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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03405493
Other study ID # R&D2017/096
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date January 18, 2018
Est. completion date September 23, 2019

Study information

Verified date January 2019
Source King's College London
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The aim of this study is to determine if altering the pattern of one's sleep and having light therapy can speed up the treatment of depression. In the UK, the large majority of patients with depression in the NHS are treated in the community, and one of the major objectives of the study one is to determine if this therapy is a practical treatment in the community. We will be comparing two treatments:

1. Sleep Therapy and a Light Box: Participants will be given information and advice on how to get a good night's sleep. Participants will be given a light box to use in the morning for 1 week. Treatment with a light box will last 30 minutes when a person gets up. Participants may continue to have any treatment as usual (for example medication or talking therapies).

2. Wake therapy and a Light Box: Participants will be helped to change the pattern of sleep by depriving participants of sleep for one night. Participants will go bed at 5pm on the following day for 8 hours and get up at 1am. Participants' sleep will then be advanced by 2 hours each night for the next three nights. Participants will be also given a light box to use in the morning for 1 week. Treatment with a light box will last 30 minutes when participants get up. Participants may continue to have any treatment as usual (for example medication or talking therapies).


Description:

- Participants will be given a wristband (Actigraph)

- Participants will be asked to complete various questionnaires and be interviewed at 1 week, 2 weeks, 4 weeks, 8 weeks and at 6 months after starting.

- Participants will be asked to make 6 extra visits to the research team at the hospital over and above those needed for normal care.


Recruitment information / eligibility

Status Completed
Enrollment 60
Est. completion date September 23, 2019
Est. primary completion date September 23, 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria:

- Diagnosis of Depressive Episode (ICD10 F32) or Recurrent Depressive Disorder (F33).

- Minimum score of 8 or more on the Hamilton Depression Rating Scale (6 item) (Range 0-22) (Bech,1981).

- Age 18-65

- Able to give informed consent

- Women of child bearing age may be included and no methods of contraception is required to enable inclusion into the trial.

Exclusion Criteria:

- Current diagnosis of Seasonal Affective Disorder

- Current diagnosis of anorexia nervosa or bulimia.

- Current diagnosis of an obsessive compulsive or related disorder

- Current diagnosis of post-traumatic stress disorder

- History of schizophrenia, schizoaffective disorder or bipolar disorder

- Severe cognitive impairment, dementia, intellectual disability or organic brain disorder.

- History of stimulant or hallucinogenic misuse, alcohol or substance misuse or dependence in past 3 months.

- Borderline Personality Disorder or other personality disorder considered to be the main problem.

- Duration of depression more than 2 years.

- Significant risk of suicide that requires hospitalisation.

- Severe eye disease or cataracts or traumatic injury or visual impairment affecting both eyes.

- History of epilepsy, uncontrolled severe headaches, or stroke as this may lower seizure threshold through sleep deprivation.

- Unstable medical condition that would make wake therapy intolerable

- Untreated sleep disorder such as obstructive sleep apnoea or narcolepsy

- Use of photo-sensitizing drugs.

- Current night-shift work.

- Non-English speaker.

Study Design


Intervention

Behavioral:
Wake and Light Therapy
Participants will be helped to change the pattern sleep by depriving participants of sleep for one night. On Day 1 participants will be supported to stay up all night and the following day at the Hospital. Participants can go to bed by 5pm at home on Day 2. Participants will need to get up by about 1am and return to the hospital to be supported to stay awake. Participants will then go to bed at 7pm on Day 3. Participants will be asked to sleep until 3am and then stay awake at home until bed at 9pm on Day 4. Participants will then get up by 5am on Day 5 and stay awake until 11pm to resume a normal sleep routine waking by 7am on Day 6. Participants will also be given a light box to use each morning. For the light box, participants will be asked to sit about one foot away from a light box. You will be free to have breakfast, read or use a computer while facing towards the light. Treatment with a light box will last 30 minutes. Participants may continue to have treatment as usual.
Sleep and Light Therapy
Participants will be given information and advice on how to get a good night's sleep. Participants will be also given a light box to use in the morning for 1 week. For the light box, participants will be asked to sit about one foot away from a light box. Participants will be free to have breakfast, read or use a computer while facing towards the light. Treatment with a light box will last 30 minutes when you get up. Participants may continue to have any treatment as usual (for example medication or talking therapies).

Locations

Country Name City State
United Kingdom South London and Maudsley NHS Foundation Trust London

Sponsors (2)

Lead Sponsor Collaborator
King's College London Kings Health Partners

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Number of participants recruited per month/Adherence to the protocol To compare the rate of recruitment and adherence to the treatments in both groups Week 1
Secondary MINI International Neuropsychiatric Interview Version 5.0 To determine diagnosis by DSM-IV criteria Baseline
Secondary Hamilton Depression Rating Scale To compare the effects on observer rated depressive symptoms in both groups Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary Clinical Global Impression and Improvement Scale (Guy, 1976) To compare the effects on observer rated clinical impression in both groups Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary Quick Inventory of Depressive Symptomatology -SR Version (Triveni et al., 2004) Questionnaire To compare the effects on subjective depressive symptoms in both groups Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary Brief Ruminative Response Scale (Topper et al, 2014). Questionnaire To compare the effects on measures of subjective rumination in both groups Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary Pittsburgh Sleep Index (Bysse et al., 1999) Questionnaire To compare the effects on subjective sleep quality in both groups Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary Euroquol 5D (1990) Questionnaire To compare the effects on subjective general quality of life in both groups Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary To check the amount of current antidepressant use Amount of antidepressant drugs (in mg of antidepressant equivalents) (Hayasaka et al., 2015) or benzodiazepine drugs (in mg of diazepam equivalents) Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary To check the amount of current psychotherapy use The amount of Cognitive Behaviour Therapy or any other counselling or psychotherapy (number of hours) Baseline, and at 1, 2, 4, 8 weeks and 6-month post-randomisation
Secondary Daily sleep diary A subjective measure of total sleep time 3 days pre-randomisation and 7 days post-randomisation
Secondary Credibility and Expectancy Questionnaire (Devilly, 2000). A measure of the credibility of the intervention Baseline
Secondary Morning/Evening Questionnaire A measure of morning/evening preference 3 days pre-randomisation
Secondary Wrist actigraph from GeneActiv daily (Physiological parameter) A measure of the sleep/wake activity, which correlates with the gold standard of sleep physiology (polysomnography). 3 days pre-randomisation and 7 days post-randomisation.
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