# Health equity informed delivery of cognitive behavioral therapy for insomnia adapted for individuals with opioid use disorder

> **NIH NIH R34** · VIRGINIA COMMONWEALTH UNIVERSITY · 2024 · $232,875

## Abstract

Project Summary
Opioid use disorder (OUD) is a leading cause of death in the United States, with disparities in morbidity and
mortality widening through the COVID-19 pandemic by race, ethnicity, sex and gender. Medications for OUD
are life-saving, and increasing access, utilization and retention in evidence-based medication treatments for
OUD is the most effective pathway forward to combat this public health crisis. Comorbid conditions common
among people with OUD, such as insomnia, hinder OUD treatment retention and benefit, rendering patients at
persistent overdose risk. Insomnia is prevalent in over half of patients receiving medication treatment for OUD,
representing an ideal target for adjunctive treatments to medications for OUD aimed to improve health and re-
covery outcomes. Cognitive Behavioral Treatment for Insomnia (CBT-I) is considered the gold-standard treat-
ment for insomnia, yet its evidence is limited in OUD populations. Historically, behavioral therapies integrated
into OUD treatment have demonstrated improved effectiveness when they are tailored to the specific biopsy-
chosocial needs of this unique patient population. The objectives of this R34 application are to develop, refine,
and preliminarily test the effects of a novel, integrated approach to treating insomnia in adults with comorbid
opioid use disorder and insomnia. Utilizing a multiple prong approach through a health equity lens, we will de-
velop, pilot test, and refine a Cognitive Behavioral Therapy for Insomnia and Opioid use disorder (CBT-IO).
The proposed study will tailor CBT-I to OUD patient-reported biopsychosocial needs gained from preliminary
qualitative data gathered from patients with insomnia and OUD receiving buprenorphine. We will adapt the
CBT-I content (OUD specific information, such as anchoring sleep schedules to buprenorphine administration)
and its delivery (utilizing telehealth vs. in person options for sessions based on barriers to access). We will take
a multi-disciplinary approach to the intervention’s development and testing, incorporating a community-based
expert panel review, and patient pre-testing using both qualitative and quantitative methods to evaluate the in-
tervention’s feasibility, acceptability, and engagement. We will then examine the preliminary effects of the
newly developed and refined intervention in a small, yet diverse, sample (N=56) of adults with comorbid insom-
nia and OUD. Outcomes of interest include both sleep and substance use outcomes. Specific Aims include:
AIM 1: Develop and refine a CBT-I intervention (CBT-IO) for individuals with OUD, which includes adapted
content and a social determinants of health (SDoH) informed decision aid to guide individualizing treatment
delivery route (telehealth vs. in person); AIM 2: Evaluate preliminary efficacy of CBT-IO to improve insomnia
and OUD outcomes for individuals receiving medication treatment for their OUD. In line with NIDA’s call to ad-
vance personalized medicine in a...

## Key facts

- **NIH application ID:** 10812095
- **Project number:** 1R34DA058494-01A1
- **Recipient organization:** VIRGINIA COMMONWEALTH UNIVERSITY
- **Principal Investigator:** Caitlin Eileen Martin
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $232,875
- **Award type:** 1
- **Project period:** 2024-05-15 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10812095

## Citation

> US National Institutes of Health, RePORTER application 10812095, Health equity informed delivery of cognitive behavioral therapy for insomnia adapted for individuals with opioid use disorder (1R34DA058494-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10812095. Licensed CC0.

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