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Better Sleep in Psychiatric Care - ADHD. (BSIP-ADHD)

21. oktober 2019 oppdatert av: Susanna Jernelöv, Karolinska Institutet

Better Sleep in Psychiatric Care - ADHD. A Randomized Naturalistic Study of a Psychological Group Treatment for Sleep Problems in Psychiatric Patients With Attention Deficit Hyperactivity Disorder.

Cognitive Behavioral Therapy (CBT) is treatment of choice for insomnia (CBT-i). Many patients in psychiatric care have sleep problems including insomnia, but are rarely given the choice to participate in CBT to improve their sleep. Patients with ADHD is a patient group with high levels of sleep difficulties. Sleep problems in this patient group can be both more general such as insomnia, but can also be related to the ADHD itself and to the use of ADHD medication. In a previous pilot study, the investigators developed a version of CBT-i that would target sleep problems in this population. The basis was CBT-i, but with more emphasis on sleep promoting behaviors specific to ADHD (e.g. appropriate timing of ADHD-medication), techniques that would also alleviate sleep phase problems, (e.g. the systematic use of light and darkness), and techniques to target more general sleep disturbing habits (e.g. not winding down before bed time), that are also common in patients with ADHD. This treatment was well tolerated and gave moderate effects on insomnia severity in the pilot study. In a naturalistic randomized controlled trial, the investigators now evaluate the effects of this psychological treatment on sleep and symptoms of ADHD in patients at the ADHD-clinics, Northern Stockholm Psychiatry, Sweden.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

58

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Sverige
      • Stockholm, Sverige, 113 21
        • Department of ADHD, Northern Stockholm Psychiatry

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Being a patient at the ADHD-clinics Northern Stockholm Psychiatry
  • Experiencing sleep problems (subjective report)

Exclusion Criteria:

  • None

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Behavioral: Adjusted CBT-i for ADHD
Cognitive Behavioral group intervention for sleep problems in ADHD, based on Cognitive Behavioral Therapy for insomnia and behavioral treatment for Sleep Phase Disorders.
Atferdsmessig: Adjusted CBT-i for ADHD
This is a version of CBT for insomnia (CBT-i) developed during the pilot phase of this Project. Traditional CBT-i is adjusted for use in the adult ADHD population. This behavioral intervention adresses not only traditional aspects of insomnia, but also sleep phase problems and other aspects of sleep specifically relevant to the ADHD-population. Treatment is given as 10 weekly group sessions with telephone calls from the therapist between sessions to increase adherence and adress individual patient needs.
Annen: Treatment as Usual
Treatment as Usual. (After about ten weeks, participants in this condition are offered the experimental group treatment.)
Annen: Treatment as Usual
Usual care at the ADHD-clinic. This mostly entails managing pharmacological treatment for ADHD, comorbid psychiatric problems and/or sleep problems. The clinic also provides different group treatments, for instance mindfulness groups and groups for developing behavioral strategies for managing ADHD symptoms, and individual therapy.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Insomnia Severity Index
Tidsramme: Changes from base-line to 10 weeks and 3 months
7-item, self-rated questionnaire measuring change in insomnia severity.
Changes from base-line to 10 weeks and 3 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Actigraphy
Tidsramme: Continuously from treatment start (week 1) to the last week of treatment (week 10)
An actigraph is placed on the participant's arm for one week. It measures participants' activity in the form of movements. It can be used for acquiring data on sleep and daytime activity, including calculated sleep latency, total sleep time, sleep efficiency, wake after sleep onset, variability in sleep timing and daytime activity.
Continuously from treatment start (week 1) to the last week of treatment (week 10)
Sleep diary
Tidsramme: Changes from base-line to 10 weeks and 3 months
Daily self-ratings on a number of sleep parameters, resulting in several measures including sleep latency, wake after sleep onset, total sleep time, sleep efficiency, subjective sleep quality and variability in sleep timing
Changes from base-line to 10 weeks and 3 months

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Brunnsviken brief quality of life scale
Tidsramme: Changes from base-line to 10 weeks and 3 months
12-items self-rating questionnaire measuring quality of life.
Changes from base-line to 10 weeks and 3 months
Adult ADHD Self-Report Scale
Tidsramme: Changes from base-line to 10 weeks and 3 months
18-items self-report questionnaire measuring ADHD-symptoms.
Changes from base-line to 10 weeks and 3 months
Dysfunctional Beliefs and Attitudes about Sleep
Tidsramme: Changes from base-line to 10 weeks and 3 months
10-items self-rating questionnaire measuring sleep related cognitions.
Changes from base-line to 10 weeks and 3 months
Sleep Problems Acceptance Questionnaire
Tidsramme: Changes from base-line to 10 weeks and 3 months
8-items self-rating questionnaire measuring acceptance of sleep problems.
Changes from base-line to 10 weeks and 3 months
Sleep habits and behaviors
Tidsramme: Changes from base-line to 10 weeks and 3 months
Self-rating questionnaire regarding the use of sleep promoting behaviors. The questionnaire was constructed for the current project and consists of two parts. The first part includes 16 statements such as "Last week I got out of bed within 15 minutes of waking up" to be answered by number of days the last week this was true (i.e. from 0 to 7). The other part is to be answered on a 6-point Likert scale from "Not at all true" to "Entirely true", with 7 statements like "I get out of bed the same time every morning".
Changes from base-line to 10 weeks and 3 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Karolinska Institutet

Samarbeidspartnere

Department of ADHD, Northern Stockholm Psychiatry

Etterforskere

  • Hovedetterforsker: Susanna Jernelöv, PhD, LP, Karolinska Institutet

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. desember 2016

Primær fullføring (Faktiske)

21. november 2018

Studiet fullført (Faktiske)

21. november 2018

Datoer for studieregistrering

Først innsendt

6. januar 2017

Først innsendt som oppfylte QC-kriteriene

9. januar 2017

Først lagt ut (Anslag)

10. januar 2017

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

23. oktober 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. oktober 2019

Sist bekreftet

1. oktober 2019

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 2016/1988-31

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

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Kliniske studier på ADHD

Kliniske studier på Adjusted CBT-i for ADHD

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