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Vagus Nerve Stimulation on Improving Sleep in Inpatient Rehab for Post-Acute Stroke

The Impact of Vagus Nerve Stimulation on Improving Sleep for Individuals in an Inpatient Rehab Facility for Post-Acute Ischemic Stroke

The goal of this clinical trial is to learn if a device which provides vagal nerve stimulation, applied to the tragus of the ear via an ear clip, can improve sleep in individuals recovering from stroke while they are treated in a rehabilitation hospital. The main questions this study aims to answer are:

  1. Does using this device improve insomnia?
  2. Does this device have any impact on the person's stroke severity, mobility, self-care, or ability to think? Researchers will compare this treatment to a sham (a look-alike device that will not deliver the stimulation).

Participants will:

  • Complete questionnaires about insomnia and their ability to think
  • Use the device for 30 minutes every evening for at least 10 nights during their inpatient stay
  • Complete a log tracking their use of the device and any concerns

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

For this randomized control trial, all patients admitted to Casa Colina's acute rehabilitation unit with a diagnosis of stroke will be screened against inclusion and exclusion criteria. Participants will be assessed using a cognition screen via the Mini Mental Exam and the Insomnia Severity Index (ISI), a validated tool for measuring and grading the presence of insomnia. The initial assessments will be completed within the first 3-5 days from admission to the acute rehabilitation unit. Participants will be randomized into the intervention group or sham treatment group. All participants will receive a handout on sleep hygiene. All participants will be instructed around the use of the non-invasive taVNS Parasym device (by Parasym Ltd., London) and the training log which will include reporting of any side effects and any other personal bedtime routines to assist with sleep. In line with previous studies investigating the impact of taVNS on other post-stroke symptoms, the intervention group will be instructed to utilize the Parasym device for 30min daily between 7-9pm for at least 10 days following. Stimulation parameters will be set at 200µs pulse width (with proprietary waveform) and 20Hz. The intensity will be set to level 21 and increased up to 32 as tolerated, but reduced sequentially to intensity level 12 if unable to tolerate due to discomfort. They will include amplitudes 1.0-1.7mA for therapeutic thresholds previously studied in stroke research (Li 2022) and allow for uniformity of application of the device between treatment and sham groups. The sham treatment group will be instructed in using the Parasym device the same way, however, their issued devices will include a sham earpiece that will prevent the transmission of taVNS. Reassessment of the ISI will be completed at 12-15 days, or earlier if the patient discharges prior to this timeline. A short 2-week taVNS program has been reported to have some effect on insomnia (Liu 2025) in a non-stroke population and this timeline has also been chosen as it coincides with the current typical length of stay for individuals post stroke in the acute rehabilitation unit.

All participants of the study will continue to receive the usual care for their individual rehabilitation program including therapy and medication interventions. Additional data will be collected beyond the screening tests including demographic information, stroke location, time since stroke, history of prior stroke, history of diabetes, NIH stroke scale on admission, record of medications that may impact sleep, consult to neurology service, use of respiratory devices on admission or during their rehab course (supplemental O2, CPAP, BiPAP), and GG and C scores of the IRF-PAI for mobility, self-care, and cognition.

研究の種類

介入

入学 (推定)

52

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

  • 名前:Hannah Cone, PT, DPT, NCS
  • 電話番号:3111 9095967733
  • メール:HCone@casacolina.org

研究場所

    • California
      • Pomona、California、アメリカ、91767
        • Casa Colina Hospital and Centers for Healthcare
        • コンタクト:
        • コンタクト:
        • 主任研究者:
          • Marie Yeseta, PT, DPT, NCS

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  1. Admitted to Casa Colina's acute rehabilitation service
  2. Diagnosis of ischemic stroke
  3. Age 18 years or older
  4. English or Spanish speaking
  5. Sufficient cognition to follow program instructions tested Mini Mental Exam (score >17/30)
  6. Confirmed sleep abnormalities based on the Insomnia Severity Index (ISI) meeting criteria for subthreshold or clinical insomnia (score >7/28)

Exclusion Criteria:

  1. Hemorrhagic stroke or hemorrhagic conversion of ischemic stroke
  2. Other confirmed neurological diagnoses
  3. Previous surgical intervention on the vagus nerve
  4. Any open wound or cancerous lesions at the ear within 1 inch of the ear tragus
  5. Contraindication to the device, including patients with severe bradycardia, patients with a permanent implanted metallic or electronic device or jewelry at close proximity (2cm) to the ear tragus, patients with a recent (within 1 year) history of trigeminal neuralgia, pregnancy

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:ダブル

武器と介入

参加者グループ / アーム
介入・治療
実験的:transauricular Vagal Nerve Stimulation (taVNS)

Participants will be assessed for cognition via the Mini Mental Exam and the Insomnia Severity Index (ISI). The initial assessments will be completed within the first 3-5 days from admission to the acute rehabilitation unit. Participants will receive a handout on sleep hygiene. Participants will be instructed around the use of the non-invasive taVNS Parasym device (by Parasym Ltd., London) and the training log which will include reporting of any side effects and any other personal bedtime routines to assist with sleep. The participant will be instructed to utilize the Parasym device for 30min daily between 7-9pm for at least 10 days following. Reassessment of the ISI will be completed at 12-15 days, or earlier if the patient discharges prior to this timeline. These participants will continue to receive the usual care for their individual rehabilitation program including therapy and medication interventions.

All participants will be instructed around the use of the non-invasive taVNS Parasym device (by Parasym Ltd., London). Participants will be instructed to utilize the Parasym device for 30min daily between 7-9pm for at least 10 days following. Stimulation parameters will be set at 200µs pulse width (with proprietary waveform) and 20Hz. The intensity will be set to level 21 and increased up to 32 as tolerated, but reduced sequentially to intensity level 12 if unable to tolerate due to discomfort. They will include amplitudes 1.0-1.7mA for therapeutic thresholds.

偽コンパレータ:Sham transauricular Vagal Nerve Stimulation (Sham taVNS)

Participants will be assessed for cognition via the Mini Mental Exam and the Insomnia Severity Index (ISI). The initial assessments will be completed within the first 3-5 days from admission to the acute rehabilitation unit. Participants will receive a handout on sleep hygiene. Participants will be instructed around the use of the non-invasive taVNS Parasym device (by Parasym Ltd., London) and the training log which will include reporting of any side effects and any other personal bedtime routines to assist with sleep. The participant will be instructed to utilize the Parasym device for 30min daily between 7-9pm for at least 10 days following. For this group, their issued devices will include a sham earpiece that will prevent transmission of taVNS. The ISI will be re-assessed at 12-15 days, or earlier if the patient discharges prior to this timeline. Participants will continue to receive the usual care for their individual rehabilitation program, including therapy and medications.

All participants will be instructed around the use of the non-invasive taVNS Parasym device (by Parasym Ltd., London). Participants will be instructed to utilize the Parasym device for 30min daily between 7-9pm for at least 10 days following. Stimulation parameters will be set to the same parameters as for the experimental group, however his device will include a sham earpiece that will prevent the transmission of taVNS.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Insomnia Severity Index
時間枠:Initial assessment on Day 3-5 of their inpatient stay. Reassessment at 12-15 days, or earlier if the patient discharges prior to this timeline.

A brief screening tool for insomnia including seven items assessing the nature and symptoms of their sleep issues. Questions relate to the responder's sleep, symptom severity and satisfaction with their sleep, as well as the effect of their insomnia on daily function, social impact, and overall distress related to their sleep. Each question is answered on a 5-point Likert scale. Total scores range from 0-28, with a higher score indicating worse insomnia severity.

Initial assessment on Day 3-5 of their inpatient stay. Reassessment at 12-15 days, or earlier if the patient discharges prior to this timeline.

二次結果の測定

結果測定
メジャーの説明
時間枠
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Admission and Discharge Scores - GG and C sections
時間枠:Assessed within 48 hours of admission, re-assessed at discharge (with a typical length of stay of 12 to 15 days).

Standardized assessments by the healthcare team regarding level of assistance required by the participant for mobility, self-care, and cognition. The GG section assesses self-care (7 items) and mobility (17 items) on a scale from 1-6, with a higher number indicating greater independence. If a participant is unwilling or unsafe to perform an activity, or if the activity is not applicable or there is an environmental limitation, special codes can be applied.

The C section of the IRF-PAI assesses cognition via the Brief Interview for Mental Status comprising repetition of 3 words, temporal orientation, and recall. Participants are scored in this section from 1-15 with a higher score indicating better cognition. The presence of any acute-onset mental status change is considered here.

Assessed within 48 hours of admission, re-assessed at discharge (with a typical length of stay of 12 to 15 days).

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • スタディディレクター:Emily Rosario, PhD、Casa Colina Hospital and Centers for Healthcare

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年10月16日

一次修了 (推定)

2027年10月16日

研究の完了 (推定)

2027年12月16日

試験登録日

最初に提出

2026年9月29日

QC基準を満たした最初の提出物

2026年9月29日

最初の投稿 (実際)

2026年10月5日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月8日

QC基準を満たした最後の更新が送信されました

2026年10月6日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • SleepVNS

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

はい

米国で製造され、米国から輸出された製品。

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。