MedPath

The Efficacy of a Transdiagnostic Sleep and Circadian Intervention for Patients With Mental Disorders and Sleep Problems

Not Applicable
Conditions
Depression
Bipolar Affective Disorder
Attention Deficit Disorder
Interventions
Behavioral: Transdiagnostic sleep and circadian treatment
Behavioral: Active waitlist control group
Registration Number
NCT05406414
Lead Sponsor
University of Aarhus
Brief Summary

The aim of this study is to examine the effect of a non-pharmacological transdiagnostic sleep intervention as add on to standard treatment for bipolar disorder, depression and attention deficit disorder. Our hypothesis is that the intervention will reduce the severity of the sleep problem and increase sleep quality compared to a control group receiving sleep hygiene education.

Detailed Description

Sleep problems include insomnia, circadian rhythm disorders, hypersomnia, and inadequate sleep hygiene. Patients suffering from mental illness are more likely to suffer from sleep problems than the general population. Sleep problems can aggravate the underlying disorder, cause relapse and suicidal ideation. Sleep problems often persist after the mental disorder is successfully treated. Sleep medication is often used but not recommended for long term use. Non-pharmacological treatment of sleep problems is in demand by patients, but treatment options are few. The present intervention is based on a transdiagnostic manual combining Cognitive Behavioral Therapy for Insomnia with chronotherapy, but more research on the efficacy is warranted.

The aim of this study is to investigate whether the intervention reduces the severity of the sleep problem, increases sleep quality, leads to increased sleep efficiency, reduces sleep latency and awakenings, provides better quality of life, increases personal recovery, provides greater readiness to take on a job or reduces consumption of sleep medication.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
88
Inclusion Criteria
  • Age ≥18 years

  • F31 Bipolar disorder, F32 unipolar depression or F90 attention deficit disorder

  • Insomnia Severity Index (ISI) ≥ 14 (exceeding the threshold for a sleep problem)

  • Sleep problems for 3 months: 3 times a week at least one of the following:

    • Sleep onset latency ≥ 30 minutes
    • Wake after sleep onset ≥ 30 minutes
    • Total sleep time ≥ 11 hours per day
    • Displaced circadian rhythm; sleeps earlier than 8 P.M. or later than 02 A.M.
    • Irregular circadian rhythm; bedtime varies ≥ 3 hours throughout the week
Exclusion Criteria
  • Acutely increased suicide risk (Central Regions guideline for assessment of suicide risk)
  • Active substance abuse (F10-19)
  • The sleep problem can be significantly explained by insufficient treatment of physical
  • disease affecting sleep (documented in patients electronic journal)
  • Unstable social situation (does not have a permanent residence)
  • Shift work (≥ 2 times a week for the last 2 months)
  • Pregnancy and breast-feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Transdiagnostic sleep and circadian treatmentTransdiagnostic sleep and circadian treatmentThe intervention group receives sleep treatment consisting of 6 sessions of 60 minutes each over 6 weeks.
Active waitlist control groupActive waitlist control groupThe control group receives sleep hygiene education
Primary Outcome Measures
NameTimeMethod
Change in sleep quality.Is measured at inclusion (baseline/ week 0) and at week 6 (endpoint).

Measured by Pittsburgh Sleeping Quality Index (PSQI). The score is between 0 and 21, "0" indicating no difficulty and "21" indicating severe difficulties.

Change in the severity of the sleep problemIs measured at inclusion (baseline/ week 0), at week 2 and at week 6 (endpoint)

Is measured by Insomnia Severity Index. A self-report instrument measuring the patient's perception of insomnia. The scale ranges from 0 to 28. The higher the score the more severe the insomnia.

Secondary Outcome Measures
NameTimeMethod
Change in well-beingIs measured at inclusion (baseline/ week 0), at week 2 and at week 6 (endpoint

Measured on The WHO-5 Well-Being Index (WHO-5). A questionnaire which measures well-being on a scale ranging from 0 to 100, the higher the score the more well-being.

Changes in sleep latencyIs measured daily during the 6 week study period

Is calculated based on the participant's registrations in sleep diaries and by measurements from actigraphs.

Changes in sleep nocturnal awakeningsIs measured daily during the 6 week study period.

Is calculated based on the participant's registrations in sleep diaries and by measurements from actigraphs.

Change in readiness to take on a jobIs measured at inclusion (baseline/ week 0), at week 2 and at week 6 (endpoint)

Measured by the questionnaire, The Work Ability Index. A score of 0 shows the lowest possibility that the person would take on a job, the score 10 is the highest possibility

Change in consumption of sleep medicationsIs registered daily during the 6 week study period

Daily use of sedatives and hypnotics will be measured by medication registration use in sleep diaries during the study period.

Level of personal recoveryIs measured at inclusion (baseline/ week 0), at week 2 and at week 6 (endpoint).

Measured by the questionnaire INSPIRE-O. A questionnaire which measures personal recovery on a scale ranging from 5 to 25, the higher the score the more recovery.

Changes in health-related items.Is measured at inclusion (baseline/ week 0), at week 2 and at week 6 (endpoint)

The International EQ-5D-5L questionnaire is applied to estimate quality-adjusted years of life.

Changes in sleep efficiencyIs measured daily during the 6 week study period.

Is calculated based on the participant's registrations in sleep diaries and by measurements from actigraphs.

Trial Locations

Locations (1)

Mette Kragh

🇩🇰

Aarhus C, Denmark

© Copyright 2025. All Rights Reserved by MedPath