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- Ensaio Clínico 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
Visão geral do estudo
Status
Descrição detalhada
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.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Sofia Gomes, MD
- Número de telefone: + 351 253540330
- E-mail: 3603@ulsaave.min-saude.pt
Locais de estudo
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Braga District
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Guimarães, Braga District, Portugal, 4835-044
- Recrutamento
- Unidade Local de Saúde do Alto Ave - Hospital Senhora da Oliveira
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Contato:
- Sofia Gomes, MD
- Número de telefone: +351 253 540 330
- E-mail: 3603@ulsaave.min-saude.pt
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Contato:
- Pedro Cunha, PhD
- Número de telefone: +351 253 540 330
- E-mail: pedrocunha@ulsaave.min-saude.pt
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Investigador principal:
- Sofia Gomes
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Subinvestigador:
- Ana Daniela Ferreira
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Dobro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: 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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Comparador Ativo: 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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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline in pulse wave velocity (PWV)
Prazo: 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)
Prazo: 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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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline in blood pressure
Prazo: 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
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Sofia Gomes, MD, Unidade Local de Saúde do Alto Ave
- Diretor de estudo: Pedro Cunha, PhD, Unidade Local de Saúde do Alto Ave
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- CIC20260049 - CAIDIS (Outro identificador: ULSAAVE Ethics Committee)
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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