Sleep in Cardiac Patients With Implantable Cardioverter Defibrillators (ICD)
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 3
- 试验地点
- 2
- 主要终点
- Change in subjective and objective sleep
研究概览
简要总结
This is a single-center, randomized controlled trial study design. Enrolled participants have a cardiovascular condition for which they are undergoing implantable cardioverter defibrillator (ICD) therapy and comorbid insomnia. Participants were randomized to a behavioral intervention for insomnia in ICD patients or a waitlist control. The treatment intervention period lasted 4 weeks with a telephone booster session administered at 3 month follow-up. The objective of the study is to examine the impact of a brief therapy combining established behavioral approaches to treating insomnia with novel components to target negative cognitions and anxieties associated with cardiac disease and ICD implantation. Primary patient outcomes include sleep, psychological functioning, daytime functioning, cardiac functioning, cognitive performance, and ICD adjustment.
详细描述
Participants will be asked to review the informed consent form and consent to the study prior to beginning any study procedure.
There are six phases of this study: (1) an in-person interview, (2) an in-home single night sleep recording, (3) a two-week baseline period, (4) a 4-week treatment period, (5) a follow-up period immediately after the completion of treatment, (6) and a two-week follow-up period 3-months after the treatment period.
During the interview, participants will be asked questions about their sleep, cardiac, and ICD history. Participants will then visit the University of Florida for a medical history and will be connected to machinery to monitor their sleep. Participants will return home to sleep while still connected to the machine and will return the machine to the University of Florida the next day. A third visit will consist of completing questionnaires and a computerized neurocognitive performance battery to assess several areas of cognitive functioning. Participants will then go home and with brief daily diaries to complete for two weeks while also wearing an actigraph (wristwatch-like device) that measures arm movements to detect sleep/wake during that time.
Participants will then be randomized to (a) the brief cognitive behavioral therapy for insomnia (CBTi) in ICD patients group or (b) the waitlist control group. The treatment consists of 2 weeks of in-person therapy and 2 weeks of therapy conducted over the telephone. Participants assigned to waitlist control will be offered therapy at no cost at the end of the study. Throughout the 4 treatment weeks, participants in both groups will be asked to complete daily sleep diaries.
A follow-up period consisting of two weeks, during which participants will wear the actigraph and complete daily sleep diaries, will take place immediately after treatment completion. Participants will travel to the University two times during this follow-up period in order to pick-up and then return the actigraph and sleep diaries, and will once again complete the questionnaires and neurocognitive testing battery at the end of the 2nd visit. A final follow-up period will occur 3-months following treatment, which will involve visits to the University to pick up the daily sleep diaries and actigraph for sleep monitoring, and then returning these items after completion 2-weeks later. Upon returning the diary and actigraph, participants will complete questionnaires and then be debriefed by study personnel.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Current ICD implantation (single or dual lead ICD, ICD and pacemaker)
- •Diagnosis of insomnia
- •No sleep medications for at least 1 month, or stable on medications for at least 6 months
- •Willing to be randomly assigned to treatment
- •Able to read and understand English
排除标准
- •Sleep disorder other than insomnia
- •Significant medical condition other than cardiac disease
- •Severe untreated psychopathology
- •Neurological disorder
- •Cognitive impairment
结局指标
主要结局
Change in subjective and objective sleep
时间窗: Change from baseline to the two study follow-ups (immediately and 3-months following treatment)
Sleep diary and actigraphy-derived sleep parameters (averaged over each 14-day data collection period at baseline, post-treatment, and at 3-month follow-up) including: time to fall asleep (sleep onset latency), wake time during the night (waketime after sleep onset), total sleep time, amount of time spent in bed sleeping (sleep efficiency), total nap time, and sleep quality rating.
次要结局
- Change in psychological functioning(Change from baseline to the two follow-up periods (immediately and 3-months following treatment))
- Change in daytime functioning(Change from baseline to the two follow-up periods (immediately and 3-months following treatment))
- Change in quality of life(Change from baseline to the two follow-up periods (immediately and 3-months following treatment))
- Change in cardiac functioning(Change from baseline to the two follow-up periods (immediately and 3-months following treatment))
- Change in device adjustment(Change from baseline to the two follow-up periods (immediately and 3-months following treatment)
- Change in cognitive functioning(Change from baseline to immediately after treatment)