NCT05456607

Brief Summary

This study has two primary objectives, each of which addresses critical clinical and research gaps for individuals who have co-occurring insomnia and depression. The first objective is to address whether sequential treatment of insomnia and depression is superior to a single treatment for either depression or for insomnia, and if so, which treatment sequence is optimal. The second objective is to determine if there are heterogeneity of treatment effects; that is, variation in which interventions are best for which individuals, and if so, to develop and individualized intervention rule to better match individuals with the treatment that is most likely to lead to the best outcomes. A large randomized trial will be conducted to meet these objectives.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
1,500

participants targeted

Target at P75+ for not_applicable depression

Timeline
16mo left

Started May 2023

Longer than P75 for not_applicable depression

Geographic Reach
1 country

1 active site

Status
recruiting

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

Study Progress69%
May 2023Sep 2027

First Submitted

Initial submission to the registry

July 5, 2022

Completed
8 days until next milestone

First Posted

Study publicly available on registry

July 13, 2022

Completed
10 months until next milestone

Study Start

First participant enrolled

May 1, 2023

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2027

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 18, 2027

Last Updated

April 13, 2026

Status Verified

June 1, 2025

Enrollment Period

3.9 years

First QC Date

July 5, 2022

Last Update Submit

April 9, 2026

Conditions

Keywords

cognitive behavioral therapydigital interventiondepressioninsomnia

Outcome Measures

Primary Outcomes (1)

  • Dual Remission of Depression and Insomnia

    The proportion of participants achieving dual remission in each study arm with Depression Remission defined as a total score of \< 5 on the Patient Health Questionnaire (PHQ-9) and Insomnia Remission defined as a total score of \< 8 on the Insomnia Severity Index (ISI).

    3 Months post-treatment

Secondary Outcomes (2)

  • Depression Response

    3 Months post treatment

  • Insomnia Response

    3 Months post treatment

Study Arms (5)

Control

ACTIVE COMPARATOR

Online Mood Monitoring for 12 weeks

Behavioral: Mood Monitoring

Single Insomnia Treatment

EXPERIMENTAL

Cognitive-behavioral therapy for insomnia delivered in a self-managed online format (computer or phone app) with access to a coach. Duration of access for 12 weeks.

Behavioral: Cognitive Behavioral Therapy for Insomnia

Single Depression Treatment

EXPERIMENTAL

Cognitive-behavioral therapy for depression delivered in a self-managed online format (computer or phone app) with access to a coach. Duration of access for 12 weeks.

Behavioral: Cognitive Behavioral Therapy for Depression

Sequenced Depression and Insomnia Treatment

EXPERIMENTAL

Cognitive-behavioral therapy for depression followed by cognitive-behavioral therapy for insomnia each delivered in a self-managed online format (computer or phone app) with access to a coach. Duration of access to the depression treatment only for 4 weeks after which the access to the insomnia treatment is also made available. Total duration of access for 12 weeks.

Behavioral: Cognitive Behavioral Therapy for InsomniaBehavioral: Cognitive Behavioral Therapy for Depression

Sequenced Insomnia and Depression Treatment

EXPERIMENTAL

Cognitive-behavioral therapy for insomnia followed by cognitive-behavioral therapy for depression each delivered in a self-managed online format (computer or phone app) with access to a coach. Duration of access to the insomnia treatment only for 4 weeks after which the access to the depression treatment is also made available. Total duration of access for 12 weeks.

Behavioral: Cognitive Behavioral Therapy for InsomniaBehavioral: Cognitive Behavioral Therapy for Depression

Interventions

Cognitive Behavioral Therapy for Insomnia consists of the standard features of this well-established insomnia treatment that will be delivered in this study via a mobile optimized web app. Participants also have access to an intervention coach/guide as needed.

Also known as: CBT-I
Sequenced Depression and Insomnia TreatmentSequenced Insomnia and Depression TreatmentSingle Insomnia Treatment

Cognitive Behavioral Therapy for Depression consists of the standard features of this well-established depression treatment that will be delivered in this study via a mobile optimized web app. Participants also have access to an intervention coach/guide as needed.

Also known as: CBT-D
Sequenced Depression and Insomnia TreatmentSequenced Insomnia and Depression TreatmentSingle Depression Treatment
Mood MonitoringBEHAVIORAL

The mood monitoring intervention is based on mood tracking principles in broader mood management interventions, but without any psychoeducational content or cognitive-behavioral exercises. Instead, participants will get access to a mobile optimized web app that allows users to enter their mood, tag related events, and view trends over time to raise awareness of how activities influence certain mood states.

Control

Eligibility Criteria

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

You may qualify if:

  • English-speaking
  • U.S. Military Veterans
  • endorse depression (Patient Health Questionnaire-depression score \> 10)
  • endorse insomnia (Insomnia Severity Index score \> 10).

You may not qualify if:

  • pregnancy
  • history of bipolar disorder
  • history of psychosis
  • current use of anti-psychotic medications or mood stabilizers (e.g., lithium)
  • current suicidal ideation with active intent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Rochester Sleep Research Laboratory

Rochester, New York, 14642, United States

RECRUITING

Related Publications (1)

  • Pigeon WR, Bishop TM, Bossarte RM, Schueller SM, Kessler RC. A two-phase, prescriptive comparative effectiveness study to optimize the treatment of co-occurring insomnia and depression with digital interventions. Contemp Clin Trials. 2023 Sep;132:107306. doi: 10.1016/j.cct.2023.107306. Epub 2023 Jul 28.

MeSH Terms

Conditions

DepressionSleep Initiation and Maintenance Disorders

Interventions

Cognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorSleep Disorders, IntrinsicDyssomniasSleep Wake DisordersNervous System DiseasesMental Disorders

Intervention Hierarchy (Ancestors)

Behavior TherapyPsychotherapyBehavioral Disciplines and Activities

Study Officials

  • Wilfred Pigeon, PhD

    University of Rochester

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Psychiatry

Study Record Dates

First Submitted

July 5, 2022

First Posted

July 13, 2022

Study Start

May 1, 2023

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

September 18, 2027

Last Updated

April 13, 2026

Record last verified: 2025-06

Data Sharing

IPD Sharing
Will share

Deidentified data will be submitted to a data repository: the Inter-university Consortium for Political and Social Research (ICPSR) data repository at the University of Michigan for secondary analysis.

Shared Documents
STUDY PROTOCOL
Time Frame
A final dataset and codebook will be submitted to the the Inter-university Consortium for Political and Social Research (ICPSR) at the conclusion of the study and will remain available in accordance with ICPSR guidelines.
Access Criteria
Access criteria will be in accordance with the policies set forth by the data repository, the Inter-university Consortium for Political and Social Research (ICPSR), which are available at: https://www.icpsr.umich.edu/web/pages/datamanagement/lifecycle/access.html

Locations