NCT02724800

Brief Summary

The purpose of this study is to directly compare the effectiveness of two interventions for insomnia: Brief Behavioral Treatment for Insomnia (BBTI) vs. Cognitive Behavioral Therapy for Insomnia (CBTI).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
92

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Apr 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 21, 2016

Completed
10 days until next milestone

First Posted

Study publicly available on registry

March 31, 2016

Completed
1 day until next milestone

Study Start

First participant enrolled

April 1, 2016

Completed
2.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2019

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2020

Completed
5 months until next milestone

Results Posted

Study results publicly available

August 11, 2020

Completed
Last Updated

August 11, 2020

Status Verified

July 1, 2020

Enrollment Period

2.9 years

First QC Date

March 21, 2016

Results QC Date

May 7, 2020

Last Update Submit

July 23, 2020

Conditions

Keywords

InsomniaVeteransCognitive Behavioral Therapy for InsomniaBrief Behavioral Treatment for InsomniaComparative Effectiveness Research

Outcome Measures

Primary Outcomes (1)

  • Insomnia Severity Index (ISI)

    Insomnia Severity Index (ISI) 0-28; 0-7 (no symptoms), 8-14 (sub-threshold symptoms), 15-21 (moderately severe), 22-28 (severe) high scores indicate worse outcome/greater severity

    post-treatment (BBTI: week 5; CBTI: week 6-9)

Secondary Outcomes (13)

  • Patient Health Questionnaire (PHQ-9)

    post-treatment (BBTI: week 5; CBTI: week 6-9)

  • Generalized Anxiety Disorder (GAD-7)

    post-treatment (BBTI: week 5; CBTI: week 6-9)

  • PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5)

    post-treatment (BBTI: week 5; CBTI: week 6-9)

  • Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale

    post-treatment (BBTI: week 5; CBTI: week 6-9)

  • Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health

    post-treatment (BBTI: week 5; CBTI: week 6-9)

  • +8 more secondary outcomes

Study Arms (2)

CBTI

ACTIVE COMPARATOR

CBTI consists of five in-person sessions within an eight week period. Topics covered include: sleep education, stimulus control, sleep restriction, relaxation strategies, cognitive therapy, and sleep hygiene.

Behavioral: CBTI

BBTI

ACTIVE COMPARATOR

BBTI consists of one in-person session with three weekly follow-up sessions (in-person or phone) in a four week period. Topics covered include: sleep education, stimulus control, and sleep restriction.

Behavioral: BBTI

Interventions

CBTIBEHAVIORAL

28 Veterans with chronic insomnia will be randomized to CBTI. The intervention will be delivered in 5 face-to-face session within an 8 week time period. The intervention will be delivered at the VA Pittsburgh Healthcare System. Treatment visits will last approximately 45 minutes.

Also known as: Cognitive Behavioral Therapy for Insomnia
CBTI
BBTIBEHAVIORAL

28 Veterans with chronic insomnia will be randomized to BBTI. The intervention will be delivered over 4 consecutive weeks, which include individual face-to-face visits on Weeks 1 and 3 (option for telephone), and telephone appointments on Weeks 2 and 4. Interventions will be delivered at the VA Pittsburgh Healthcare System. The duration of the first treatment visit is approximately 45-minutes, and the follow-up visit on Week 3 will last no more than 30 minutes. Brief (\<20 minutes) telephone sessions will be conducted on Weeks 2 and 4.

Also known as: Brief Behavioral Treatment for Insomnia
BBTI

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 years old and older
  • Military Veteran
  • Insomnia Severity Index (ISI) ≥15 \& Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for insomnia disorder
  • If using sleep medications, medication and dosage have not been changed in the past month, and will remain unchanged for the duration of the treatment phase of the study (i.e., 4-8 weeks)
  • If using other psychotropic medications, medication and dosage have not been changed in the past 2 months, and will remain unchanged for the duration of the treatment phase of the study (i.e., 4-8 weeks)

You may not qualify if:

  • Untreated, current, and severe PTSD as determined by the Structured Clinical Interview for DSM-5 (SCID)
  • Untreated, current, and severe Major Depressive Disorder as determined by the SCID
  • Current/Past Psychotic or Bipolar disorder
  • Current substance or alcohol use disorder as determined by the SCID
  • Current unstable medical condition
  • Hospitalization in the previous 1 month for a medical condition or surgery for which recovery overlaps with the study onset and duration
  • Seizure disorder, open skull brain injury, or moderate to severe traumatic brain injury (TBI)
  • Current, untreated, sleep disorders such as nightmare disorder, restless legs syndrome, circadian rhythm disorder (or shift work), or a suspected sleep disorder requiring polysomnographic assessment, such as obstructive sleep apnea or periodic leg movements as determined by the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR) Clinical Interview for DSM-5 Sleep-Wake Disorders and/or the STOP-BANG questionnaire
  • Moderate to severe cognitive impairment (St. Louis University Mental Status \[SLUMS\] exam ≤20) and/or diagnosis in medical record indicative of moderate to severe cognitive impairment
  • Unstable environment that is not in one's control (e.g., homeless, temporary group home, care taking duties at night)
  • Pregnancy and/or breast-feeding
  • STOP-BANG is not a true acronym but indicates the symptoms each item assess:
  • S-snores T-tired/sleepy O-observed apneas P-high blood pressure
  • B-body mass index A-age N-neck circumference G-gender

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

VA Pittsburgh Healthcare System

Pittsburgh, Pennsylvania, 15240, United States

Location

Related Publications (2)

  • Bramoweth AD, Lederer LG, Youk AO, Germain A, Chinman MJ. Brief Behavioral Treatment for Insomnia vs. Cognitive Behavioral Therapy for Insomnia: Results of a Randomized Noninferiority Clinical Trial Among Veterans. Behav Ther. 2020 Jul;51(4):535-547. doi: 10.1016/j.beth.2020.02.002. Epub 2020 Feb 20.

  • Bramoweth AD, Germain A, Youk AO, Rodriguez KL, Chinman MJ. A hybrid type I trial to increase Veterans' access to insomnia care: study protocol for a randomized controlled trial. Trials. 2018 Jan 26;19(1):73. doi: 10.1186/s13063-017-2437-y.

MeSH Terms

Conditions

Sleep Initiation and Maintenance Disorders

Interventions

Cognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Sleep Disorders, IntrinsicDyssomniasSleep Wake DisordersNervous System DiseasesMental Disorders

Intervention Hierarchy (Ancestors)

Behavior TherapyPsychotherapyBehavioral Disciplines and Activities

Limitations and Caveats

In general, higher than expected dropout leading to smaller number of participants analyzed. For sleep diaries, higher than expected dropout and poor completion at post-treatment resulted in small number analyzed.

Results Point of Contact

Title
Adam Bramoweth, PhD
Organization
VA Pittsburgh Healthcare System

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Research Health Scientist

Study Record Dates

First Submitted

March 21, 2016

First Posted

March 31, 2016

Study Start

April 1, 2016

Primary Completion

March 1, 2019

Study Completion

March 1, 2020

Last Updated

August 11, 2020

Results First Posted

August 11, 2020

Record last verified: 2020-07

Locations