ClinicalTrials.gg
RecruitingNCT05663034Updated Jul 13, 2026

CBT-I vs. MBTI for Traumatic Brain Injury (TBI)-Related Insomnia and Post-Traumatic Stress Symptoms

An interventional study of Mindfulness-based treatment for insomnia (MBTI) and Cognitive behavioral therapy for insomnia (CBT-I) in Traumatic Brain Injury, Insomnia and Depression, sponsored by Johns Hopkins University. Recruiting at 5 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-13.

Primary conditionBrain ConcussionRegistry: Brain Injuries, TraumaticReclassifiedWhy we changed it
Registry
Brain Injuries, Traumatic — the first condition term the registry derived for this study.
ClinicalTrials.gg
Brain Concussion
Why
  1. The study's listed conditions name Brain Concussion, a narrower term within Brain Injuries, Traumatic.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Johns Hopkins University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started May 2024; still recruiting 2 years 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
360
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is a prospective two-arm, single blind randomized controlled trial design to compare the clinical effectiveness of telemedicine-delivered, 6-session, standardized cognitive behavioral therapy for insomnia (CBT-I) and mindfulness-based treatment for insomnia (MBTI) in treating insomnia symptoms and ameliorating depressive symptoms in persons with mild to moderate TBI and comorbid Post-Traumatic Stress Symptoms (PTSS) and insomnia symptoms in a 360 patients. Participants will undergo assessment (psychosocial questionnaires, neurocognitive testing, sleep monitoring) at baseline, at the end of treatment, and at 2-, 6- and 12-weeks post-treatment. The primary outcome is sleep as measured by the Insomnia Severity Index (ISI).

Read the detailed description

This study is a prospective two-arm, randomized single blind controlled trial design to compare the clinical effectiveness of telemedicine-delivered cognitive behavioral therapy for insomnia (CBT-I) and mindfulness-based treatment for insomnia (MBTI) in treating insomnia and ameliorating depressive symptoms in persons with mild to moderate TBI and comorbid symptoms of posttraumatic stress and insomnia. A cohort of n=360 adults with mild to moderate TBI and comorbid symptoms of posttraumatic stress and insomnia will be randomized to receive either telemedicine-delivered CBT-I or MBTI. Consistent with previous scientific literature, the interventions will be standardized and six sessions in length. All participants will wear an actigraph wrist monitor throughout the course of the project. All participants will also complete electronic sleep diaries throughout the course of the project. Participants will undergo assessment (psychosocial questionnaires, neurocognitive testing, sleep diaries, actigraphy, ambulatory EEG sleep monitoring) at baseline, at the end of treatment, and at 2-, 6- and 12-weeks post-treatment (12- and 24-weeks post randomization, respectively). The primary outcome is insomnia severity (ISI) and secondary outcomes are pre-sleep arousal, and depressive symptoms (PSAS; Patient Health Questionnaire (PHQ-8). Exploratory analyses will include neurocognitive functioning (ANAM) and pre-sleep arousal (PSAS).

02

Conditions studied

  • Traumatic Brain Injury
  • Insomnia
  • Depression
  • Post-traumatic Stress
  • Sleep
  • Memory Impairment
  • Cognitive Behavioral Therapy
  • Concussion, Brain
  • Head Injury
  • Brain Injury Traumatic Mild

Keywords

  • Traumatic Brain Injury
  • Insomnia
  • Posttraumatic Stress Symptoms
  • Depression
  • Concussion
  • Head Injury
  • Brain Injury
  • Cognitive Behavioral Therapy for Insomnia
  • Mindfulness-based Treatment for Insomnia
03

In context

Brain Concussion Reclassified

637 studies on the registry are indexed under Brain Concussion; 163 are open to participants now.

This study's planned enrollment of 360 is above the median of 63 across 446 interventional studies indexed under Brain Concussion.

Browse Brain Concussion studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.

Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.

Compared within Brain Concussion, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Brain Injuries, Traumatic. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Current or former member of the uniform services
  2. Meet the Veterans Affairs Medical Center (VAMC) Department of Defense (DoD) criteria for TBI;
  3. Time duration since traumatic brain injury (TBI) injury >90 days
  4. Insomnia symptom duration >90 days
  5. Endorse insomnia symptoms (Insomnia Severity Index [ISI] score > 10)
  6. Display sufficient cognitive capacity to provide ( (MoCA) Z-score > -2)
  7. >18 years of age
  8. Access to and ability and to use computer.

Exclusion criteria

Exclusion Criteria:

  1. History of neurological diseases other than TBI and not attributable to TBI
  2. Sleep apnea [apnea hypopnea index (AHI) >15; individuals with mild apnea (AHI > 5 and \<15) will be informed, but allowed to participate]. Participants who use a continuous positive airway pressure (CPAP) device for sleep apnea will be eligible for participation if they are below the apnea/hypopnea cutoff while using CPAP, are adherent to using the device (> 4 hours/night 21/30 consecutive days) and agree to continue using the device during study participation.
  3. Lastly, people using psychotropic medications may be included if they are on a stable dosage for the last three weeks prior to the study.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
360 participants (estimated)

Study arms

  • Active comparator
    Cognitive behavioral therapy for insomnia (CBT-I)

    CBT-I treatment will involve a standardized 6-session blended intervention that combines cognitive and behavioral techniques. The core components include (1) education about sleep and insomnia, stimulus control (SC) and sleep restriction (SRT) (week 1); (2) sleep hygiene education (week 2); and (3) relaxation training, cognitive restructuring (to counter-arousal and address sleep-interfering cognitions), adherence monitoring, and adjusting the recommended sleep-wake schedule (weeks 3 through 6). The final session will also include a review of treatment content and relapse prevention. Common to all sessions is an initial review of participant diary data, charting progress, setting measurable goals, discussing adherence, and reinforcing learned skills.

    Behavioral: Cognitive behavioral therapy for insomnia (CBT-I)

  • Active comparator
    Mindfulness-based treatment for insomnia (MBTI)

    MBTI treatment will involve a standardized 6-session intervention which integrates the mindfulness training and exercises from mindfulness-based stress reduction (MBSR) with behavioral strategies based on sleep restriction therapy and stimulus control delivered within the context of mindfulness principles. Mindfulness principles include: 1) increase awareness of the mental and physical states that promote sleep (i.e., sleepiness), 2) shift sleep-related metacognitions to reduce hyperarousal, and 3) promote a mindful stance to respond when symptoms of insomnia arise. An overview of the treatment program, sleep education, and an introduction to the principles of mindfulness meditation is given (week 1). Then a combination of mindfulness meditations, sleep restriction, and stimulus control is conducted (week 2-6).

    Behavioral: Mindfulness-based treatment for insomnia (MBTI)

Interventions

  • BehavioralMindfulness-based treatment for insomnia (MBTI)

    A 6-week intervention that uses the principles and practices of mindfulness meditation along with behavioral strategies (stimulus control, sleep restriction therapy) to reduce symptoms of insomnia

  • BehavioralCognitive behavioral therapy for insomnia (CBT-I)

    Standard of care for adults with chronic insomnia. 6-week program that uses behavioral techniques to decrease psychophysiological arousal and increase sleep propensity to deepen and consolidate sleep.

06

What researchers measure

Primary outcomes

  1. Change in Insomnia severity as assessed by the insomnia severity index (ISI)

    Insomnia symptoms and severity measured by insomnia severity index (ISI); score range: 0-28; Higher scores are associated with greater insomnia symptoms

    Time frame: At the end of treatment, and 2-, 6- and 12-weeks post treatment

07

Study locations

5 of 5 sites recruiting
  • Intrepid Spirit Center - Eglin Air Force Base
    Eglin Air Force Base, Florida 32542, United States
    Recruiting
    • Mary Fergus · Contact240-204-1573
  • Naval School Explosive Ordance Disposal - Eglin Air Force Base
    Eglin Air Force Base, Florida 32542, United States
    Recruiting
    • Mary Fergus · Contact240-204-1573
  • Walter Reed National Medical Military Center
    Bethesda, Maryland 20814, United States
    Recruiting
    • Seyi Gbade-Alabi · Contact301-550-0350
  • Womack Army Medical Center
    Fort Bragg, North Carolina 28310, United States
    Recruiting
    • Katherine Dermers · Contact301-550-0352
  • Madigan Army Medical Center
    Fort Lewis, Washington 98431, United States
    Recruiting
    • Rachel Satter · Contact301-550-0353
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05663034
Collaborators
Congressionally Directed Medical Research Programs
Responsible party
Sponsor
First posted
Dec 23, 2022
Start date
May 10, 2024
Primary completion
Jun 2027 (estimated)
Completion
Jun 2027 (estimated)
Last update
Jul 13, 2026

Study contacts

Luis Buenaver, PHD
Contact
lbuenav1@jhmi.edu
4105507986
Elizabeth Wysocki, MS
Contact
ewysock2@jhu.edu
Luis Buenaver, PhD
principal investigator · Johns Hopkins School of Medicine

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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