Insomnia Clinical Trial
Official title:
Sleep in Cardiac Patients With Implantable Cardioverter Defibrillators (ICD)
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.
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.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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