Medications for Opioid Use Disorder Photosensitive Retinal Ganglion Cell Function, Sleep, and Circadian Rhythms: Implications for Treatment (MOUD)
Medications for Opioid Use Disorder Differentially Modulate Intrinsically Photosensitive Retinal Ganglion Cell Function, Sleep, and Circadian Rhythms: Implications for Treatment (MOUD)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Brionna Smith, B.S.
- Phone Number: 205-975-7809
- Email: Cropseylab@uabmc.edu
Study Contact Backup
- Name: Karen Gamble, PhD
- Phone Number: 205-975-7809
- Email: kcropsey@uabmc.edu
Study Locations
-
-
Alabama
-
Birmingham, Alabama, United States, 35233
- Recruiting
- University of Alabama at Birmingham
-
Contact:
- Brionna Smith, B.S.
- Phone Number: 205-975-7809
- Email: Cropseylab@uabmc.edu
-
Contact:
- Susan Dufour, MD
- Email: cropseylab@uabmc.edu
-
Principal Investigator:
- Karen Gamble, PhD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Adults (18+)
- prescribed one of three medications for opioid use disorder (methadone, XR-NTX, buprenorphine) or healthy control
- stable on MOUD (no dose change) for the past month
- positive on urine drug screen (UDS) for buprenorphine or methadone if prescribed those medications
Exclusion Criteria:
- eye disease reported by history or noted on exam including disease of the anterior and posterior segment of the eye, cataracts, retinopathy, glaucoma, cataracts, amblyopia, scotoma, color or night blindness, corneal pathologies, macular degeneration, or retinitis pigmentosa;
- acutely suicidal, manic, intoxicated, or otherwise not stable enough to provide informed consent
- self-reported use of illicit opioids, stimulants (prescribed or illicit), or benzodiazepines/sedative/hypnotics in the past month
- alcohol or cannabis use disorder measured as severe on The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Checklist
- positive on UDS for illicit opioids (e.g., morphine, oxycodone, fentanyl),stimulants, benzodiazepines/sedative/hypnotics
- shift workers who work outside normal 7 a.m. to 6 p.m. hours, according to the National Institute of Occupational Safety and Health (NIOSH)
- persons diagnosed with narcolepsy
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
MOUD therapy methadone
50 methadone participants
|
The PIPR is measured in six, 80-s test periods in which the stimulus, either Blue (470 nm) or Red (623 nm), is presented to the dilated eye while the pupil response of the un-dilated eye is measured (consensual pupil response
Other Names:
Measure electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), respiratory channels (effort and nasal pressure), and oxygen saturation.
Other Names:
Assist in the diagnosis of disorders of hypersomnolence,63 it is also used in research to quantify daytime sleepiness and serves as a more objective measure of daytime sleepiness than self-report questionnaires
Other Names:
Morning after overnight Visit 2, participants will complete ecological momentary assessments (EMAs) over a 10-day assessment period.
Using EMA through the InsightTM mHealth platform to capture momentary craving, withdrawal and mood states across 10 days among persons who smoke and nonsmokers prior to an overnight procedures.
Participants will complete morning and evening sleep diaries via the EMA InsightTM mHealth platform self-reported sleep and wake information, fatigue, naps, opioid craving and withdrawal.
Other Names:
7-day actigraphy period will be used to determine the habitual sleep start and wake times.
The CamNTech MotionWatch8 (Cambridge, UK) is a solid-state piezo-electric accelerometer that collects data on activity (i.e., arm motion) and ambient light.Actigraphy data are downloaded from the MotionWatch8 into the software (MotionWare) for analysis, management, and exportation.
Bed and wake times will be entered by the subjects via a REDCap link and this information coupled with the sleep diary reports will be entered to determine sleep intervals.
Algorithms in the Motion Watch 8 software will determine sleep start, sleep end, total sleep time (duration), sleep quality, sleep efficiency, wake after sleep onset, and sleep fragmentation
Participants will be given an evening meal and then be accompanied to the UAB Highlands Hospital Sleep Unit by 5:30pm.
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.Participants will be allowed to sleep in darkness until 8:00am, at which time they will be provided transportation.We will also bank frozen samples taken prior to the light exposure for later calculation of the Dim Light Melatonin Onset (DLMO), a circadian phase estimate.
Other Names:
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.
Participants will be asked to refrain from caffeine consumption 12 hours before reporting to the sleep unit and will provide 2-3 ml of saliva every 30 minutes starting at 6:00pm and ending after the light exposure.
For melatonin suppression, 2-hours light exposure will begin 2 hours before the calculated mid-sleep time.
Collection saliva samples 1-h, 30-min, and immediately before the light exposure and every 30 min throughout exposure.
Samples will be centrifuged and frozen/stored at -20ºC until assay and remaining samples stored at -80ºC.
Melatonin levels will be assayed via the Buhlmann Direct Saliva Melatonin.
Melatonin suppression will be calculated as the percent decrease from the sample taken immediately prior to the light exposure
|
|
MOUD therapy buprenorphine
50 buprenorphine participants
|
The PIPR is measured in six, 80-s test periods in which the stimulus, either Blue (470 nm) or Red (623 nm), is presented to the dilated eye while the pupil response of the un-dilated eye is measured (consensual pupil response
Other Names:
Measure electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), respiratory channels (effort and nasal pressure), and oxygen saturation.
Other Names:
Assist in the diagnosis of disorders of hypersomnolence,63 it is also used in research to quantify daytime sleepiness and serves as a more objective measure of daytime sleepiness than self-report questionnaires
Other Names:
Morning after overnight Visit 2, participants will complete ecological momentary assessments (EMAs) over a 10-day assessment period.
Using EMA through the InsightTM mHealth platform to capture momentary craving, withdrawal and mood states across 10 days among persons who smoke and nonsmokers prior to an overnight procedures.
Participants will complete morning and evening sleep diaries via the EMA InsightTM mHealth platform self-reported sleep and wake information, fatigue, naps, opioid craving and withdrawal.
Other Names:
7-day actigraphy period will be used to determine the habitual sleep start and wake times.
The CamNTech MotionWatch8 (Cambridge, UK) is a solid-state piezo-electric accelerometer that collects data on activity (i.e., arm motion) and ambient light.Actigraphy data are downloaded from the MotionWatch8 into the software (MotionWare) for analysis, management, and exportation.
Bed and wake times will be entered by the subjects via a REDCap link and this information coupled with the sleep diary reports will be entered to determine sleep intervals.
Algorithms in the Motion Watch 8 software will determine sleep start, sleep end, total sleep time (duration), sleep quality, sleep efficiency, wake after sleep onset, and sleep fragmentation
Participants will be given an evening meal and then be accompanied to the UAB Highlands Hospital Sleep Unit by 5:30pm.
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.Participants will be allowed to sleep in darkness until 8:00am, at which time they will be provided transportation.We will also bank frozen samples taken prior to the light exposure for later calculation of the Dim Light Melatonin Onset (DLMO), a circadian phase estimate.
Other Names:
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.
Participants will be asked to refrain from caffeine consumption 12 hours before reporting to the sleep unit and will provide 2-3 ml of saliva every 30 minutes starting at 6:00pm and ending after the light exposure.
For melatonin suppression, 2-hours light exposure will begin 2 hours before the calculated mid-sleep time.
Collection saliva samples 1-h, 30-min, and immediately before the light exposure and every 30 min throughout exposure.
Samples will be centrifuged and frozen/stored at -20ºC until assay and remaining samples stored at -80ºC.
Melatonin levels will be assayed via the Buhlmann Direct Saliva Melatonin.
Melatonin suppression will be calculated as the percent decrease from the sample taken immediately prior to the light exposure
|
|
MOUD therapy extended-release naltrexone
50 extended-release naltrexone (XR-NTX) participants
|
The PIPR is measured in six, 80-s test periods in which the stimulus, either Blue (470 nm) or Red (623 nm), is presented to the dilated eye while the pupil response of the un-dilated eye is measured (consensual pupil response
Other Names:
Measure electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), respiratory channels (effort and nasal pressure), and oxygen saturation.
Other Names:
Assist in the diagnosis of disorders of hypersomnolence,63 it is also used in research to quantify daytime sleepiness and serves as a more objective measure of daytime sleepiness than self-report questionnaires
Other Names:
Morning after overnight Visit 2, participants will complete ecological momentary assessments (EMAs) over a 10-day assessment period.
Using EMA through the InsightTM mHealth platform to capture momentary craving, withdrawal and mood states across 10 days among persons who smoke and nonsmokers prior to an overnight procedures.
Participants will complete morning and evening sleep diaries via the EMA InsightTM mHealth platform self-reported sleep and wake information, fatigue, naps, opioid craving and withdrawal.
Other Names:
7-day actigraphy period will be used to determine the habitual sleep start and wake times.
The CamNTech MotionWatch8 (Cambridge, UK) is a solid-state piezo-electric accelerometer that collects data on activity (i.e., arm motion) and ambient light.Actigraphy data are downloaded from the MotionWatch8 into the software (MotionWare) for analysis, management, and exportation.
Bed and wake times will be entered by the subjects via a REDCap link and this information coupled with the sleep diary reports will be entered to determine sleep intervals.
Algorithms in the Motion Watch 8 software will determine sleep start, sleep end, total sleep time (duration), sleep quality, sleep efficiency, wake after sleep onset, and sleep fragmentation
Participants will be given an evening meal and then be accompanied to the UAB Highlands Hospital Sleep Unit by 5:30pm.
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.Participants will be allowed to sleep in darkness until 8:00am, at which time they will be provided transportation.We will also bank frozen samples taken prior to the light exposure for later calculation of the Dim Light Melatonin Onset (DLMO), a circadian phase estimate.
Other Names:
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.
Participants will be asked to refrain from caffeine consumption 12 hours before reporting to the sleep unit and will provide 2-3 ml of saliva every 30 minutes starting at 6:00pm and ending after the light exposure.
For melatonin suppression, 2-hours light exposure will begin 2 hours before the calculated mid-sleep time.
Collection saliva samples 1-h, 30-min, and immediately before the light exposure and every 30 min throughout exposure.
Samples will be centrifuged and frozen/stored at -20ºC until assay and remaining samples stored at -80ºC.
Melatonin levels will be assayed via the Buhlmann Direct Saliva Melatonin.
Melatonin suppression will be calculated as the percent decrease from the sample taken immediately prior to the light exposure
|
|
Non-opioid using controls
non-opioid using controls
|
The PIPR is measured in six, 80-s test periods in which the stimulus, either Blue (470 nm) or Red (623 nm), is presented to the dilated eye while the pupil response of the un-dilated eye is measured (consensual pupil response
Other Names:
Measure electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), respiratory channels (effort and nasal pressure), and oxygen saturation.
Other Names:
Assist in the diagnosis of disorders of hypersomnolence,63 it is also used in research to quantify daytime sleepiness and serves as a more objective measure of daytime sleepiness than self-report questionnaires
Other Names:
Morning after overnight Visit 2, participants will complete ecological momentary assessments (EMAs) over a 10-day assessment period.
Using EMA through the InsightTM mHealth platform to capture momentary craving, withdrawal and mood states across 10 days among persons who smoke and nonsmokers prior to an overnight procedures.
Participants will complete morning and evening sleep diaries via the EMA InsightTM mHealth platform self-reported sleep and wake information, fatigue, naps, opioid craving and withdrawal.
Other Names:
7-day actigraphy period will be used to determine the habitual sleep start and wake times.
The CamNTech MotionWatch8 (Cambridge, UK) is a solid-state piezo-electric accelerometer that collects data on activity (i.e., arm motion) and ambient light.Actigraphy data are downloaded from the MotionWatch8 into the software (MotionWare) for analysis, management, and exportation.
Bed and wake times will be entered by the subjects via a REDCap link and this information coupled with the sleep diary reports will be entered to determine sleep intervals.
Algorithms in the Motion Watch 8 software will determine sleep start, sleep end, total sleep time (duration), sleep quality, sleep efficiency, wake after sleep onset, and sleep fragmentation
Participants will be given an evening meal and then be accompanied to the UAB Highlands Hospital Sleep Unit by 5:30pm.
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.Participants will be allowed to sleep in darkness until 8:00am, at which time they will be provided transportation.We will also bank frozen samples taken prior to the light exposure for later calculation of the Dim Light Melatonin Onset (DLMO), a circadian phase estimate.
Other Names:
The sleep unit allows for strict control of light exposure (< 5 lux at eye level), room temperature and oral intake factors that could alter melatonin levels.
Participants will be asked to refrain from caffeine consumption 12 hours before reporting to the sleep unit and will provide 2-3 ml of saliva every 30 minutes starting at 6:00pm and ending after the light exposure.
For melatonin suppression, 2-hours light exposure will begin 2 hours before the calculated mid-sleep time.
Collection saliva samples 1-h, 30-min, and immediately before the light exposure and every 30 min throughout exposure.
Samples will be centrifuged and frozen/stored at -20ºC until assay and remaining samples stored at -80ºC.
Melatonin levels will be assayed via the Buhlmann Direct Saliva Melatonin.
Melatonin suppression will be calculated as the percent decrease from the sample taken immediately prior to the light exposure
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Aim 1: Post-Illumination Pupillary Response (PIPR)
Time Frame: 45 minutes
|
10-day at home actigraphy and ecological momentary assessments (EMA period), participants will be scheduled for Visit 3. Upon arrival, the non-dominant eye is dilated with Tropicamide 0.5% and Phenylephrine 2.5% (this lower-than-normal dilation dosage will be effective for the duration of the experiment but will fully dissipate within ~6 hours).
Subjects are then seated in a dimly lit room (< 5 lux, background light) for 30 minute to dark adapt and to ensure complete pupil dilation prior to the study.
The PIPR is measured in six, 80-second test periods in which the stimulus, either Blue (470 nm) or Red (623 nm), is presented to the dilated eye while the pupil response of the un-dilated eye is measured (consensual pupil response).
During a test period, after an initial 20-second fixation period, the stimulus is presented for 1 second followed by a 60-second fixation period.
The red stimulus primarily serves as a control for any nonspecific influences on the PIPR.
|
45 minutes
|
|
Aim 2: Polysomnography
Time Frame: 2 night PSG
|
Polysomnography (PSG)110: To avoid potential first-night effects often observed with PSG, participants will undergo two consecutive nights of PSG, scheduled to begin according to their habitual sleep/wake times.
PSG will be conducted in dedicated research rooms located at the University of Alabama at Birmingham Sleep/Wake Disorders Center at Highlands Hospital (refer to Sleep and Circadian Research Core LOS).
Trained staff will attach electrodes to measure electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), respiratory channels (effort and nasal pressure), and oxygen saturation.
The values of the EEG, EOG, EMG, ECG respiratory channels, and oxygen saturation will be combined to report a single PSG value.
|
2 night PSG
|
|
Aim 3: Number of Participants Multiple Sleep Latency Test
Time Frame: 2 night PSG
|
On the morning following the second night of PSG, participants will undergo an MSLT following standardized guidelines.
Briefly, the multiple sleep latency test (MSLT) consists of 5 nap opportunities that occur every two hours with the first nap beginning 1.5 to 3 hours after the end of the PSG (in this case, after the end of the 2nd night of PSG).
|
2 night PSG
|
|
Aim 4: Number of Participants with Relapse
Time Frame: 6-month follow up
|
Self reported drug cravings, and self-reported withdrawal symptoms by 6-month follow up.Self-reported and urine drug screen confirmed drug use.
|
6-month follow up
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dim Light Melatonin Onset (DLMO)
Time Frame: 12 hours
|
Samples taken prior to the light exposure for later calculation of the Dim Light Melatonin Onset (DLMO)
|
12 hours
|
|
Melatonin suppression test
Time Frame: 12 hours
|
Melatonin suppression test, actigraphy parameters (rhythmic amplitude, inter-daily stability, intra-daily variation, sleep fragmentation, sleep efficiency, sleep duration, mid-sleep time, and wake after sleep onset), and sleep architecture (PSG).
provide 2-3 ml of saliva every 30 min starting at 6:00pm and ending after the light exposure.Participants will be seated in a chair in front of a white light source lights will be calibrated for intensity and spectral distribution at eye level with a PR-670 spectrophotometer).
During the light exposure, participants will be allowed to watch an unexciting movie on a 15-inch iPad tablet.
Collect saliva samples 1-h, 30-min, and immediately before the light exposure and every 30 min throughout exposure.
After the last sample, participants will be allowed to sleep in darkness until 8:00 am
|
12 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Karen Cropsey, PsyD, University of Alabama at Birmingham
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
- Narcotic-Related Disorders
- Nervous System Diseases
- Mental Disorders
- Substance-Related Disorders
- Chemically-Induced Disorders
- Sleep Wake Disorders
- Opioid-Related Disorders
- Parasomnias
- Investigative Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Behavioral Disciplines and Activities
- Psychological Tests
- Monitoring, Physiologic
- Accelerometry
- Ecological Momentary Assessment
- Actigraphy
Other Study ID Numbers
Other Study ID Numbers
- IRB-300011499
- R01DA059471-01 (U.S. NIH Grant/Contract)
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.