Prescription Digital Therapeutic for the Treatment of Insomnia (SLEEP-I)
Randomized Controlled Trial Examining Real-World Effectiveness of a Prescription Digital Therapeutic for the Treatment of Insomnia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Connecticut
-
New Haven, Connecticut, United States, 06510
- Yale-New Haven Hospital
-
-
Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
• Age between 22-64 years
- English-speaking (both reading and writing in English required)
- Diagnosis of chronic insomnia
- Participant is willing and able to give consent and participate in study
- Participant has an email account or is willing to create one and a smartphone able to download the necessary applications
- Participant is willing and able to use the PDT, the Hugo data sharing platform and the syncable devices (e.g. Fitbit)
- Participant has primary care at YNHH or Mayo Clinic
Exclusion Criteria:
- Pregnancy
- Shift work or family/other commitments that interfere with establishment of regular night-time sleep patterns, and if wake/sleep time is outside the ranges of 4:00h - 10:00h (wake time) and 20:00h - 02:00h (bed time)
- Absence of a reliable internet access and smartphone
- A reported diagnosis of psychosis, schizophrenia or bipolar disorder, or any medical disorders contraindicated with sleep restriction
- Current involvement in a non-medication treatment program for insomnia (participants are still eligible if they are taking traditional sleep medications)
- Those with untreated co-existing sleep conditions (e.g. sleep apnea)
- Those who have failed CBT for insomnia in the past
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: PEAR-003b PDT Intervention
Participants will receive the PEAR-003b digital therapeutic, a Fitbit, and materials on sleep hygiene and healthy sleep tips.
Using the Hugo platform, patient-generated engagement data, healthcare utilization, and patient activity/clinical outcomes for patients with insomnia will also be collected.
|
The PEAR-003b digital therapeutic delivers CBT-I via mobile devices as 6 treatment core modules over 9 weeks.
Patients will receive a Fitbit and receive standard of care
Patients will receive sleep hygiene and healthy sleep tips.
|
|
Placebo Comparator: Control Arm
Participants will receive a Fitbit, and materials on sleep hygiene and healthy sleep tips.
Using the Hugo platform, patient-generated engagement data, healthcare utilization, and patient activity/clinical outcomes for patients with insomnia will also be collected.
|
Patients will receive a Fitbit and receive standard of care
Patients will receive sleep hygiene and healthy sleep tips.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Insomnia Severity
Time Frame: From baseline to 9 weeks post randomization
|
Insomnia will be measured by the Insomnia Severity Index (ISI) score.
Participants rate the severity of sleep problems (e.g.
problems with sleep onset, sleep maintenance, and early morning awakening), interference with daytime functioning, how noticeable the impairment is to others, distress or concern caused by the sleep problem(s), as well as satisfaction with the current sleep pattern on a 5-point Likert scale.
The ISI's total score ranges from 0 (not clinically significant) to 28 (clinically significant)
|
From baseline to 9 weeks post randomization
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Insomnia Severity
Time Frame: From baseline to 21 weeks post-randomization
|
Insomnia will be measured by the Insomnia Severity Index (ISI) score.
Participants rate the severity of sleep problems (e.g.
problems with sleep onset, sleep maintenance, and early morning awakening), interference with daytime functioning, how noticeable the impairment is to others, distress or concern caused by the sleep problem(s), as well as satisfaction with the current sleep pattern on a 5-point Likert scale.
The ISI's total score ranges from 0 (not clinically significant) to 28 (clinically significant)
|
From baseline to 21 weeks post-randomization
|
|
Change in Insomnia Severity
Time Frame: From baseline to 35 weeks post-randomization
|
Insomnia will be measured by the Insomnia Severity Index (ISI) score.
Participants rate the severity of sleep problems (e.g.
problems with sleep onset, sleep maintenance, and early morning awakening), interference with daytime functioning, how noticeable the impairment is to others, distress or concern caused by the sleep problem(s), as well as satisfaction with the current sleep pattern on a 5-point Likert scale.
The ISI's total score ranges from 0 (not clinically significant) to 28 (clinically significant)
|
From baseline to 35 weeks post-randomization
|
|
Change in Insomnia Severity
Time Frame: From baseline to 61 weeks post-randomization
|
Insomnia will be measured by the Insomnia Severity Index (ISI) score.
Participants rate the severity of sleep problems (e.g.
problems with sleep onset, sleep maintenance, and early morning awakening), interference with daytime functioning, how noticeable the impairment is to others, distress or concern caused by the sleep problem(s), as well as satisfaction with the current sleep pattern on a 5-point Likert scale.
The ISI's total score ranges from 0 (not clinically significant) to 28 (clinically significant)
|
From baseline to 61 weeks post-randomization
|
|
Change in Depressive Symptoms
Time Frame: From baseline to 9 weeks post-randomization
|
Depressive symptoms will be measured by the Patient Health Questionnaire (PHQ-8.
The PHQ-8 is an 8 item 0 to 3 scale questionnaire.
Total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 9 weeks post-randomization
|
|
Change in Depressive Symptoms
Time Frame: From baseline to 21 weeks post-randomization
|
Depressive symptoms will be measured by the Patient Health Questionnaire (PHQ-8.
The PHQ-8 is an 8 item 0 to 3 scale questionnaire.
Total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 21 weeks post-randomization
|
|
Change in Depressive Symptoms
Time Frame: From baseline to 35 weeks post-randomization
|
Depressive symptoms will be measured by the Patient Health Questionnaire (PHQ-8.
The PHQ-8 is an 8 item 0 to 3 scale questionnaire.
Total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 35 weeks post-randomization
|
|
Change in Depressive Symptoms
Time Frame: From baseline to 61 weeks post-randomization
|
Depressive symptoms will be measured by the Patient Health Questionnaire (PHQ-8.
The PHQ-8 is an 8 item 0 to 3 scale questionnaire.
Total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 61 weeks post-randomization
|
|
Change in Anxiety
Time Frame: From baseline to 9 weeks post-randomization
|
The General Anxiety Disorder-7 (GAD-7) is a widely used diagnostic self-report scale that screens, diagnoses, and assesses the severity of anxiety disorder.
The GAD-7 is a 7-item 0 to 3 (0 = Not at all, 3 = Nearly every day) scale that measures the degree of severity of anxiety over the last 2 weeks with a total score ranging from 0 to 21, with a higher score indicating a more severe anxiety.
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From baseline to 9 weeks post-randomization
|
|
Change in Anxiety
Time Frame: From baseline to 21 weeks post-randomization
|
The General Anxiety Disorder-7 (GAD-7) is a widely used diagnostic self-report scale that screens, diagnoses, and assesses the severity of anxiety disorder.
The GAD-7 is a 7-item 0 to 3 (0 = Not at all, 3 = Nearly every day) scale that measures the degree of severity of anxiety over the last 2 weeks with a total score ranging from 0 to 21, with a higher score indicating a more severe anxiety.
|
From baseline to 21 weeks post-randomization
|
|
Change in Anxiety
Time Frame: From baseline to 35 weeks post-randomization
|
The General Anxiety Disorder-7 (GAD-7) is a widely used diagnostic self-report scale that screens, diagnoses, and assesses the severity of anxiety disorder.
The GAD-7 is a 7-item 0 to 3 (0 = Not at all, 3 = Nearly every day) scale that measures the degree of severity of anxiety over the last 2 weeks with a total score ranging from 0 to 21, with a higher score indicating a more severe anxiety.
|
From baseline to 35 weeks post-randomization
|
|
Change in Anxiety
Time Frame: From baseline to 61 weeks post-randomization
|
The General Anxiety Disorder-7 (GAD-7) is a widely used diagnostic self-report scale that screens, diagnoses, and assesses the severity of anxiety disorder.
The GAD-7 is a 7-item 0 to 3 (0 = Not at all, 3 = Nearly every day) scale that measures the degree of severity of anxiety over the last 2 weeks with a total score ranging from 0 to 21, with a higher score indicating a more severe anxiety.
|
From baseline to 61 weeks post-randomization
|
|
Change in Stress
Time Frame: From baseline to 9 weeks post-randomization
|
The Perceived Stress Scale (PSS) is a widely used self-reported 10-item questionnaire that assesses how stressful participants believe their life is.
Scores range from 0 - 40 with higher scores pointing to more perceived stress.
|
From baseline to 9 weeks post-randomization
|
|
Change in Stress
Time Frame: From baseline to 21 weeks post-randomization
|
The Perceived Stress Scale (PSS) is a widely used self-reported 10-item questionnaire that assesses how stressful participants believe their life is.
Scores range from 0 - 40 with higher scores pointing to more perceived stress.
|
From baseline to 21 weeks post-randomization
|
|
Change in Stress
Time Frame: From baseline to 35 weeks post-randomization
|
The Perceived Stress Scale (PSS) is a widely used self-reported 10-item questionnaire that assesses how stressful participants believe their life is.
Scores range from 0 - 40 with higher scores pointing to more perceived stress.
|
From baseline to 35 weeks post-randomization
|
|
Change in Stress
Time Frame: From baseline to 61 weeks post-randomization
|
The Perceived Stress Scale (PSS) is a widely used self-reported 10-item questionnaire that assesses how stressful participants believe their life is.
Scores range from 0 - 40 with higher scores pointing to more perceived stress.
|
From baseline to 61 weeks post-randomization
|
|
Change in Daytime Sleepiness
Time Frame: From baseline to 9 weeks post-randomization
|
Daytime sleepiness is measured by the Epworth Sleepiness Scale (ESS) The ESS total score ranges from 0 (not clinically significant) to 24 (clinically significant)
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From baseline to 9 weeks post-randomization
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Change in Daytime Sleepiness
Time Frame: From baseline to 21 weeks post-randomization
|
Daytime sleepiness is measured by the Epworth Sleepiness Scale (ESS) The ESS total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 21 weeks post-randomization
|
|
Change in Daytime Sleepiness
Time Frame: From baseline to 35 weeks post-randomization
|
Daytime sleepiness is measured by the Epworth Sleepiness Scale (ESS) The ESS total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 35 weeks post-randomization
|
|
Change in Daytime Sleepiness
Time Frame: From baseline to 61 weeks post-randomization
|
Daytime sleepiness is measured by the Epworth Sleepiness Scale (ESS) The ESS total score ranges from 0 (not clinically significant) to 24 (clinically significant)
|
From baseline to 61 weeks post-randomization
|
|
Healthcare Utilization
Time Frame: From baseline to 9 weeks post-randomization
|
Healthcare utilization will be reported as the number of outpatient visits with a primary care clinician or specialty care clinician.
|
From baseline to 9 weeks post-randomization
|
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Healthcare Utilization
Time Frame: From baseline to 21 weeks post-randomization
|
Healthcare utilization will be reported as the number of outpatient visits with a primary care clinician or specialty care clinician.
|
From baseline to 21 weeks post-randomization
|
|
Healthcare Utilization
Time Frame: From baseline to 35 weeks post-randomization
|
Healthcare utilization will be reported as the number of outpatient visits with a primary care clinician or specialty care clinician.
|
From baseline to 35 weeks post-randomization
|
|
Healthcare Utilization
Time Frame: From baseline to 61 weeks post-randomization
|
Healthcare utilization will be reported as the number of outpatient visits with a primary care clinician or specialty care clinician.
|
From baseline to 61 weeks post-randomization
|
|
Medication Utilization
Time Frame: From baseline to 9 weeks post-randomization
|
Medication utilization will be reported as the number of medication refills for sleep and/or psychotropic medications.
|
From baseline to 9 weeks post-randomization
|
|
Medication Utilization
Time Frame: From baseline to 21 weeks post-randomization
|
Medication utilization will be reported as the number of medication refills for sleep and/or psychotropic medications.
|
From baseline to 21 weeks post-randomization
|
|
Medication Utilization
Time Frame: From baseline to 35 weeks post-randomization
|
Medication utilization will be reported as the number of medication refills for sleep and/or psychotropic medications.
|
From baseline to 35 weeks post-randomization
|
|
Medication Utilization
Time Frame: From baseline to 61 weeks post-randomization
|
Medication utilization will be reported as the number of medication refills for sleep and/or psychotropic medications.
|
From baseline to 61 weeks post-randomization
|
|
Change in Quality of Life (PCS)
Time Frame: From baseline to 9 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The physical health component (PCS) score ranges from 0-100 with higher scores representing better self-reported physical health.
|
From baseline to 9 weeks post-randomization
|
|
Change in Quality of Life (PCS)
Time Frame: From baseline to 21 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The physical health component (PCS) score ranges from 0-100 with higher scores representing better self-reported physical health.
|
From baseline to 21 weeks post-randomization
|
|
Change in Quality of Life (PCS)
Time Frame: From baseline to 35 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The physical health component (PCS) score ranges from 0-100 with higher scores representing better self-reported physical health.
|
From baseline to 35 weeks post-randomization
|
|
Change in Quality of Life (PCS)
Time Frame: From baseline to 61 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The physical health component (PCS) score ranges from 0-100 with higher scores representing better self-reported physical health.
|
From baseline to 61 weeks post-randomization
|
|
Change in Quality of Life (MCS)
Time Frame: From baseline to 9 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The mental health component (MCS) score ranges from 0-100 with higher scores representing better self-reported mental health.
|
From baseline to 9 weeks post-randomization
|
|
Change in Quality of Life (MCS)
Time Frame: From baseline to 21 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The mental health component (MCS) score ranges from 0-100 with higher scores representing better self-reported mental health.
|
From baseline to 21 weeks post-randomization
|
|
Change in Quality of Life (MCS)
Time Frame: From baseline to 35 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The mental health component (MCS) score ranges from 0-100 with higher scores representing better self-reported mental health.
|
From baseline to 35 weeks post-randomization
|
|
Change in Quality of Life (MCS)
Time Frame: From baseline to 61 weeks post-randomization
|
Change in quality of life as measured in the Short Form 12 (SF-12).
The mental health component (MCS) score ranges from 0-100 with higher scores representing better self-reported mental health.
|
From baseline to 61 weeks post-randomization
|
|
Change in Sleep Efficiency
Time Frame: From baseline to 9 weeks post-randomization
|
Change in sleep efficiency, calculated as time spent sleeping divided by time spent in bed.
This data is acquired from sleep diaries filled out by patient.
(range 0-100 percentage points)
|
From baseline to 9 weeks post-randomization
|
|
Change in Sleep Efficiency
Time Frame: From baseline to 21 weeks post-randomization
|
Change in sleep efficiency, calculated as time spent sleeping divided by time spent in bed.
This data is acquired from sleep diaries filled out by patient.
(range 0-100 percentage points)
|
From baseline to 21 weeks post-randomization
|
|
Change in Sleep Efficiency
Time Frame: From baseline to 35 weeks post-randomization
|
Change in sleep efficiency, calculated as time spent sleeping divided by time spent in bed.
This data is acquired from sleep diaries filled out by patient.
(range 0-100 percentage points)
|
From baseline to 35 weeks post-randomization
|
|
Change in Sleep Efficiency
Time Frame: From baseline to 61 weeks post-randomization
|
Change in sleep efficiency, calculated as time spent sleeping divided by time spent in bed.
This data is acquired from sleep diaries filled out by patient.
(range 0-100 percentage points)
|
From baseline to 61 weeks post-randomization
|
|
Change in Sleep Onset Latency
Time Frame: From baseline to 9 weeks post-randomization
|
Change in sleep-onset latency (SOL; hour), is based on the participants sleep diary and how many hours it took the participants to fall asleep.
|
From baseline to 9 weeks post-randomization
|
|
Change in Sleep Onset Latency
Time Frame: From baseline to 21 weeks post-randomization
|
Change in sleep-onset latency (SOL; hour), is based on the participants sleep diary and how many hours it took the participants to fall asleep.
|
From baseline to 21 weeks post-randomization
|
|
Change in Sleep Onset Latency
Time Frame: From baseline to 35 weeks post-randomization
|
Change in sleep-onset latency (SOL; hour), is based on the participants sleep diary and how many hours it took the participants to fall asleep.
|
From baseline to 35 weeks post-randomization
|
|
Change in Sleep Onset Latency
Time Frame: From baseline to 61 weeks post-randomization
|
Change in sleep-onset latency (SOL; hour), is based on the participants sleep diary and how many hours it took the participants to fall asleep.
|
From baseline to 61 weeks post-randomization
|
|
Change in Health Utility Score
Time Frame: From baseline to 9 weeks post-randomization
|
The Short Form 6 dimensions (SF-6D) is a health-related quality-of-life classification system that was developed from the SF-36 health survey (SF-36) and SF-12 health survey (SF-12).
In this study, a scoring method was applied that focuses on seven of the health domains covered by the SF-12: Physical Functioning, Role Limitation (combined Physical and Emotional), Social Functioning, Bodily Pain, Mental Health, and Vitality- to create a single index of health.
The resulting SF-6D is scored from 0.0 (worst measured health state) to 1.0 (best measured health state), with the difference being calculated to determine the change in health utility score for each arm in each time period.
Data presented here is the percent change in score from baseline to 9 weeks post-randomization.
|
From baseline to 9 weeks post-randomization
|
|
Change in Health Utility Score
Time Frame: From baseline to 21 weeks post-randomization
|
The Short Form 6 dimensions (SF-6D) is a health-related quality-of-life classification system that was developed from the SF-36 health survey (SF-36) and SF-12 health survey (SF-12).
In this study, a scoring method was applied that focuses on seven of the health domains covered by the SF-12: Physical Functioning, Role Limitation (combined Physical and Emotional), Social Functioning, Bodily Pain, Mental Health, and Vitality- to create a single index of health.
The resulting SF-6D is scored from 0.0 (worst measured health state) to 1.0 (best measured health state), with the difference being calculated to determine the change in health utility score for each arm in each time period.
Data presented here is the percent change in score from baseline to 21 weeks post-randomization.
|
From baseline to 21 weeks post-randomization
|
|
Change in Health Utility Score
Time Frame: From baseline to 35 weeks post-randomization
|
The Short Form 6 dimensions (SF-6D) is a health-related quality-of-life classification system that was developed from the SF-36 health survey (SF-36) and SF-12 health survey (SF-12).
In this study, a scoring method was applied that focuses on seven of the health domains covered by the SF-12: Physical Functioning, Role Limitation (combined Physical and Emotional), Social Functioning, Bodily Pain, Mental Health, and Vitality- to create a single index of health.
The resulting SF-6D is scored from 0.0 (worst measured health state) to 1.0 (best measured health state), with the difference being calculated to determine the change in health utility score for each arm in each time period.
Data presented here is the percent change in score from baseline to 35 weeks post-randomization.
|
From baseline to 35 weeks post-randomization
|
|
Change in Health Utility Score
Time Frame: From baseline to 61 weeks post-randomization
|
The Short Form 6 dimensions (SF-6D) is a health-related quality-of-life classification system that was developed from the SF-36 health survey (SF-36) and SF-12 health survey (SF-12).
In this study, a scoring method was applied that focuses on seven of the health domains covered by the SF-12: Physical Functioning, Role Limitation (combined Physical and Emotional), Social Functioning, Bodily Pain, Mental Health, and Vitality- to create a single index of health.
The resulting SF-6D is scored from 0.0 (worst measured health state) to 1.0 (best measured health state), with the difference being calculated to determine the change in health utility score for each arm in each time period.
Data presented here is the percent change in score from baseline to 61 weeks post-randomization.
|
From baseline to 61 weeks post-randomization
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Joseph S Ross, MD MHS, Yale University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2000029050
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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