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

21 oktober 2019 uppdaterad 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

58

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

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

Exclusion Criteria:

  • None

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Beteende: 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.
Övrig: Treatment as Usual
Treatment as Usual. (After about ten weeks, participants in this condition are offered the experimental group treatment.)
Övrig: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Insomnia Severity Index
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Actigraphy
Tidsram: 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
Tidsram: 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

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Brunnsviken brief quality of life scale
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Karolinska Institutet

Samarbetspartners

Department of ADHD, Northern Stockholm Psychiatry

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 december 2016

Primärt slutförande (Faktisk)

21 november 2018

Avslutad studie (Faktisk)

21 november 2018

Studieregistreringsdatum

Först inskickad

6 januari 2017

Först inskickad som uppfyllde QC-kriterierna

9 januari 2017

Första postat (Uppskatta)

10 januari 2017

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

23 oktober 2019

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

21 oktober 2019

Senast verifierad

1 oktober 2019

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 2016/1988-31

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

OBESLUTSAM

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Kliniska prövningar på ADHD

Kliniska prövningar på Adjusted CBT-i for ADHD

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