Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders
Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders
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DOI：
10.2196/resprot.3852
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发表时间：
2015-07-01
影响因子：
1.7
通讯作者：
Bonn-Miller, Marcel O.
中科院分区：
文献类型：
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作者：
Babson, Kimberly A.;Ramo, Danielle E.;Bonn-Miller, Marcel O.
背景：大麻是美国最常用的非法物质，导致大麻使用障碍的发生率很高。目前的大麻使用治疗通常会出现很高的复发率/复发率，这与 (1) 影响大麻使用的行为健康因素（如睡眠不佳）和 (2) 接受药物使用干预的机会、耻辱、供应和成本有关。 目的：这项试点研究探讨了在尝试戒除大麻的情况下，通过手机提供失眠认知行为疗法 (CBT-I) 后大麻使用和睡眠困难的变化。方法：四名男性退伍军人患有 DSM-5 大麻使用障碍和睡眠问题的患者被随机分配接受为期 2 周的干预：CBT-I Coach 移动应用程序 (n=2) 或安慰剂对照（情绪跟踪应用程序）(n=2)。在治疗前和治疗后评估大麻和睡眠指标。参与者还报告了每个应用程序的使用情况和帮助。对每位参与者的睡眠和大麻使用变化进行了单独评估。结果：接受 CBT-I 的两名参与者在两周内每天使用该应用程序，并发现该应用程序用户友好、有帮助，并且将来会使用它。此外，他们还报告说，大麻的使用减少了，睡眠效率提高了；一位患者还报告说睡眠质量有所提高。相比之下，对照组的一名参与者退出了研究，另一名参与者很少使用该应用程序，并报告睡眠质量有所提高，但大麻的使用也有所增加。情绪应用程序被评为没有帮助，并且未来参与的可能性很低。结论：这项试点研究考察了手机传送 CBT-I 治疗大麻依赖的可行性和初步患者接受度。该应用程序的积极评价以及大麻使用减少和睡眠改善的初步报告都令人鼓舞，并支持对该干预措施的进一步评估。
Background: Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention.Objective: This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt.Methods: Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually.Results: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation.Conclusions: This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.