NCT06281756

Brief Summary

Individuals who have insomnia with short sleep duration (ISS) differ from individuals who have insomnia with normal sleep duration (INS) in terms of health risks (i.e., hypertension) and treatment response. This study will examine whether patients with ISS and INS demonstrate a differential response to two common insomnia treatments. One is behavioral, Cognitive Behavioral Therapy for Insomnia (CBT-I). The other is a widely prescribed, non-habit-forming medication, trazodone used at a low dose. The investigators' findings could lead to evidence-based treatment guidelines that help clinicians more effectively match treatments to insomnia patients and reduce associated health problems.

Trial Health

80
On Track

Trial Health Score

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

Enrollment
600

participants targeted

Target at P75+ for early_phase_1

Timeline
25mo left

Started Mar 2024

Longer than P75 for early_phase_1

Geographic Reach
2 countries

4 active sites

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 Progress51%
Mar 2024May 2028

First Submitted

Initial submission to the registry

February 19, 2024

Completed
9 days until next milestone

First Posted

Study publicly available on registry

February 28, 2024

Completed
21 days until next milestone

Study Start

First participant enrolled

March 20, 2024

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 30, 2027

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

May 31, 2028

Last Updated

November 10, 2025

Status Verified

November 1, 2025

Enrollment Period

3.7 years

First QC Date

February 19, 2024

Last Update Submit

November 6, 2025

Conditions

Keywords

sleepsleep disorderinsomnia

Outcome Measures

Primary Outcomes (3)

  • Remission of insomnia symptoms following Cognitive Behavioral Therapy for Insomnia (CBT-I)

    Based on Insomnia Severity Index (ISI) published criteria; 0-28, with 0 being mild and 28 being severe

    9 weeks

  • Remission of insomnia symptoms following trazodone/placebo Randomized Controlled Trial (RCT)

    Based on Insomnia Severity Index (ISI) published criteria; 0-28, with 0 being mild and 28 being severe

    9 weeks

  • Remission of insomnia symptoms 6 months following completion of CBT-I Or RCT Treatment

    Based on Insomnia Severity Index (ISI) published criteria; 0-28, with 0 being mild and 28 being severe

    35 weeks

Secondary Outcomes (11)

  • Insomnia Severity Index (ISI) Score following CBT-I

    9 weeks

  • Polysomnography (PSG) Sleep efficiency following Cognitive Behavioral Therapy for Insomnia (CBT-I)

    9 weeks

  • Actigraphy Sleep efficiency following Cognitive Behavioral Therapy for Insomnia (CBT-I)

    9 weeks

  • Evening Cortisol levels following CBT-I

    9 weeks

  • Insomnia Severity Index (ISI) Score following RCT

    9 weeks

  • +6 more secondary outcomes

Study Arms (2)

Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with placebo

PLACEBO COMPARATOR

Subjects with insomnia treated with Cognitive Behavior Treatment for Insomnia (CBT-I) for 8 weeks, then non-remitting subjects received placebo for 8 weeks.

Behavioral: Cognitive Behavioral Treatment for Insomnia (CBT-I)Other: Placebo

Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with Trazodone

ACTIVE COMPARATOR

Subjects with insomnia treated with Cognitive Behavior Treatment for Insomnia (CBT-I) for 8 weeks, then non-remitting subjects received trazodone for 8 weeks.

Behavioral: Cognitive Behavioral Treatment for Insomnia (CBT-I)Drug: Trazodone

Interventions

Subjects will receive therapy for 8 weeks

Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with TrazodoneSubjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with placebo

Non-remitting subjects will receive Trazodone (dosage) for 8 weeks

Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with Trazodone
PlaceboOTHER

Non-remitting subjects will receive placebo for 8 weeks

Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with placebo

Eligibility Criteria

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

You may qualify if:

  • Age 18 or older
  • Able to read and effectively communicate in English at the United States sites or able to read and effectively communicate in English or French at the Canadian site.
  • Meets criteria for chronic insomnia
  • Body Mass Index (BMI) 18.5 kg/m2 and higher

You may not qualify if:

  • Age \< 18
  • Unable to read and effectively communicate in English at the United States sites or able to read and effectively communicate in English or French at the Canadian site.
  • Unwilling to share email address/cell phone number to accept survey links.
  • Life time diagnosis of psychotic or bipolar disorder
  • History of severe apnea or an Apnea Hypopnea Index (AHI) ≥15 that is not currently treated with Positive Airway Pressure (PAP) therapy, an oral device or an implanted device, or was not treated with surgery or weight loss.
  • Started new or changed treatment for sleep apnea in the past three months
  • Does not meet criteria for chronic insomnia
  • Meets criteria for narcolepsy or hypersomnia disorder
  • Meets criteria for circadian rhythm disorder (including night shift work)
  • Unstable medical conditions that would make participation unsafe or unfeasible
  • Falls resulting in hospitalization, significant injury or fracture within past 12 months
  • hospitalizations or emergency room visits within past 12 months for chronic conditions
  • Active chemotherapy or radiation therapy for cancer
  • Lifetime diagnoses/treatment of chronic renal failure, hepatic insufficiency, chronic heart failure
  • Does not agree to refrain from other treatments for insomnia beyond what is offered in this study
  • +9 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

National Jewish Health

Denver, Colorado, 80206-2761, United States

RECRUITING

Penn State University

Hershey, Pennsylvania, 17033, United States

RECRUITING

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213-3203, United States

RECRUITING

Université Laval

Québec, Quebec, G1V 0A6, Canada

RECRUITING

MeSH Terms

Conditions

Sleep Initiation and Maintenance DisordersHypertensionSleep Wake Disorders

Interventions

Trazodone

Condition Hierarchy (Ancestors)

Sleep Disorders, IntrinsicDyssomniasNervous System DiseasesMental DisordersVascular DiseasesCardiovascular DiseasesNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

PiperazinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsPyridonesPyridines

Study Officials

  • Alexandros Vgontzas, MD

    Professor, Psychiatry

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
early phase 1
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Masking Details
Both prescribing physicians and participants will be blind to phenotype and treatment groups.
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Model Details: A 4-site (Hershey, Pennsylvania; Pittsburgh, Pennsylvania; Denver, Colorado; and Quebec, Canada) cohort study will examine the effect of CBT-I as a recommended first-line treatment for insomnia. This will be followed by a placebo-controlled randomized controlled trial (RCT) in those who do not remit in the Cohort Study. The subsequent RCT will compare the efficacy of trazodone vs. placebo among CBT-I non-remitters.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor, Department of Psychiatry

Study Record Dates

First Submitted

February 19, 2024

First Posted

February 28, 2024

Study Start

March 20, 2024

Primary Completion (Estimated)

November 30, 2027

Study Completion (Estimated)

May 31, 2028

Last Updated

November 10, 2025

Record last verified: 2025-11

Data Sharing

IPD Sharing
Will share

The investigators have extensive experience preparing data and documentation to be available for public. They agree to abide by the principles for sharing research resources described by the National Heart, Lung, Blood Institute (NHLBI). A copy of the data will be uploaded to the NHLBI Biologic Specimen and Data Repositories Information Coordinating Center (BioLINCC) repository. The datasets will not include any personal identifiers related to participants or clinical sites. Dates will be de-identified through a date-shifting algorithm to mask actual dates while maintaining a relation to the epoch in which events occurred. Data tables will be exported in comma-separated format, readable by statistical software. Variable dictionaries and code books, detailing variable description, format, value domain and labels, will be produced. Raw data files for polysomnogram/actigraphy/cortisol will also be made available, ensuring that data are linkable to study data and data are de-identified.

Shared Documents
STUDY PROTOCOL, ANALYTIC CODE
Time Frame
Data collected for aim 1 (an observational study) and aim 2 (a randomized clinical trial) will be made available no more than 3 years after the completion of the last follow-up assessment. Data will be submitted to the Program Officer and uploaded to the NHLBI BioLINCC repository no later than 3 years after the end of clinical activity or 2 years after the main outcomes paper is published, whichever comes first.
Access Criteria
NHLBI BioLINCC repository
More information

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