Justin Thomas, Ph.D., associate professor in the 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, titled “The Impact of Brief Behavioral Therapy for Insomnia on Cognition and Sleep Health in Older Adults with HIV,” will run from 2025 to 2030. Thomas serves as co-principal investigator alongside Shameka Cody, Ph.D., associate professor in the UA Capstone College of Nursing. UAB collaborators include David Vance, Ph.D., professor in the School of Nursing, and Shu Chen, Ph.D., professor in the Department of Pathology.
Thomas, who has long focused on sleep research in the HIV population, said the project builds on earlier work examining the link between sleep and pain in people with HIV (PWH). That research led to piloting Brief Behavioral Therapy for Insomnia (BBTi), a streamlined version of Cognitive Behavioral Therapy for Insomnia, which is well-suited for individuals managing complex medical needs.
“We’ve been exploring BBTi in PWH 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 PWH are at least twice as high as in the general population.
“BBTi is not only effective but also 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.
“This study provides an avenue for clinicians working with HIV patients who struggle with sleep to access a free, evidence-based treatment,” Thomas said.
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, cost-effective, and has the potential to outperform medication in the long run.”