- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03785600
Improving Sleep in Veterans With TBI (SPTBI)
A Sleep Intervention to Improve Rehabilitation in Veterans With Chronic mTBI
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Each year ~2.5 million people sustain a traumatic brain injury (TBI). Also a prominent general public health issue, TBI is particularly prevalent in Veterans, with 60-80% reporting a history of TBI. Over 80% of all TBI are categorized as mild TBI (mTBI), which is associated with a myriad of short- and long-term complications. Two of the principal complicating factors associated with mTBI are sleep-wake disturbances (e.g., insomnia, excessive daytime sleepiness, and circadian rhythm sleep disorders) and chronic pain, including headache and diffuse/global pain. Sleep-wake disturbances and chronic pain have an independent prevalence of ~70%, individually impair quality of life, impede effective rehabilitative therapies, and have staggering functional and economic impacts.
Furthermore, there is a strong bidirectional relationship between sleep-wake disturbances and pain such that impaired sleep exacerbates pain, which leads to greater impairments in sleep and worse pain. This vicious cycle between sleep disturbances and pain, which is a particularly prevalent and detrimental condition in Veterans with chronic mTBI, represents a central challenge precluding effective treatment and ultimately, improving Veteran quality of life. Although there are pharmacological and non-pharmacological therapies for chronic pain, the presence of TBI significantly complicates the effectiveness of these treatment options, and have significant adverse effects (e.g., long-term prescription opioid dependence, misuse, or overdose). The investigators believe there is profound potential to intervene at the sleep level, and, by improving sleep quality, enable Veterans with chronic mTBI to better manage their pain and end this vicious cycle.
This proposal aims to apply a sleep intervention to improve chronic pain in Veterans with mTBI. The investigators propose to use morning bright light therapy (MBLT), a readily deployable, cost-effective, non-pharmacologic, and home-based sleep intervention, to improve sleep-wake disturbances and therefore ameliorate chronic pain and improve quality of life in Veterans with chronic mTBI. Outcomes will be assessed pre- and post-intervention, and at a 3-month follow-up time point. The central hypothesis is that MBLT will improve sleep quality and ameliorate pain, resulting in improved quality of life in Veterans with chronic mTBI.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jonathan E Elliott, PhD
- Phone Number: (503) 220-8262
- Email: jonathan.elliott@va.gov
Study Contact Backup
- Name: Joshua P Kreider
- Phone Number: 53851 (503) 220-8262
- Email: Joshua.Kreider@va.gov
Study Locations
-
-
Oregon
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Portland, Oregon, United States, 97207-2964
- Recruiting
- VA Portland Health Care System, Portland, OR
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Principal Investigator:
- Jonathan E Elliott, PhD
-
Contact:
- Jonathan E Elliott, PhD
- Phone Number: 503-220-8262
- Email: jonathan.elliott@va.gov
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Veteran
- Medical record-confirmed diagnosis of mTBI
Current self-reported sleep-wake disturbances
- defined by clinically abnormal Insomnia Severity Index and/or Functional Outcomes of Sleep scores
Moderate to severe pain
- defined as a score of 4 on an 11-point scale94) persisting for longer than 6 months
- English speaking with phone access
Exclusion Criteria:
Exclusion Criteria:
- Decisional impairment and/or dementia
- Current usage of a lightbox or negative ion generator
- Shift work
- History of macular degeneration and/or bipolar disorder
- Evidence for suicidal ideation
- Cancer diagnosis within the past 6 months
- Surgery within the past 6-12 months
- Substance abuse within the past 6-12 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Morning Bright Light Therapy
Morning bright light: Sitting in front of a lightbox for 60 minutes every morning within 90 minutes of waking up.
|
Morning bright light: Sitting in front of a lightbox for 60 minutes every morning within 90 minutes of waking up.
Other Names:
|
Sham Comparator: Negative Ion Generator
Negative ion generator: Sitting in front of a modified negative ion generator for 60 min every morning within 90 minutes of waking up.
|
Negative ion generator: Sitting in front of a modified negative ion generator for 60 min every morning within 90 minutes of waking up.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
self-reported pain change determined via the NIH PROMIS scale
Time Frame: Pre- and post-4 weeks of MBLT or sham treatment, and 12 weeks following the end of MBLT or sham treatment
|
NIH PROMIS Pain Scale 4 questions; each question is a 0-4 scale, total score range is 0-16 Higher scores represent worse outcomes
|
Pre- and post-4 weeks of MBLT or sham treatment, and 12 weeks following the end of MBLT or sham treatment
|
Collaborators and Investigators
Investigators
- Principal Investigator: Jonathan E Elliott, PhD, VA Portland Health Care System, Portland, OR
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- D2947-W
- IK2RX002947 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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