- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04009447
Sleep Quality and Mechanisms of Cardiovascular Risks in Adults With Hypertension
February 21, 2024 updated by: Duke University
The objective of this study is to elucidate the potential mechanisms responsible for the increased risk of cardiovascular disease among patients with hypertension and comorbid insomnia.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
The investigators propose to utilize a behavioral intervention to manipulate sleep quality in 150 adults with hypertension and comorbid insomnia, who will receive a 6-week Cognitive Behavioral therapy for Insomnia (CBT-I) intervention, which has been shown to markedly improve sleep quality and promote consolidated sleep in approximately 60% of those treated.
A lowering of nighttime blood pressure is one of several proposed mechanisms to be examined.
Study Type
Interventional
Enrollment (Estimated)
150
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Kristy Johnson, MPH
- Phone Number: 919-681-5874
- Email: johns121@mc.duke.edu
Study Contact Backup
- Name: Andrew Sherwood, PhD
- Phone Number: 919-684-8835
- Email: sherw002@mc.duke.edu
Study Locations
-
-
North Carolina
-
Durham, North Carolina, United States, 27710
- Duke University Medical Center
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
30 years to 60 years (Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Systolic BP ≥ 130 mm Hg based upon two standardized BP screening assessments
- A current diagnosis of insomnia disorder as defined in the International Classification of Sleep Disorders (ICSD-3); or undiagnosed, but suspected, insomnia disorder that is confirmed at their screening lab visit
Exclusion Criteria:
- Uncontrolled hypertension (screening office BP > 160/100 mm Hg)
- Antihypertensive medication use
- Cardiovascular medications
- Previously diagnosed moderate or severe obstructive sleep apnea
- Severe obesity defined by BMI>40 kg/m2
- Pacemakers
- Atrial fibrillation
- Acute coronary syndrome or coronary revascularization procedure within 6 months of enrollment
- Congestive heart failure
- Identifiable cause of hypertension (e.g., primary hyperaldosteronism, renal artery stenosis, untreated hyper- or hypothyroidism, chronic kidney disease, Cushing's disease, pheochromocytoma, coarctation of the aorta)
- Severe uncorrected valvular heart disease
- Current pregnancy
- Active diagnosis of psychosis, bipolar disorder
- Diabetes
- Severely impaired hearing or speech
- Participation in another interventional study to address insomnia
- Rotating shift workers
- Prominent suicidal or homicidal ideation (as assessed through a clinical interview)
- Psychiatric Hospitalization within the past 12 months
- Alcohol or drug abuse within 12 months
- Exposure-based PTSD treatment
- Dementia
- Unstable comorbid sleep disorder requiring assessment and/or treatment outside of the study protocol
- Medical or psychiatric conditions judged to be the primary cause of insomnia
- Inability to comply with the assessment procedures or inability to provide informed consent.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Cognitive Behavioral Therapy for Insomnia
Cognitive Behavioral Therapy for Insomnia (CBT-I) 6 sessions of Cognitive Behavioral Training for Insomnia (1 hour each).
|
6-week CBT-I therapy to help improve sleep quality
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in blood pressure during the nighttime sleep period
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Average nighttime blood pressure (mm Hg) measured by 24 hour ambulatory blood pressure monitoring before and after CBT-I
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in sleep during the nighttime sleep period
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Sleep efficiency (percent-time asleep during the sleep period) measured by sleep diary and actigraphy before and after CBT-I.
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Changes in insomnia severity
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Insomnia measured by the Insomnia Severity Index before and after CBT-I.
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in nighttime sympathetic nervous system activity
Time Frame: 6 week, 12 week
|
Measured by 24 hour urine collection (awake and sleep period collection separated) assayed for catecholamines (epinephrine, norepinephrine) and creatinine before and after CBT-I
|
6 week, 12 week
|
Change in awake blood pressure
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Average awake blood pressure (mm Hg) measured by 24 hour ambulatory blood pressure monitoring before and after CBT-I
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in nighttime blood pressure dipping
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Average percent change in blood pressure (mm Hg) from awake to nighttime measured by 24 hour ambulatory blood pressure monitoring before and after CBT-I
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in vascular endothelial function
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Percent dilation of the brachial artery to reactive hyperemia measured by flow mediated dilation before and after CBT-I
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in arterial stiffness
Time Frame: 6 week, 6 months post intervention
|
Pulse wave velocity (m/s) of the descending aorta measured using the Complior system before and after CBT-I
|
6 week, 6 months post intervention
|
Change in lipid profile
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Lipids (Total, HDL, LDL, Cholesterol and Triglycerides) from fasting venous blood draw measured before and after CBT-I
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in cardiac structure
Time Frame: 6 week, 6 months post intervention
|
Cardiac left ventricular mass (g m^-2.7)
before and after CBT-I
|
6 week, 6 months post intervention
|
Change in cardiac function
Time Frame: 6 week, 6 months post intervention
|
Cardiac left ventricular strain (%) before and after CBT-I
|
6 week, 6 months post intervention
|
Change in sleep fragmentation during the nighttime sleep period
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Sleep Fragmentation Index measured by actigraphy before and after CBT-I.
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in subjective sleep quality
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Subjective Sleep Quality measured by Pittsburgh Sleep Quality Index before and after CBT-I.
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Change in Office Blood Pressure
Time Frame: Baseline, 6 week, 12 week, 6 months post intervention
|
Average office seated blood pressure taken by automated clinic blood pressure monitor after 5 minutes rest and based on the average of 3 readings taken at one minute intervals (mm Hg)
|
Baseline, 6 week, 12 week, 6 months post intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Andrew Sherwood, PhD, Duke University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 14, 2020
Primary Completion (Estimated)
November 1, 2024
Study Completion (Estimated)
November 1, 2024
Study Registration Dates
First Submitted
July 3, 2019
First Submitted That Met QC Criteria
July 3, 2019
First Posted (Actual)
July 5, 2019
Study Record Updates
Last Update Posted (Estimated)
February 23, 2024
Last Update Submitted That Met QC Criteria
February 21, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PRO00102036
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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