- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05228444
Managing Sleep-wake Disruption Due to Hospitalisation: the Circadian Care Project (CircadianCare)
Sleep is regulated by the interaction of homeostatic and circadian processes. The homeostatic process determines sleep propensity in relation to sleep-wake history, the circadian one is responsible for the alternation of high/low sleep propensity in relation to dark/light cues, and is substantially independent of preceding sleep-wake behaviour. The circadian timing system encompasses a master clock in the brain and peripheral, ancillary time-keepers in virtually every organ of the body.
In recent years, evidence has emerged that circadian disruption has serious medical consequences, including sleep loss, increased cardiovascular morbidity and increased risk of certain types of cancer. Evidence is also emerging that hospitalization per se weakens circadian rhythmicity, due to disease itself and to modified light, food and activity cues.
The aim of our project is to test an inpatient management system (CircadianCare) that limits the circadian impact of hospitalisation by enhancing circadian rhythmicity through an assessment of the patient's specific circadian features/needs and an ad hoc, personalized light-dark, meal and activity schedule to cover the whole of the inpatient stay. This will be compared to standard inpatient management in terms of patients' perception, sleep-wake quality and timing during hospitalisation, inpatient utilization of sleep-inducing medication, length of hospitalisation, and prognosis (i.e. outcome of hospitalisation, subsequent hospitalisations and post-discharge sleep-wake disturbances).
The CircadianCare system is expected to benefit prognosis, decrease costs, and change the way hospitals are organized and designed in future, with potential direct relevance to the plans for the new University Hospital of Padova.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Sara Montagnese
- Phone Number: +390498218675
- Email: sara.montagnese@unipd.it
Study Locations
-
-
-
Padova, Italy, 35128
- Recruiting
- Padova University Hospital
-
Contact:
- Sara Montagnese
- Phone Number: +390498218675
- Email: sara.montagnese@unipd.it
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
• Hospitalized patients
Exclusion Criteria:
• absence of compliance
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control
|
|
Experimental: Circadiancare
limits the circadian impact of hospitalisation by enhancing circadian rhythmicity through an assessment of the patient's specific circadian features/needs and an ad hoc, personalized light-dark, meal and activity schedule to cover the whole of the inpatient stay.
|
enhancing circadian rhythmicity through an assessment of the patient's specific circadian features/needs and an ad hoc, personalized light-dark, meal and activity schedule to cover the whole of the inpatient stay.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in sleep onset latency - actigraphy
Time Frame: first, 7th and 14 day
|
Sleep latency (number of minutes between try to sleep and sleep onset, SL) is objectively assessed by wrist actigraphy device.
SL > 30 min is considered clinically significant.
(scale minutes)
|
first, 7th and 14 day
|
Change in sleep onset latency - sleep diary
Time Frame: first, 7th and 14 day
|
The number of minutes between try to sleep and sleep onset as measured by sleep diary.
Sleep latency > 30 min is considered clinically significant.
(scale minutes)
|
first, 7th and 14 day
|
Change in sleep duration - actigraphy
Time Frame: first, 7th and 14 day
|
Total sleep time (TST) is calculated as hours per night spent sleeping while in bed after light off.
It is objectively assessed by wrist actigraphy device.
(scale hours)
|
first, 7th and 14 day
|
Change in sleep duration - sleep diary
Time Frame: first, 7th and 14 day
|
Total sleep time (TST) is calculated as hours per night spent sleeping while in bed after light off.
It is assessed using daily sleep diaries.
(scale hours)
|
first, 7th and 14 day
|
Change in sleep awakening - actigraphy
Time Frame: first, 7th and 14 day
|
Measured with wrist actigraphy, wake after sleep onset (WASO) is the number of minutes scored as wake from sleep onset until the end of the last sleep episode while in bed.
(scale minutes)
|
first, 7th and 14 day
|
Change in sleep awakening - sleep diary
Time Frame: first, 7th and 14 day
|
Measured with sleep diary.
Wake after sleep onset (WASO) is a subjective measure of participants' sleeping and waking times in which time awake expressed in minutes after sleep onset is obtained.
|
first, 7th and 14 day
|
Change in sleep efficiency - actigraphy
Time Frame: first, 7th and 14 day
|
Measured with wrist actigraphy, sleep efficiency (SE) is the percentage of time (0%-100%) the participant was sleeping from sleep onset (defined as the first 20 continuous minutes of sleep after getting into bed) until the last minute scored as sleep (the following morning).
|
first, 7th and 14 day
|
Change in sleep efficiency - sleep diary
Time Frame: first, 7th and 14 day
|
Measured with sleep diary.
The sleep efficiency is a subjective measure of participants' sleeping and waking times, from which sleep efficiency is computed as the quota between time sleeping/time spent in bed, expressed in percentage.
|
first, 7th and 14 day
|
Actigraphy - change in fragmentation of activity-rest periods
Time Frame: 14 days
|
Interdaily variability (IV) quantifies the degree of fragmentation.
The variable has a theoretical range of 0 to 2 with higher values indicating higher fragmentation.
Typical values for healthy subjects will be below 1.
|
14 days
|
Actigraphy - change in sleep regularity over days
Time Frame: 14 days
|
Intradaily stability (IS) quantifies the degree of regularity in the activity-rest pattern with a range of 0 to 1 where a value of 0 indicates a total lack of rhythm and a value of 1 indicates a perfectly stable rhythm.
|
14 days
|
Change in daytime sleepiness
Time Frame: first day then again at 7th and 14th day
|
Karolinska Sleepiness Scale (KSS) comprises a single item assessing state sleepiness at a particular time (every hour) during the day on a scale from 1 (very rested) to 9 (very sleepy).
|
first day then again at 7th and 14th day
|
Salivary melatonin shift
Time Frame: baseline DLMO and then again at 7th and 14th day
|
A change in the timing of the circadian system is measured using the Dim Light Melatonin Onset (DLMO), gold standard for measuring human circadian phase.
Salivary melatonin is measured five times every 1h before usual bedtime and assayed using standard commercially-available radioimmunoassay (RIA) kits.
The time at which melatonin rises above a 4 pg/mL threshold is the DLMO.
|
baseline DLMO and then again at 7th and 14th day
|
Diurnal preference
Time Frame: first day
|
Short version Munich Chronotype Questionnaire (microMCTQ), measure chronotype based on the midpoint of sleep.
|
first day
|
Assess circadian preference
Time Frame: first day
|
Morning-evening questionnaire (MEQ) scale: MEQ sum score, range: 16-86, participants are classified as Morning-types (scores between 59 and 86), Neither-types (scores between 42 and 58), and Evening-types (scores between 16 and 41).
|
first day
|
Sleep quality
Time Frame: first day
|
Pittsburgh Sleep Quality Index (PSQI) scale: global PSQI score, range: 0 - 21, scores of 5 or higher indicate poor sleep quality.
|
first day
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Monitoring environment temperature
Time Frame: first, 7th 14th day
|
Temperature levels within ward rooms will be monitored at regular intervals by ibutton temperature sensors, using the Celsius scale.
|
first, 7th 14th day
|
Monitoring environment noise
Time Frame: first, 7th 14th day
|
Noise levels within ward rooms will be monitored at regular intervals by phonometers.
Noise level is measured in decibels (dB)
|
first, 7th 14th day
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- 150949
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
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.
Clinical Trials on Circadian Rhythm Disorders
-
Brigham and Women's HospitalNSBRICompletedCircadian RhythmUnited States
-
Academisch Medisch Centrum - Universiteit van Amsterdam...RecruitingSleep | Sleep Disturbance | Anesthesia | Sleep Disorders, Circadian Rhythm | Circadian Rhythm Sleep Disorder | Circadian Rhythm Disorder Caused by Drug | Circadian Rhythm Sleep Disorder, Jet Lag Type | Jet LagNetherlands
-
Vanda PharmaceuticalsCompletedCircadian Rhythm Sleep DisordersUnited States
-
Brigham and Women's HospitalNational Center for Complementary and Integrative Health (NCCIH)Completed
-
Taipei Veterans General Hospital, TaiwanNational Yang Ming UniversityRecruitingShift Work Type Circadian Rhythm Sleep DisorderTaiwan
-
Yale UniversityCompletedCircadian Rhythm Sleep Disorder, UnspecifiedUnited States
-
Columbia UniversityRecruitingEating Behavior | Shift Work Type Circadian Rhythm Sleep DisorderUnited States
-
Federal University of UberlandiaCompletedShift Work Type Circadian Rhythm Sleep DisorderBrazil
-
University of Alabama at BirminghamAmerican Heart AssociationCompletedBlood Pressure | Circadian RhythmUnited States
-
Samsung Medical CenterCompletedCircadian Rhythm Phase Shift