- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04932096
Sleep Management And Recovery After Traumatic Brain Injury in Kids: Pilot Intervention of Melatonin (SMARTKids)
Sleep Management And Recovery After Traumatic Brain Injury in Kids (SMARTKids): Evidence for Targeting Sleep to Improve Outcomes
Sleep wake disturbances compound recovery in over half of pediatric traumatic brain injury survivors, leading to impaired quality of life, and few effective interventions exist to treat this important morbidity. Therefore, this study will conduct a randomized controlled trial evaluating a melatonin intervention started during hospitalization and continued after discharge compared to placebo. The trial will investigate if this intervention is feasible, acceptable, and effective at reducing sleep wake disturbances as measured on the Sleep Disturbances Scale for Children 1-month after hospital discharge.
Participants will be randomly assigned to receive the intervention (melatonin) or to the control group (placebo) with a goal of equal numbers of participants in each group and all will receive sleep education. Participants will be followed closely after consent and outcomes will be assessed at hospital discharge, and 1-month. Outcomes will focus on feasibility (ability to recruit patients into the trial) and acceptability (patient safety and satisfaction), but will also assess the effectiveness of the intervention to reduce sleep disturbances after discharge. The investigators will assess sleep using questionnaires and actigraphy (watch-like activity monitors). Exploratory outcomes will include global health outcomes.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Cydni N Williams, MD
- Phone Number: 503-494-5522
- Email: willicyd@ohsu.edu
Study Contact Backup
- Name: Andrea Rano, BS
- Phone Number: 503-494-5522
- Email: rano@ohsu.edu
Study Locations
-
-
Oregon
-
Portland, Oregon, United States, 97239
- Recruiting
- Oregon Health & Science University
-
Contact:
- Andrea Rano, BS
- Phone Number: 503-494-5522
- Email: rano@ohsu.edu
-
Contact:
- Cydni Williams, MD
- Phone Number: 503-494-5522
- Email: willicyd@ohsu.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion:
- Children age ≥6 years and <19 years
- Traumatic brain injury defined as disruption of the normal function of the brain resulting from blunt force injury with a severity defined as mild complicated, moderate, or severe by the Glasgow Coma Scale with the presence of intracranial injury on imaging
- Admission to Oregon Health & Science University Hospitals
- Deemed likely to survive hospitalization by clinical care team
- Able to tolerate enteral medications within 72 hours of admission
- Child participant resides with parent or legal guardian
Exclusion:
- Lack stable means of communication with study team (phone, email, mailing address)
- Abusive trauma suspected or confirmed
- Dialysis
- Extracorporeal support (e.g. ECMO)
- Significant liver injury defined as >2x normal levels for AST or ALT
- Clinical team safety concerns with use of intervention
- Pregnancy
- Prisoners
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo
|
microcrystalline cellulose filled capsule
|
Experimental: Melatonin
(melatonin doses of 3mg or 5mg based on patient size given nightly 1 hour prior to bedtime every night for 30 days)
|
melatonin supplementation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
sleep disturbance
Time Frame: 1-month
|
Sleep Disturbances Scale for Children: 26-item parent proxy sleep questionnaire with higher scores reflecting greater disturbance and risk for clinically important sleep disorders.
Each question is scored 1 through 5 for a range of possible total scores of 26 - 130.
|
1-month
|
Recruitment
Time Frame: through study completion, an average of 6-months
|
Quantitative number of patients consented per patients approached
|
through study completion, an average of 6-months
|
Retention
Time Frame: through study completion, an average of 6-months
|
Quantitative number of participants completing trial procedures per patients consented
|
through study completion, an average of 6-months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
adherence quantitative
Time Frame: 1-month
|
pill counts
|
1-month
|
adherence qualitative
Time Frame: 1-month
|
participant report of compliance with treatment regimen evaluated by survey question estimating percentage of study days compliant with intervention
|
1-month
|
Fatigue
Time Frame: 1-month
|
Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS); 18 item parent proxy report of fatigue.
Scores range 0-100 with higher scores indicating better function and less fatigue.
|
1-month
|
Chronotype
Time Frame: 1-month
|
Children's Chronotype Questionnaire, parent reported survey of circadian rhythm characteristics.
Each item assessed independently.
|
1-month
|
sleep latency
Time Frame: 1-month
|
actigraphy measured time in minutes to fall asleep
|
1-month
|
total sleep time
Time Frame: 1-month
|
actigraphy measured total time asleep in minutes
|
1-month
|
wake after sleep onset
Time Frame: 1-month
|
actigraphy measured time in minutes awake after sleep onset
|
1-month
|
number of night awakenings
Time Frame: 1-month
|
actigraphy measured number of instances awoken after sleep onset
|
1-month
|
sleep efficiency
Time Frame: 1-month
|
actigraphy measure percentage of nighttime period spent asleep
|
1-month
|
sleep onset
Time Frame: 1-month
|
time of day fell asleep
|
1-month
|
sleep offset
Time Frame: 1-month
|
time of day waking from nighttime sleep
|
1-month
|
adverse events time 0
Time Frame: hospital discharge assessed up to 7 days
|
Evaluation of adverse events asking participants to report any side effects of study interventions
|
hospital discharge assessed up to 7 days
|
adverse events time 1
Time Frame: 1-month
|
Evaluation of adverse events asking participants to report any side effects of study interventions
|
1-month
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
reason for non-adherence
Time Frame: 1-month
|
qualitative response to survey question about reasons for non-compliance with treatment regimen or sleep plan
|
1-month
|
health related quality of life
Time Frame: 1-month
|
Pediatric Quality of Life Inventory (PedsQL): parent reported measure of quality of life.
Scores range 0-100 with higher scores indicating better quality of life.
|
1-month
|
cognitive functioning
Time Frame: 1-month
|
Behavior Rating Inventory of Executive Function, second edition (BRIEF-2); parent proxy report of everyday executive function, reported as standardized Global Executive Composite T-score, with higher scores indicating worse function.
T-scores range from 0-100, with a mean of 50 and standard deviation of 10.
|
1-month
|
physical functioning
Time Frame: 1-month
|
Functional Status Scale, range 6-30, with higher scores indicating worse function
|
1-month
|
anxiety
Time Frame: 1-month
|
Patient Reported Outcome Measurement Information System (PROMIS) anxiety short form T-score with higher scores indicating worse outcome.
T-scores range from 0 - 100, with a mean of 50 and standard deviation of 10.
|
1-month
|
depression
Time Frame: 1-month
|
Patient Reported Outcome Measurement Information System (PROMIS) depression short form T-score with higher scores indicating worse outcome.
T-scores range from 0-100, with a mean of 50 and standard deviation of 10.
|
1-month
|
pain
Time Frame: 1-month
|
Patient Reported Outcome Measurement Information System (PROMIS) pain intensity (raw score out of 10), and pain behavior (T-score with mean of 50 and standard deviation of 10) parent report forms; Higher scores indicate worse pain outcomes
|
1-month
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Cydni Williams, MD, Oregon Health and Science University
Publications and helpful links
General Publications
- Luther M, Poppert Cordts KM, Williams CN. Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery. Sleep. 2020 Oct 13;43(10):zsaa083. doi: 10.1093/sleep/zsaa083.
- Poppert Cordts KM, Hall TA, Hartman ME, Luther M, Wagner A, Piantino J, Guilliams KP, Guerriero RM, Jara J, Williams CN. Sleep Measure Validation in a Pediatric Neurocritical Care Acquired Brain Injury Population. Neurocrit Care. 2020 Aug;33(1):196-206. doi: 10.1007/s12028-019-00883-5.
- Williams CN, Hartman ME, McEvoy CT, Hall TA, Lim MM, Shea SA, Luther M, Guilliams KP, Guerriero RM, Bosworth CC, Piantino JA. Sleep-Wake Disturbances After Acquired Brain Injury in Children Surviving Critical Care. Pediatr Neurol. 2020 Feb;103:43-51. doi: 10.1016/j.pediatrneurol.2019.08.010. Epub 2019 Aug 26.
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 (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Disease Attributes
- Craniocerebral Trauma
- Trauma, Nervous System
- Brain Injuries
- Wounds and Injuries
- Brain Injuries, Traumatic
- Critical Illness
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Protective Agents
- Antioxidants
- Melatonin
Other Study ID Numbers
- GPEDI1282A
- 1K23HL150229-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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