Insomnia Prevalence and Treatment Impact on Systemic Hypertension
Overview
- Phase
- Phase 4
- Intervention
- sleep hygiene
- Conditions
- Insomnia
- Sponsor
- University of Sao Paulo
- Enrollment
- 5
- Locations
- 1
- Primary Endpoint
- Efficacy of insomnia treatment on blood pressure (evaluated by Ambulatory blood pressure monitoring)
- Status
- Terminated
- Last Updated
- 3 years ago
Overview
Brief Summary
Insomnia is defined as some difficulty in sleep onset, consolidation, duration, or quality, despite appropriate opportunities for getting sleep. In the last decade, there is growing evidence associating insomnia and high blood pressure, (HBP), coronary disease, heart failure, atrial fibrillation, as well as with an increased mortality rate. Despite the previously mentioned advances, the real impact of insomnia on HBP is unknown. It is unclear whether the diagnosis and pharmacologic treatment of insomnia will have an impact on 24-h BP. The aim of this study is to outline the prevalence of insomnia in patients with HBP followed in the ambulatories from the Hypertension Units at InCor and Hospital das Clínicas. The main hypothesis is that the prevalence of insomnia is high and most patients remain undiagnosed and consequently untreated. For this phase, up to 1,500 patients with HBP will be selected. Besides the medical records with demographic and anthropometric data, personal and familiar background, as well as regular medication, all patients will perform three systematic and standardized blood pressure checks on electric monitors.
Detailed Description
Prevalence of insomnia in patients with HBP The aim of this study is to outline the prevalence of insomnia in patients with HBP followed by the outpatients' clinics at the InCor and Hospital das Clínicas. The main hypothesis is that the prevalence of insomnia is high and most patients remain undiagnosed and consequently untreated. For this phase, up to 1,500 patients with HBP will be recruited. Besides the medical records with demographic and anthropometric data, personal and familiar background, as well as regular medication, all patients will perform three systematic and standardized blood pressure checks on electric monitors. The average of the second and third checks will be the final result. Furthermore, the following exams will be made: 1. Definition of the presence of insomnia following the criteria from DSM V and filling up the insomnia severity index. 2. Evaluation of the Pittsburgh Sleep Quality Index. 3. Evaluation of obstructive sleep apnea by NoSAS score. 4. Evaluation of daytime sleepiness by the Epworth Sleepiness Scale. 5. Filling the DDAS form for evaluation of perception and impact of insomnia on the life of HBP patients. 6. Filling the Beck form for depression evaluation. The clinical characteristics of HBP patients with and without insomnia will be compared testing the hypothesis that patients with insomnia will be under more blood pressure medications and/or uncontrolled bllod pressure than patients without insomnia. If positive, a multivariate analysis will be performed for adjusting for counfonding factors.
Investigators
Luciano F Drager, MD, PhD
Principal Investigator
University of Sao Paulo
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
Control Group
Sleep hygiene alone (control group)
Intervention: sleep hygiene
Intervention Group
Sleep Hygiene and Ramelteone (RozeremTM) 8 mg at night
Intervention: Ramelteon (RozeremR)
Intervention Group
Sleep Hygiene and Ramelteone (RozeremTM) 8 mg at night
Intervention: sleep hygiene
Outcomes
Primary Outcomes
Efficacy of insomnia treatment on blood pressure (evaluated by Ambulatory blood pressure monitoring)
Time Frame: 3 months
To assess the impact of treatment of early insomnia with ramelteon on daytime and nighttime blood presure (in mmHg) in hypertensive patients on 24-hour evaluation of ambulatory blood pressure monitoring.
Secondary Outcomes
- Efficacy of insomnia treatment on Sleep duration(3 months)
- Efficacy of insomnia treatment on blood pressure (evaluated by office blood pressure)(3 months)
- Efficacy of insomnia treatment on sleep quality(3 months)
- Efficacy of insomnia treatment on subgroups of patients (intending to be a sub-study)(3 months)