); TLFB allows participants to trace their alcohol and drug use back 42 days.

Alcohol or Other Drugs as Sleep AidsChange from baseline to post-treatment (week 6) to follow-up (week 12)

Assessed using the daily sleep diary; Sleep Diaries are quotidian questionnaires that measure self-reported sleep quality, sleep time, and daily habits concerning substance use. Diaries will be used to determine if participants used alcohol or other substances specifically to go to sleep

Sleep qualityChange from baseline to post-treatment (week 6) to follow-up (week 12)

Assessed using the daily sleep diary; Sleep Diaries are quotidian questionnaires that measure self-reported sleep quality, sleep time, and daily habits concerning substance use. Diaries will be used to determine if participants used alcohol or other substances specifically to go to sleep.

Dysfunctional beliefsChange from baseline to post-treatment (week 6) to follow-up (week 12)

Assessed using the Dysfunctional Beliefs and Attitudes about Sleep questionnaire (DBAS;Morin, 1994). The DBAS is designed to measure sleep and insomnia-related cognitions.

Alcohol ProblemsChange from baseline to post-treatment (week 6) to follow-up (week 12)

Assessed using the Short Inventory of Problems (SIP); SIP measures adverse consequences of substance use.

Total Wake TimeChange from baseline to post-treatment (week 6) to follow-up (week 12)

The amount of time the participant is awake after they try to go to sleep. Measured using Daily Diaries and actigraphy.

Trial Locations

Locations (1)

University of Missouri-Columbia

🇺🇸

Columbia, Missouri, United States

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