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Sleep and Arterial Function in Hypertensive Patients With Poor Sleep Quality (SLEEP-ARTerY)

24. august 2026 oppdatert av: Unidade Local de Saúde do Alto Ave, EPE

Impact of Sleep on Arterial Function, Psychological and Cognitive Complaints in Hypertensive Patients With Poor Sleep Quality

This prospective, parallel-group randomised controlled trial evaluates whether cognitive-behavioural therapy for insomnia (CBT-I) improves arterial function and psychological and cognitive outcomes in hypertensive patients with poor sleep quality. Adults aged 18-70 with controlled hypertension and poor baseline sleep quality (sleep efficiency <=85%) are randomised 1:1 to CBT-I (four weekly 60-minute sessions) or passive sleep education. The primary outcomes are change from baseline in pulse wave velocity and central arterial pressure at 12 months. Secondary outcomes include blood pressure, depressive symptoms, perceived stress, cognitive complaints, and sleep quality, assessed at baseline, 1, 6, and 12 months.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

234

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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

Studiekontakt

Studiesteder

  • Portugal
    • Braga District
      • Guimarães, Braga District, Portugal, 4835-044
        • Rekruttering
        • Unidade Local de Saúde do Alto Ave - Hospital Senhora da Oliveira
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Sofia Gomes
        • Underetterforsker:
          • Ana Daniela Ferreira

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

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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

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: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Atferdsmessig: Behavioral: Cognitive-Behavioural Therapy for Insomnia (CBT-I)
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).
Aktiv komparator: Passive sleep education
Informational leaflets plus non-interactive follow-up calls. Control participants are offered CBT-I after study completion.
Atferdsmessig: Passive sleep education
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change from baseline in pulse wave velocity (PWV)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in carotid-femoral pulse wave velocity (m/s), a marker of arterial stiffness.
Baseline, 1 month, 6 months, and 12 months
Change from baseline in central arterial pressure (CAP)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in central arterial pressure (mmHg).
Baseline, 1 month, 6 months, and 12 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change from baseline in blood pressure
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in systolic and diastolic blood pressure (mmHg)
Baseline, 1 month, 6 months, and 12 months
Change from baseline in body weight
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in body weight (kg).
Baseline, 1 month, 6 months, and 12 months
Change from baseline in body mass index (BMI)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in body mass index (kg/m^2).
Baseline, 1 month, 6 months, and 12 months
Change from baseline in depressive symptoms (MADRS)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
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.
Baseline, 1 month, 6 months, and 12 months
Change from baseline in depressive symptoms (PHQ-9)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
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.
Baseline, 1 month, 6 months, and 12 months
Change from baseline in perceived stress (PSS)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in perceived stress measured by the Perceived Stress Scale (PSS). Higher scores indicate greater perceived stress.
Baseline, 1 month, 6 months, and 12 months
Change from baseline in cognitive function (MoCA)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
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.
Baseline, 1 month, 6 months, and 12 months
Change from baseline in sleep quality (PSQI)
Tidsramme: Baseline, 1 month, 6 months, and 12 months
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.
Baseline, 1 month, 6 months, and 12 months
Change from baseline in sleep efficiency
Tidsramme: Baseline, 1 month, 6 months, and 12 months
Change from baseline in sleep efficiency (%) assessed via actigraphy or type II polysomnography.
Baseline, 1 month, 6 months, and 12 months

Samarbeidspartnere og etterforskere

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

Sponsor

Unidade Local de Saúde do Alto Ave, EPE

Etterforskere

  • Hovedetterforsker: Sofia Gomes, MD, Unidade Local de Saúde do Alto Ave
  • Studieleder: Pedro Cunha, PhD, Unidade Local de Saúde do Alto Ave

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 (Faktiske)

18. mai 2026

Primær fullføring (Antatt)

1. desember 2029

Studiet fullført (Antatt)

1. mars 2030

Datoer for studieregistrering

Først innsendt

24. august 2026

Først innsendt som oppfylte QC-kriteriene

24. august 2026

Først lagt ut (Faktiske)

27. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

27. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

24. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CIC20260049 - CAIDIS (Annen identifikator: ULSAAVE Ethics Committee)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

IPD-planbeskrivelse

A data-sharing plan has not yet been established. Decisions regarding whether and how individual participant data will be shared will be made by the sponsor and investigators, in accordance with institutional policies, ethics committee requirements, and applicable data protection regulations (GDPR). The record will be updated once a decision has been made.

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Nei

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