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Electrophysiological Analysis of Gamma-Hydroxybutyrate-induced Sleep in Intensive Care Patients (GAMMA-SLEEP)

20 de maio de 2026 atualizado por: Assistance Publique - Hôpitaux de Paris

Electrophysiological Analysis of Gamma-Hydroxybutyrate-induced Sleep in Intensive Care Patients: A Pilot Double-Blind Randomized Controlled Trial

In intensive care, sleep disturbances are extremely common and represent a major source of discomfort for patients. Restorative sleep is very limited. Beyond being the primary source of discomfort reported by patients, these sleep disturbances are associated with difficulties in weaning from mechanical ventilation, an increased risk of delirium, and potentially higher mortality. Traditional treatments artificially increase the total duration of sleep but lead to disrupted sleep architecture.

Gamma-hydroxybutyrate (GHB) is currently used for several sleep disorders, such as narcolepsy, due to its ability to increase restorative sleep. This medication has been used for years as a sedative in intensive care. Despite these potential benefits, the efficacy of GHB has never been evaluated for sleep disturbances in intensive care settings.

This study focuses on evaluating the effectiveness of intravenous Gamma-hydroxybutyrate (GHB) in the treatment of sleep disorders in intensive care.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

In intensive care, sleep disturbances are extremely common and represent a major source of discomfort for patients. While the total duration of sleep is minimally affected, deep slow-wave sleep (N3) is significantly underrepresented. Beyond being the primary source of discomfort reported by patients, these sleep disturbances are associated with difficulties in weaning from mechanical ventilation, an increased risk of delirium, and potentially higher mortality. Traditional treatments with benzodiazepines or propofol artificially increase the total duration of sleep but lead to disrupted sleep architecture.

Gamma-hydroxybutyrate (GHB) is currently used for several sleep disorders, such as narcolepsy, due to its ability to reduce sleep onset latency, increase deep slow-wave sleep (N3), improve sleep quality, and enhance daytime alertness scores. Despite these potential benefits, the efficacy of GHB has never been evaluated for sleep disturbances in intensive care settings.

This study focuses on evaluating the effectiveness of intravenous Gamma-hydroxybutyrate (GHB) in the treatment of sleep disorders in intensive care. The primary objective of this pilot study is to show that the intravenous administration of GHB improves the duration (in minutes) of deep slow-wave sleep (N3 stage) in critically ill adult patients compared to a placebo

Tipo de estudo

Intervencional

Inscrição (Estimado)

24

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

  • França
    • Île-de-France Region
      • Paris, Île-de-France Region, França, 75013
        • Intensive Care Unit, Hospital Pitié Salpêtrière
        • Contato:

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  1. Aged 18 years or older
  2. Hospitalized in the ICU for more than 48 hours
  3. Informed consent obtained from the patient

Exclusion Criteria:

  1. Unstable patient
  2. Known allergy to Gamma-Hydroxybutyrate or any of the excipients
  3. Technical impossibility of performing polysomnography
  4. Childbearing or Positive pregnancy test for women of childbearing age or breastfeeding
  5. Patient who has already received the study treatment
  6. History of chronic alcoholism
  7. Uncontrolled epilepsy despite appropriate antiepileptic treatment
  8. Traumatic brain injury or neurological lesion at risk of epilepsy in the last month
  9. Severe hypertension: SBP > 180 mmHg despite antihypertensive treatment
  10. Hypokalemia < 3.5 mmol/L despite potassium supplementation
  11. Bradycardia due to intra-cardiac conduction disorders
  12. Obstructive sleep apnea syndrome
  13. Sodium restriction: Salt intake < 3g/24h
  14. Patients with known or suspected succinic semialdehyde dehydrogenase (SSADH) deficiency, given the risk of GHB accumulation due to impaired endogenous metabolism.
  15. Patients receiving barbiturates at inclusion
  16. Patients receiving opioids at inclusion for non-mechanically ventilated patient
  17. Patients presenting with hypernatraemia (sodium > 145 mmol/L) or hyperchloraemia (chloride > 110 mmol/L) at inclusion
  18. Patients with hepatic impairment (Child-Pugh B or C)
  19. Deep sedation defined by a RASS score < -2
  20. Presence of mental confusion: Positive CAM-ICU
  21. Moribund patient or high likelihood of death within 48 hours
  22. Legal protection: guardianship, curatorship, or judicial protection
  23. Lack of social security or on AME (state medical aid)
  24. Participation in another interventional clinical trial related to the management of sleep disorders, delirium, or sedation in the ICU.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Quadruplicar

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: GHB
Intravenous GHB (Gamma-OH) will be administered at a dose of 15 mg/kg as induction over 20 minutes (in a 100 mL NaCl bag), followed by a continuous infusion of 10 mg/kg/h over 8 hours (via an electric syringe pump) from 10:00 PM to 6:00 AM for one night.
Medicamento: GHB
Administration of GHB intravenously with a induction followed by a maintenance dose for 8 hours.
Comparador de Placebo: Control
A placebo in the form of 0.9% NaCl (as Gamma-OH is transparent and completely soluble), administered intravenously as a induction (after a dilution in a 100 mL NaCl bag) and then continuously (without dilution via an electric syringe pump) for 8 hours from 10:00 PM to 6:00 AM for one night.
Medicamento: Placebo
Administration of a placebo in the form of 0.9% NaCl intravenously, with a induction followed by a maintenance infusion for 8 hours.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Deep slow-wave sleep
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
The primary endpoint is the duration (in minutes) of deep slow-wave sleep (N3 stage) based on polysomnographic recordings.
During the night between the day of enrollment (Day0) and the next day (Day 1).

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Sleep onset latency
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Total sleep time
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Duration of N1 stage
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Percentage of N1 stage
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1)
During the night between the day of enrollment (Day0) and the next day (Day 1)
Duration of N2 stage
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Percentage of N2 stage
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1)
During the night between the day of enrollment (Day0) and the next day (Day 1)
Percentage of N3 stage
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Duration of Rapid Eye Movement sleep
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Percentage of Rapid Eye Movement sleep
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1)
During the night between the day of enrollment (Day0) and the next day (Day 1)
Number of intra-sleep wakefulness.
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
Intra-sleep wakefulness is defined as a period of wakefulness between sleep phases. The quantification of intra-sleep wakefulness corresponds to the number of awakenings during the night.
During the night between the day of enrollment (Day0) and the next day (Day 1).
Duration of atypical sleep.
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
Duration of atypical sleep relative to the total sleep time. Atypical sleep is defined as slow-wave sleep equivalent to N2 stage but without sleep spindles or K-complexes
During the night between the day of enrollment (Day0) and the next day (Day 1).
Percentage of atypical sleep
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1)
Percentage of atypical sleep relative to the total sleep time. Atypical sleep is defined as slow-wave sleep equivalent to N2 stage but without sleep spindles or K-complexes
During the night between the day of enrollment (Day0) and the next day (Day 1)
Duration of pathological wakefulness
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
Duration of pathological wakefulness relative to the total sleep time is defined as rapid eye movements and chin EMG activity associated with slow delta wave EEG activity
During the night between the day of enrollment (Day0) and the next day (Day 1).
Percentage of pathological wakefulness
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1)
Percentage of pathological wakefulness relative to the total sleep time is defined as rapid eye movements and chin EMG activity associated with slow delta wave EEG activity
During the night between the day of enrollment (Day0) and the next day (Day 1)
Number of micro-awakenings.
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
Micro-awakenings are defined as an abrupt change in EEG frequency (fromdelta-theta to theta-alpha) lasting 3 to 15 seconds in a patient who has been asleep for more than 10 seconds, with or without an increase in chin EMG activity during slow-wave sleep and with an activation lasting more than one second during REM sleep.
During the night between the day of enrollment (Day0) and the next day (Day 1).
Sleep efficiency
Prazo: During the night between the day of enrollment (Day0) and the next day (Day 1).
is defined as total sleep time relative to the sleep period (corresponding to total sleep time + intra-sleep wakefulness).
During the night between the day of enrollment (Day0) and the next day (Day 1).
Average sleep latency during the Maintenance of Wakefulness Test
Prazo: On the day after enrollment ( Day 1)
On the day after enrollment ( Day 1)
Analgesic consumption
Prazo: From the day after enrollment (Day 1) to two days after enrollment (Day 2)
Morphine equivalent quantification of analgesic consumption (mg) over the 24 hours following the study night.
From the day after enrollment (Day 1) to two days after enrollment (Day 2)
Adverse event assessment
Prazo: From the day of enrollment (Day 0) to the end of follow-up (Day 2)
All adverse events will be recorded during the study with special attention to potential side effects of GHB
From the day of enrollment (Day 0) to the end of follow-up (Day 2)
Self-assessment questionnaire of the quality of sleep
Prazo: On the day after enrollment ( Day 1)
Questionnaire of the quality of sleep :Richard-Campbell Sleep Questionnaire. min : 0 max : 100 Higher is a better outcome
On the day after enrollment ( Day 1)
Hetero-evaluation questionnaire of the quality of sleep
Prazo: On the day after enrollment ( Day 1)
min : 0 max : 4 Higher is a worse outcome
On the day after enrollment ( Day 1)
Daytime vigilance score
Prazo: On the day after enrollment ( Day 1)
Karolinska Sleepiness scale min : 1 max : 9 Higher is a worse outcome
On the day after enrollment ( Day 1)
Participation in rehabilitation
Prazo: From the day after enrollment (Day 1) to two days after enrollment (Day 2)

Assessment of rehabilitation participation by the physiotherapy team using a visual analog scale.

min : 0 max : 100 Higher is a better outcome
From the day after enrollment (Day 1) to two days after enrollment (Day 2)

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Assistance Publique - Hôpitaux de Paris

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de junho de 2026

Conclusão Primária (Estimado)

1 de outubro de 2027

Conclusão do estudo (Estimado)

1 de outubro de 2027

Datas de inscrição no estudo

Enviado pela primeira vez

30 de abril de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

12 de maio de 2026

Primeira postagem (Real)

19 de maio de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

22 de maio de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

20 de maio de 2026

Última verificação

1 de maio de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • APHP241595
  • 2025-521967-11-00 (Ctis)

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano IPD

The procedures carried out with the French data privacy authority (CNIL, Commission nationale de l'informatique et des libertés) do not provide for the transmission of the database, nor do the information and consent documents signed by the patients.

Consultation by the editorial board or interested researchers of individual participant data that underlie the results reported in the article after deidentification may nevertheless be considered, subject to prior determination of the terms and conditions of such consultation and in respect for compliance with the applicable regulations.

Prazo de Compartilhamento de IPD

Beginning 3 months and ending 3 years following article publication. Requests out of these time frame can also be submitted to the sponsor

Critérios de acesso de compartilhamento IPD

Researchers who provide a methodologically sound proposal

Tipo de informação de suporte de compartilhamento de IPD

  • PROTOCOLO DE ESTUDO
  • SEIVA
  • CIF

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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