- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05823844
Efficacy of Suvorexant on Post-operative Sleep Disturbance
Improvement of Restorative Sleep and Post-surgical Insomnia Following Suvorexant Administration
The study is a parallel group, double blind, randomized trial. Subjects will be recruited from individuals undergoing elective surgery for orthopedic, abdominal, urologic, gynecologic or spine reasons. Out of 92 subjects, one experimental group of 46 subjects will receive 20 mg Suvorexant beginning the first in-hospital night ("day 0") and continuing for their hospital stay. If the dose is not well tolerated (e.g., daytime sleepiness), then the dose may be decreased to 10 mg of Suvorexant.
For blinding purposes each arm will receive two tablets (two 10 mg tablets or one 10 mg tablet and a placebo). The other control group of 46 subjects will receive placebo (two tablets) and treatment as usual.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Paul S. Garcia, MD PhD
- Phone Number: 212-304-7523
- Email: pg2618@cumc.columbia.edu
Study Contact Backup
- Name: Meah T. Ahmed, BSBme
- Email: ma4373@cumc.columbia.edu
Study Locations
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New York
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New York, New York, United States, 10032
- Columbia University Irving Medical Center/NewYork-Presbyterian Milstein Hospital/New York State Psychiatric Institute
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Contact:
- Paul S. Garcia, MD PhD
- Phone Number: 212-304-7523
- Email: pg2618@cumc.columbia.edu
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Contact:
- Meah T. Ahmed, BSBme
- Email: ma4373@cumc.columbia.edu
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Sub-Investigator:
- Terry E. Goldberg, PhD
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Principal Investigator:
- Paul S. Garcia, MD, PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion criteria:
- Aged 50 years to 90 years old.
- Patients getting elective surgeries for orthopedic reasons (e.g., hip or knee replacement), abdominal surgery (e.g., hernia repair, renal cancer), urologic or gynecologic surgery, and spine surgery with a projected inpatient stay of 24 hours or longer.
- Patients experiencing insomnia characterized by difficulties with sleep onset, early morning awakening, and/or sleep maintenance three or more times weekly over a three-month period for eligibility.
Exclusion criteria:
- Patients who undergo surgery and then are admitted to intensive care.
- Coronary artery bypass graft (CABG) or other cardiac surgeries.
- Intra-cranial surgery.
- Chronic pain (i.e., patients on opioid medications as an outpatient).
- Circadian rhythm disorders.
- High Beck Depression or Beck Anxiety scores.
- Moderate to severe dementia (failed 3D CAM)
- Severe obstructive sleep apnea (OSA) (Apnea-hypopnea index (AHI)>30 and/or screen high risk)
- Patients receiving Cytochrome P-450 (CYP3) inhibitors or inducers (Inhibitors: clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole, ritonavir, verapamil, goldenseal, and grapefruit. Inducers: phenobarbital, phenytoin, rifampicin, St. John's Wort, and glucocorticoids).
- Vulnerable populations (i.e., children, pregnant women, non-English speaking patients).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Suvorexant administration
Subjects will receive 20 mg Suvorexant beginning the first in-hospital night ("day 0") and continuing for their hospital stay.
If the dose is not well tolerated (e.g., daytime sleepiness), then the dose may be decreased to 10 mg of Suvorexant.
For blinding purposes, each arm will receive two tablets (two 10 mg tablets or one 10 mg tablet and a placebo).
Suvorexant will be administered beginning on the night after surgery and through the hospitalization period (it is estimated that stays will be 1-3 days; subjects will be followed for a maximum of 5 days).
|
Suvorexant (Belsomra™) is an orexin receptor antagonist that will be administered as 2 tablets (10mg each) for a starting dose of 20mg.
If the dose is not well tolerated (e.g., daytime sleepiness), then the dose may be decreased to 10 mg of Suvorexant.
Other Names:
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Placebo Comparator: Placebo administration
Subjects will receive a placebo (two tablets) and treatment as usual.
The placebo will be administered beginning on the night after surgery and through the hospitalization period (it is estimated that stays will be 1-3 days; subjects will be followed for a maximum of 5 days).
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The placebo pill will look identical to Suvorexant and will be taken as 2 tablets.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total sleep time on day 0 (TST)
Time Frame: Day 0 of in-hospital stay after surgery
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Analysis will be adjusted for group baseline differences, including pre-existing cognitive impairment, medical co-morbidities, and the type and duration of surgery.
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Day 0 of in-hospital stay after surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Longitudinal trend of TST
Time Frame: Up to Day 5 post-surgery
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The longitudinal trend of TST over the five days will be measured using mixed-effect regression.
Group, time (day 0-4), and group x time will be included as the fixed effects and a random intercept of subjects to account for within-subject correlation due to repeated measurement.
Regression quotients will be reported.
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Up to Day 5 post-surgery
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Rate of attrition
Time Frame: Up to Day 5 post-surgery
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The rate of attrition over the 5 days will be measured.
If any specific patterns are identified, inverse propensity treatment weighting will be performed to adjust the effect of nonrandom dropout.
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Up to Day 5 post-surgery
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Richards Campbell Self-Report Sleep Scale
Time Frame: Up to Day 5 post-surgery
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The Richards Campbell self-report sleep scale will be used to determine the quality of sleep each morning.
This five-item, visual analogue scale was designed as an outcome measure for assessing the perception of sleep.
The scale evaluates perceptions of depth of sleep, sleep onset latency, number of awakenings, time spent awake, and overall sleep quality.
For each item, respondents are given a visual analogue scale and are asked to place a mark on the line indicating where their own experiences fit between two extremes (for example, the degree to which they received a "good night's sleep" or "a bad night's sleep").
Scale lines extend from 0 to 100 mm, and scores are calculated by measuring where responses fall on each line.
A total score is obtained by summing each score out of 100 and dividing the total by five.
Lower scores indicate a poorer quality of sleep (worse outcome).
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Up to Day 5 post-surgery
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Incidence of Delirium
Time Frame: Up to Day 5 post-surgery
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The 3-minute diagnostic interview for Confusion Assessment Method (CAM)-defined delirium (3D-CAM) is a brief verbal assessment tool that can be used to test for delirium.
For all items, if the subject's answer is 'incorrect', 'yes', 'don't know', 'no response', or 'non-sensical response', then the appropriate (unshaded) column on the right side is checked.
Each of the 4 columns designates a CAM feature.
If any one box in a column is checked, the feature is considered present.
The CAM algorithm is considered positive if the following features are present: Feature 1) Acute onset or fluctuating course and Feature 2) Inattention and either Feature 3) Disorganized thinking or Feature 4) Altered level of consciousness.
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Up to Day 5 post-surgery
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Paul S. Garcia, MD PhD, Columbia University
Study record dates
Study Major Dates
Study Start (Anticipated)
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
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Nervous System Diseases
- Sleep Disorders, Intrinsic
- Dyssomnias
- Sleep Wake Disorders
- Sleep Initiation and Maintenance Disorders
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Hypnotics and Sedatives
- Sleep Aids, Pharmaceutical
- Orexin Receptor Antagonists
- Suvorexant
Other Study ID Numbers
- AAAU4343
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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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