Cannabis Use Did Not Interfere with Cognitive Behavioral Therapy for Insomnia

Among young adults with insomnia who also binge drink, cannabis use during treatment did not reduce the effectiveness of cognitive behavioral therapy for insomnia.

Miller, Mary Beth et al.·Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine·2022·Moderate EvidenceRandomized Controlled Trial
RTHC-04062Randomized Controlled TrialModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=28

What This Study Found

Among 56 young adult binge drinkers with insomnia, 46% used cannabis during the treatment phase. Cannabis use did not moderate CBT-I effects on insomnia severity (b=-0.002, P=0.99) or any other outcomes. Cannabis users reported heavier drinking and more cigarette use but CBT-I remained effective regardless.

Key Numbers

56 participants; 46% used cannabis during treatment; 27% of cannabis users used it for sleep; cannabis moderation effect b=-0.002 (P=0.99); 23% of treatment days involved cannabis use

How They Did This

Secondary analysis of a published RCT. Young adults (18-30) with binge drinking and insomnia disorder were randomized to CBT-I (n=28) or sleep hygiene (n=28). Cannabis use was assessed during the treatment phase and tested as a moderator using multilevel models.

Why This Research Matters

Clinicians may worry that cannabis use undermines insomnia therapy. This study suggests CBT-I works whether or not patients use cannabis concurrently, which is reassuring for clinical practice.

The Bigger Picture

Many people with insomnia use cannabis for sleep. Rather than requiring cannabis cessation before starting CBT-I, this study suggests the therapy can proceed effectively alongside concurrent cannabis use.

What This Study Doesn't Tell Us

Secondary analysis not powered to detect cannabis effects. Small sample. Cannabis use was naturalistic and self-reported. Only young adult binge drinkers, limiting generalizability.

Questions This Raises

  • ?Would heavier cannabis use interfere with CBT-I?
  • ?Does cannabis use decline naturally once insomnia improves through therapy?

Trust & Context

Key Stat:
Cannabis moderation effect: b = -0.002 (P = 0.99)
Evidence Grade:
Secondary analysis of an RCT with small sample. Provides reassuring but preliminary evidence.
Study Age:
Published in 2022
Original Title:
Cannabis use as a moderator of cognitive behavioral therapy for insomnia.
Published In:
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 18(4), 1047-1054 (2022)
Database ID:
RTHC-04062

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

Does cannabis use interfere with insomnia therapy?

This study found cannabis use had virtually zero effect on CBT-I outcomes (b=-0.002, P=0.99). The therapy was equally effective for cannabis users and non-users.

How many insomnia patients used cannabis for sleep?

Among the 46% who used cannabis during treatment, about 27% reported using it specifically for sleep. However, cannabis users and non-users did not differ in using alcohol as a sleep aid.

Read More on RethinkTHC

Cite This Study

RTHC-04062·https://rethinkthc.com/research/RTHC-04062

APA

Miller, Mary Beth; Carpenter, Ryan W; Freeman, Lindsey K; Curtis, Ashley F; Yurasek, Ali M; McCrae, Christina S. (2022). Cannabis use as a moderator of cognitive behavioral therapy for insomnia.. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 18(4), 1047-1054. https://doi.org/10.5664/jcsm.9796

MLA

Miller, Mary Beth, et al. "Cannabis use as a moderator of cognitive behavioral therapy for insomnia.." Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2022. https://doi.org/10.5664/jcsm.9796

RethinkTHC

RethinkTHC Research Database. "Cannabis use as a moderator of cognitive behavioral therapy ..." RTHC-04062. Retrieved from https://rethinkthc.com/research/miller-2022-cannabis-use-as-a

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.