Sleep Clinical Trial
Official title:
Hypnosis to Improve Sleep in Menopause: Determination of Optimal Dose and Method
The purpose of this study is to determine feasibility and adherence to a hypnosis program to improve sleep. It is theorized (based on prior experience and pilot data) that one or more hypnosis program(s) will be feasible and will exhibit acceptable adherence. The programs will assess to determine optimal dose (3 vs 5 sessions) and method (audio-recorded vs therapist delivered).
It is conceptually theorized that one or more hypnosis program(s) [dose and delivery] will
be feasible and will exhibit acceptable adherence to daily hypnosis practice to improve
sleep. The optimal dose (3 vs. 5 sessions) and delivery method (audio recorded vs. therapist
delivered) are as yet unknown. It is hypothesized that a hypnosis program will indicate an
effect on objectively measured sleep duration. It is expected that one or more hypnosis
interventions will have effects on both the primary outcome (objectively measured sleep
duration) and secondary outcomes (sleep quality, insomnia symptom severity, daytime
sleepiness, menopausal symptoms, pain, and bothersomeness).
This study will provide estimated effect sizes for the primary and secondary outcomes for
later studies. In addition, it is possible that there are potential covariates such as age,
race, menopausal stage, sleep environment, and/or socioeconomic status that require
consideration. These will be explored (Aim 4) to guide the future, larger study.
Stratified randomization will be utilized, with one variable present in the randomization:
the presence/absence of hot flash . "Presence" of hot flash is determined by criteria used
in a prior study (i.e., 7 hot flashes per day, or 50 hot flashes per week) during the
screening or baseline week. If the criteria is not met that indicates presence of hot
flashes and reported during those two weeks, then the woman will be determined as not having
hot flashes.
Objectives
- Aim 1: Determine the feasibility of and adherence to the four hypnosis programs.
Feasibility will be determined by (1) a dropout rate of less than 25%, (2)
participants' rating of the program (from poor to excellent; with rating of good or
better defined as feasible), (3) participants' rating of treatment satisfaction (from
completely satisfied to completely dissatisfied) and (4) few adverse events (<5%).
Adherence will be determined through daily at-home practice forms. An adherence
threshold of 75% will be utilized as this level of adherence is likely to be needed for
an optimal hypnosis program for sleep.
- Aim 2: Determine initial effect sizes for the primary outcome of objectively measured
sleep duration, including the percent of women who achieve a clinically meaningful
improvement. Wrist actigraphy recordings supplemented by sleep diaries will be used to
measure sleep duration. Clinically meaningful improvement is defined as the percentage
of women who move from poor to average sleep duration (e.g., from < 6.5 hours per night
to > 6.5 hours but <9.0 per night).
- Aim 3: Determine initial effect sizes for secondary outcomes of sleep quality, insomnia
symptom severity, daytime sleepiness, menopausal symptoms, and pain.
- Aim 4: Examine trends in potential covariates including endogenous factors (e.g., age,
race/ethnicity, menopausal status) and exogenous factors (e.g., sleep environment,
socioeconomic status).
Study Design
This study is designed as a 4-arm comparison, with participants randomized to the following
arms:
1. Standard audio recordings for home practice, with 5 in-person therapist delivered
hypnotic inductions
2. Standard audio recordings for home practice, with 3 in-person therapist delivered
hypnotic inductions
3. Standard audio recordings only, with 5 telephone contacts to encourage home practice
4. Standard audio recordings only, with 3 telephone contacts to encourage home practice
;
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