- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05995132
Compromised Sleep and Circadian Health After Critical Illness: From Diagnosis to Prediction (CHRONOCRIT) (CHRONOCRIT)
Study Overview
Status
Conditions
Detailed Description
The intensive care unit environment is recognizably detrimental for sleep and circadian rhythms due to a plethora of factors such as the mistimed and excessive use of artificial light, unusual feeding schedules, night-time noise and interruptions, events associated with acute illness, among others. The reported sleep and circadian alterations often persist after hospital discharge, but there is a lack of quantitative data obtained through appropriate tools for the intensive care unit context, with a proper sample size, and comprising the different profiles of critical patients. The investigators will address this, by evaluating the prevalence of sleep and circadian alterations during the intensive care unit stay and after hospital discharge in the short (3-month follow-up) and long term (12-month follow-up). This will indicate the magnitude of the problem to the healthcare professionals. In the sequence, the investigators will evaluate whether the expected alterations in the sleep and circadian rhythms of critical survivors are associated with important factors for their recovery such as quality of life, mental health, respiratory, and immune function. This is especially relevant given that it will indicate possible clinical markers for compromised sleep and circadian health and thereby increase the probability of patients' referral to a sleep unit whenever a marker is observed.
Despite the frequent complaints of sleep and circadian alterations among critical survivors, the evaluation of sleep and circadian health within this context is often neglected due to a high associated cost and/or the need of collaboration of the patients, which is not always possible. This proposal aims to counteract this matter, by identifying sleep and circadian alterations with the use of a non-invasive, feasible, and reliable approach. Accordingly, the investigators propose to identify such alterations by evaluating the levels of miRNAs, small molecules that are easily obtained through blood collection. This has the potential to increase the overlooked evaluations of sleep and circadian rhythms within this context. Furthermore, with a prompt identification of sleep and circadian alterations, appropriate strategies can be implemented, improving the quality of life and recovery of the patients, also preventing the outcomes associated with compromised sleep and circadian health in the long-term. Finally, the investigators propose to predict sleep and circadian alterations by integrating the information available during the intensive care unit stay with the use of informatic techniques. By doing so, the pertinent management will be implemented according to the needs of each patient. A proper follow-up contributes to the prompt identification of problems in this regard and consequent implementation of therapeutic strategies on time, potentiating the benefits of appropriate sleep and circadian health for the recovery and quality of life. It is important to note that such approach has the potential to aid in decreasing the time and cost-associated burden to which the healthcare system is exposed.
For doing all this, critical patients (n = 271) will be recruited during the ICU stay. Sleep and circadian rhythms will be assessed through actigraphy, and blood samples will be collected for miRNAs expression profile determination. Three months after hospital discharge, a clinical evaluation will be performed, followed by the assessment of the quality of life, mental health, and respiratory function. Sleep and circadian rhythms will be investigated through validated questionnaires and 7 consecutive days of actigraphy. Furthermore, blood will be collected for miRNAs expression profile determination and immune function evaluation. The same procedures will be performed 12 months after hospital discharge
The general objective of the study is to improve the management of sleep and circadian health after critical illness.
The specific objectives are:
- To evaluate the sleep and circadian health of critical patients in three time-points: during the intensive care unit stay, in the short-term (3 months after hospital discharge), and in the long-term (12 months after hospital discharge).
- To evaluate possible associations between sleep and circadian health and important factors for the recovery of critical survivors such as quality of life, mental health, respiratory, and immune function in the short and long-term.
- To evaluate the role of miRNAs expression profile in identifying the compromised sleep and circadian health of critical patients during the intensive care unit stay, in the short, and in the long-term.
- To identify possible biological events underlying the compromised sleep and circadian health of critical patients during the intensive care unit stay, in the short, and in the long-term.
- To develop models to predict the compromised sleep and circadian health of critical survivors in the short and long-term.
- To establish a cohort of critical survivors with available information related to sleep and circadian health to further explore this unravelled research field.
- To validate the findings in an independent cohort outside Europe.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Adriano Targa Dias Santos, PhD
- Phone Number: +34 973702491
- Email: adrianotargads@gmail.com
Study Contact Backup
- Name: David de Gonzalo Calvo, PhD
- Phone Number: +34 973702491
- Email: dgonzalo@irblleida.cat
Study Locations
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Lleida, Spain, 25198
- Recruiting
- Hospital Universitari Arnau de Vilanova
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Contact:
- Adriano Targa, PhD
- Email: adrianotargads@gmail.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Being older than 18 years old.
- Intensive care unit admission.
- Intensive care unit stay ≥7 days.
Exclusion Criteria:
- Transference to another hospital during hospitalization or follow-up.
- Mental or physical disability that could prevent the proposed evaluations.
- Palliative care
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Intensive care unit
This group will be composed of patients admitted to the intensive care unit who did not receive invasive mechanical ventilation.
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Intensive care unit and invasive mechanical ventilation
This group will be composed of patients admitted to the intensive care unit who did receive invasive mechanical ventilation.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sleep efficiency
Time Frame: 12-month follow-up
|
The sleep health of critical patients will be evaluated using this parameter, which will be obtained through 7 days of actigraphy at the 3- and 12-month follow-up.
Sleep efficiency is defined as the ratio between total sleep time and the time spent in bed.
The following cut-offs are used: i) sleep efficiency ≥ 85% (represents good sleep quality), ii) sleep efficiency <85% (represents inappropriate sleep quality).
|
12-month follow-up
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Circadian function index (CFI)
Time Frame: 12-month follow-up
|
The circadian health of critical patients will be evaluated using this parameter, which will be obtained through 7 days of actigraphy at the 3- and 12-month follow-up.
The circadian function index is defined as the average of intradaily variability, interdaily stability, and relative amplitude of the rhythm.
There are no specific cut-offs for this parameter.
The circadian function index values range from 0-1, in which 1 represents an appropriate circadian function.
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12-month follow-up
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Adriano Targa Dias Santos, PhD, Institut de Recerca Biomèdica de Lleida
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
- PI22/00216
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.
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