Clinical Trials Logo

Clinical Trial Summary

Post-traumatic stress disorder (PTSD) is a common consequence of combat that can result in trauma-related hyperarousal and sleep disturbances. Poor sleep, one of the most common complaints in Veterans with PTSD, can be distressing, impair concentration and memory, and contribute to physical health conditions, such as metabolic syndrome, inflammation, and cardiovascular disease. The orexin neuropeptide system underlies both sleep and stress reactivity. Suvorexant, a drug that reduces orexin, improves sleep in civilians, but has not yet been tested in Veterans with PTSD. This study will test whether suvorexant can improve sleep disturbances and PTSD symptoms in Veterans. Suvorexant may benefit Veterans by improving sleep quickly while also reducing PTSD symptoms over the long term, and with fewer side effects that were common in previous medications used to treat these conditions. Improving Veterans' sleep and PTSD symptoms could lead to better emotional and physical well-being, quality of life, relationships, and functioning.


Clinical Trial Description

The investigators propose a multi-site parallel group, randomized, double-blind, placebo-controlled Phase IV clinical trial to test the efficacy and safety of suvorexant on trauma-related sleep disturbance and PTSD symptoms in Veterans. The investigators will use a flexible dose design of suvorexant with a 2-week titration followed by a 10-week steady-dose phase. The investigators predict that suvorexant, as compared to placebo, will result in a greater decrease in insomnia on the Insomnia Severity Index (ISI) over the 12-week trial. The investigators also predict that suvorexant, as compared to placebo, will result in a greater reduction in non-sleep PTSD symptoms in the Clinician Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSMV) (CAPS-5) over the 12-week trial. Secondarily, the investigators will examine potential objectively measured wrist actigraphy as a biological mechanism of clinical improvement with as well as concomitant effects on PTSD-related nightmares using the Pittsburgh Sleep Quality Index-PTSD addendum (PSQI-A). Pending a significant effect of suvorexant on PTSD, the investigators will perform exploratory analyses to evaluate whether sleep improvement mediates the effect of suvorexant on PTSD symptoms. The investigators will also examine safety and tolerability of suvorexant compared to placebo (including depression, mood, vigor, suicidality, and daytime somnolence, psychomotor vigilance, and functional disability). Results from this study will provide substantive rationale for the use of Suvorexant in the treatment of Veterans with these concerns. This study will be the first to examine a selective orexin-receptor antagonist in a Veteran sample with PTSD. Suvorexant is an accessible, non-stigmatized medication whose use and safety has been well-established in non-mental-health settings. It has outstanding promise for treating common and distressing symptoms in Veterans as well as civilians with trauma-related sleep disturbance and PTSD. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03642028
Study type Interventional
Source VA Office of Research and Development
Contact Sabra S Inslicht, PhD
Phone (415) 221-4810
Email sabra.inslicht@va.gov
Status Recruiting
Phase Phase 4
Start date August 30, 2019
Completion date December 31, 2024

See also
  Status Clinical Trial Phase
Enrolling by invitation NCT03276585 - Night in Japan Home Sleep Monitoring Study
Recruiting NCT05000528 - Evaluation of the Effectiveness of Patient Therapeutic Education on Chronic Insomnia N/A
Completed NCT04661306 - The Better Sleep for Supporters With Insomnia Study N/A
Completed NCT03673397 - The Acute Effect of Aerobic Exercise on Sleep in Patients With Depression N/A
Completed NCT01784614 - A Study of LY2624803 in Japanese Participants With Transient Insomnia Phase 1
Completed NCT00380003 - Efficacy Study of EVT 201 to Treat Insomnia Phase 2
Completed NCT00365261 - Effect of Eszopiclone on Sleep Disturbance and Pain in Cancer Phase 4
Completed NCT00183378 - Using Behavioral Programs to Treat Sleep Problems in Individuals With Alzheimer's Disease N/A
Completed NCT00946530 - Light Treatment for Sleep/Wake Disturbances in Alzheimer's Disease N/A
Completed NCT00097604 - Effects of Valerian on Sleep in Healthy Older Adults Phase 2
Completed NCT00630175 - Evaluation of the Hypnotic Properties of Zolpidem-MR 12.5 mg and Zolpidem 10 mg Marketed Product Compared to Placebo in Patients With Primary Insomnia Phase 3
Completed NCT00044629 - Combined Behavioral/Pharmacological Therapy for Insomnia Phase 2
Completed NCT00079664 - Comparing Tai Chi Training to a Low-Stress Physical Activity to Enhance Sleep in Older Adults Phase 1
Completed NCT01154023 - Behavioral Intervention for Insomnia in Older Adults N/A
Recruiting NCT04417153 - Who Benefits More? Optimising Mindfulness Based Interventions for Improved Psychological Outcomes
Completed NCT04560595 - Remote Guided Caffeine Reduction N/A
Recruiting NCT04986007 - Addressing Nocturnal Sleep/Wake Effects on Risk of Suicide in Older Adults N/A
Completed NCT03852966 - Better Sleep in Psychiatric Care - ADHD Pilot Study N/A
Terminated NCT00750919 - Twenty-six Week Extension Trial of Org 50081 (Esmirtazapine) in Outpatients With Chronic Primary Insomnia (176003/P05721/MK-8265-007) Phase 3
Recruiting NCT04550507 - Mind-Body Interventions to Mitigate Effects of Media Use on Sleep in Early Adolescents N/A