S. Justin Thomas, Ph.D.
The study will enroll 240 adults with HIV and insomnia, randomly assigning them to one of two treatments to evaluate how each approach affects sleep and cognitive health., associate professor in the University of Alabama at Birmingham’s Department of Psychiatry and Behavioral Neurobiology, has been awarded a $3.4 million grant from the National Institute on Aging and the Office of AIDS Research to study the impact of insomnia treatment on cognitive health in older adults living with HIV.
The five-year, multi-site R01 study is titled “The Impact of Brief Behavioral Therapy for Insomnia on Cognition and Sleep Health in Older Adults with HIV.” Thomas serves as co-principal investigator alongside UAB collaborators David Vance, Ph.D., professor in the School of Nursing; Shu Chen, Ph.D., professor in the Department of Pathology; and Shameka Cody, Ph.D., primary and corresponding PI and associate professor in the University of Alabama Capstone College of Nursing.
Thomas says the project builds on earlier work that examined the link between sleep and pain in people with HIV. That research led to piloting a streamlined version of cognitive behavioral therapy for insomnia called brief behavioral therapy for insomnia.
“We’ve been exploring BBTi in people with HIV for several years,” Thomas said. “Dr. Cody and I wanted to specifically examine how BBTi affects sleep and cognitive function in older adults with HIV, a group that faces a disproportionately high prevalence of insomnia.”
The study aims to enroll 240 participants who will be randomly assigned to receive either BBTi or a brief mindfulness-based control intervention. Researchers anticipate that BBTi will lead to greater and sustained reductions in insomnia symptoms, as well as improvements in cognitive function. The study will also examine Alzheimer’s disease biomarkers to assess whether sleep improvements influence neurodegenerative risk.
Thomas emphasized the clinical significance of the research, noting that insomnia rates in people with HIV are at least twice as high as in the general population.
“BBTi is effective and highly accessible,” he said. “It can be delivered via telemedicine or even phone visits, making it a practical solution for patients with limited access to care.”
Beyond its research goals, the project offers a valuable clinical resource. Thomas hopes the findings will inspire broader adoption of BBTi in HIV care settings.
“If we demonstrate improvements in sleep and cognition, this could support BBTi as a reimbursable service with significant implications for the overall health of this population,” he said. “The intervention is brief and cost-effective and has the potential to outperform medication in the long run.”