- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07789535
Sleep and Arterial Function in Hypertensive Patients With Poor Sleep Quality (SLEEP-ARTerY)
Impact of Sleep on Arterial Function, Psychological and Cognitive Complaints in Hypertensive Patients With Poor Sleep Quality
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Background: Poor sleep quality is associated with increased arterial stiffness, depression, and cognitive decline, all of which contribute to cardiovascular risk in hypertensive patients. This trial tests whether improving sleep through CBT-I can attenuate arterial dysfunction and psychological/cognitive burden.
Design: Prospective, single-centre, parallel-group randomised controlled trial with 1:1 allocation, conducted at the Hypertension and Psychiatry Outpatient Clinics of the Unidade Local de Saude Alto Ave (ULSAAVE).
Intervention: CBT-I delivered in four weekly 60-minute sessions (sleep hygiene, stimulus control, relaxation techniques), adapted for participants with mild obstructive sleep apnea or comorbid insomnia and sleep apnea (COMISA).
Comparator: Passive sleep education (informational leaflets plus non-interactive follow-up calls); control participants are offered CBT-I after study completion.
Randomisation and blinding: Computer-generated block randomisation (blocks of 4-6), 1:1 allocation, with allocation concealment via sequentially numbered, opaque, sealed envelopes managed by a third party. Outcome assessors and data analysts are blinded; participants are partially blinded (control presented as an educational intervention).
Sample size: 234 participants (117 per group), accounting for 20% attrition, powered (80%, alpha 0.05) to detect a 0.4 m/s between-group difference in pulse wave velocity at 12 months.
Analysis: Linear mixed-effects models for repeated measures (time as fixed effect, participant as random effect, group as factor), with baseline apnea-hypopnea index included as a covariate.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Sofia Gomes, MD
- Numéro de téléphone: + 351 253540330
- E-mail: 3603@ulsaave.min-saude.pt
Lieux d'étude
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Braga District
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Guimarães, Braga District, Le Portugal, 4835-044
- Recrutement
- Unidade Local de Saúde do Alto Ave - Hospital Senhora da Oliveira
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Contact:
- Sofia Gomes, MD
- Numéro de téléphone: +351 253 540 330
- E-mail: 3603@ulsaave.min-saude.pt
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Contact:
- Pedro Cunha, PhD
- Numéro de téléphone: +351 253 540 330
- E-mail: pedrocunha@ulsaave.min-saude.pt
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Chercheur principal:
- Sofia Gomes
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Sous-enquêteur:
- Ana Daniela Ferreira
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Adults aged 18 to 70 years
- Controlled hypertension
- Poor baseline sleep quality (sleep efficiency <=85% assessed via actigraphy or type II polysomnography)
- Capable of providing informed consent
- Participants with mild obstructive sleep apnea (apnea-hypopnea index 5-14.9/h on type II polysomnography) who do not meet criteria for CPAP/PAP therapy are eligible
Exclusion Criteria:
- Severe cardiovascular disease (e.g., acute myocardial infarction or stroke)
- Severe neurological diseases
- Moderate-to-severe obstructive sleep apnea (AHI >=15/h) or any obstructive sleep apnea with an indication for CPAP/PAP therapy
- Central disorders of hypersomnolence
- Intellectual disability
- Pregnancy
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: CBT-I
Cognitive-behavioural therapy for insomnia: four weekly 60-minute sessions covering sleep hygiene, stimulus control, and relaxation techniques, adapted for participants with mild obstructive sleep apnea or COMISA.
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Cognitive-behavioural therapy for insomnia delivered in four weekly 60-minute sessions, incorporating sleep hygiene, stimulus control, and relaxation techniques.
Based on baseline polysomnography, the protocol is adapted for participants without obstructive sleep apnea, with mild obstructive sleep apnea, or with comorbid insomnia and mild sleep apnea (COMISA).
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Comparateur actif: Passive sleep education
Informational leaflets plus non-interactive follow-up calls.
Control participants are offered CBT-I after study completion.
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Passive sleep education consisting of informational leaflets plus non-interactive follow-up calls.
Participants in this control condition are offered access to CBT-I after study completion.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline in pulse wave velocity (PWV)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in carotid-femoral pulse wave velocity (m/s), a marker of arterial stiffness.
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in central arterial pressure (CAP)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in central arterial pressure (mmHg).
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Baseline, 1 month, 6 months, and 12 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline in blood pressure
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in systolic and diastolic blood pressure (mmHg)
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in body weight
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in body weight (kg).
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in body mass index (BMI)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in body mass index (kg/m^2).
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in depressive symptoms (MADRS)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in depressive symptoms measured by the Montgomery-Asberg Depression Rating Scale (MADRS).
Scores range from 0 to 60, with higher scores indicating more severe depression.
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in depressive symptoms (PHQ-9)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9).
Scores range from 0 to 27, with higher scores indicating more severe depression.
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in perceived stress (PSS)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in perceived stress measured by the Perceived Stress Scale (PSS).
Higher scores indicate greater perceived stress.
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Baseline, 1 month, 6 months, and 12 months
|
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Change from baseline in cognitive function (MoCA)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in cognitive function measured by the Montreal Cognitive Assessment (MoCA).
Scores range from 0 to 30, with lower scores indicating greater cognitive impairment.
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in sleep quality (PSQI)
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI).
Scores range from 0 to 21, with higher scores indicating worse sleep quality.
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Baseline, 1 month, 6 months, and 12 months
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Change from baseline in sleep efficiency
Délai: Baseline, 1 month, 6 months, and 12 months
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Change from baseline in sleep efficiency (%) assessed via actigraphy or type II polysomnography.
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Baseline, 1 month, 6 months, and 12 months
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Sofia Gomes, MD, Unidade Local de Saúde do Alto Ave
- Directeur d'études: Pedro Cunha, PhD, Unidade Local de Saúde do Alto Ave
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- CIC20260049 - CAIDIS (Autre identifiant: ULSAAVE Ethics Committee)
Plan pour les données individuelles des participants (IPD)
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Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
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