NCT06976138

Brief Summary

This research study is being done to compare different methods of addressing sleep problems before total knee replacement surgery. These methods include Cognitive Behavioral Therapy and light exposure.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
252

participants targeted

Target at P75+ for not_applicable

Timeline
39mo left

Started Jun 2025

Longer than P75 for not_applicable

Geographic Reach
1 country

2 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 Progress22%
Jun 2025Jul 2029

First Submitted

Initial submission to the registry

May 8, 2025

Completed
8 days until next milestone

First Posted

Study publicly available on registry

May 16, 2025

Completed
28 days until next milestone

Study Start

First participant enrolled

June 13, 2025

Completed
4.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 31, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 31, 2029

Last Updated

June 18, 2025

Status Verified

June 1, 2025

Enrollment Period

4.1 years

First QC Date

May 8, 2025

Last Update Submit

June 17, 2025

Conditions

Keywords

total knee arthroplastyknee replacementkoaknee osteoarthritis

Outcome Measures

Primary Outcomes (1)

  • Chronic postsurgical pain as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index

    Higher scores indicate higher pain. Asked to rate pain in different situations from 0 (no pain) to 10 (extreme pain) on Visual Analog Scale.

    3 and 6 months post-surgery

Secondary Outcomes (5)

  • Post-surgical pain as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index Pain Severity

    immediately post surgery, 6 weeks post surgery

  • Number of participants with Post-surgical opioid use

    6-weeks post-surgery, 3 and 6 months post surgery

  • Insomnia Severity as assessed by the Insomnia Severity Index

    pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6-months

  • Circadian Rest Activity Rhythm (RAR) assessed by actigraphy

    pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6-months

  • Depressed mood as assessed by the Patient Health Questionnaire (PHQ-9)

    pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6 months

Other Outcomes (5)

  • Post-surgical Physical Functioning as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index Physical Functioning

    3 and 6 months post-surgery

  • Wake After Sleep Onset Time (minutes) as assessed by actigraphy

    pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6 months

  • Total Sleep Time (minutes) as assessed by actigraphy

    pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6 months

  • +2 more other outcomes

Study Arms (3)

Cognitive Behavioral Therapy + Morning Bright Light exposure

EXPERIMENTAL

Cognitive-Behavioral Therapy for Insomnia. This program will focus on changing the participant's sleep patterns, activities, and habits. Morning Bright Light involves wearing glasses (Re-Timer Device) that give off a special type of bright light for one full hour in the morning. The participant will be asked to wear these glasses every morning for about four weeks before surgery, four weeks after surgery and again for 1-week , 3-months after surgery. The participant will fill out a log to note light on/off times, any interruptions to light treatment, and primary activity while receiving the light exposure. The participant will also receive daily reminders to charge the device and turn it on during the scheduled time.

Behavioral: Cognitive-Behavioral Therapy for InsomniaDevice: Bright Light therapy via the Re-Timer®

Cognitive Behavioral Therapy for Insomnia + Negative Ion exposure

ACTIVE COMPARATOR

Cognitive-Behavioral Therapy for Insomnia. This program will focus on changing the participant's sleep patterns, activities, and habits. Negative Ion exposure. This procedure involves wearing a light weight negative ionizer (IonMi Device) around the neck for one hour in the morning. An ionizer gives off special negatively charged ions into the air. the participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery The participant will also receive daily reminders to charge the device and turn it on during the scheduled time.

Behavioral: Cognitive-Behavioral Therapy for InsomniaDevice: Negative Ion exposure via IonMi Device

Sleep / Knee Osteoarthritis Education + Negative Ion exposure

ACTIVE COMPARATOR

Sleep / Knee Osteoarthritis Education. This program will focus on increasing the participant's knowledge about sleep, sleep disorders and knee osteoarthritis. Negative Ion exposure. This procedure involves wearing a light weight negative ionizer (IonMi Device) around the neck for one hour in the morning. An ionizer gives off special negatively charged ions into the air. The participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery The participant will also receive daily reminders to charge the device and turn it on during the scheduled time.

Device: Negative Ion exposure via IonMi DeviceBehavioral: Sleep / Knee Osteoarthritis Education

Interventions

This program will focus on changing the participant's sleep patterns, activities, and habits.

Cognitive Behavioral Therapy + Morning Bright Light exposureCognitive Behavioral Therapy for Insomnia + Negative Ion exposure

Subjects will conduct light treatment in the mornings at home for one hour using Re-timer® The participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery

Cognitive Behavioral Therapy + Morning Bright Light exposure

This procedure involves wearing a light weight negative ionizer (IonMi Device) around neck for one hour in the morning. An ionizer gives off special negatively charged ions into the air. The participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery

Cognitive Behavioral Therapy for Insomnia + Negative Ion exposureSleep / Knee Osteoarthritis Education + Negative Ion exposure

This program will focus on increasing The participant's knowledge about sleep, sleep disorders and knee osteoarthritis.

Also known as: koa Education
Sleep / Knee Osteoarthritis Education + Negative Ion exposure

Eligibility Criteria

Age60 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • People with knee osteoarthritis,
  • years old and older,
  • scheduled to have unilateral (one knee) total knee replacement surgery for osteoarthritis and
  • have trouble falling or staying asleep

You may not qualify if:

  • currently using medications to help sleep
  • have completed Cognitive Behavioral Therapy for Insomnia
  • used either Bright Light or Negative Ion exposures in the past year
  • have an inflammatory rheumatologic disorder, seizure disorder
  • serious mental health disorder, Bipolar I disorder, substance or alcohol use disorder
  • serious sleep or circadian rhythm disorder, untreated sleep apnea
  • are pregnant or lactating
  • have retinal pathology
  • history of eye surgery (Lasik or cataract okay if more than 3 months ago)
  • are taking disease-modifying antirheumatic drugs
  • taking photosensitizing medications
  • are unwilling to discontinue over the counter sleep aids (for example, melatonin) for at least 2 weeks before enrolling

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Johns Hopkins School of Medicine

Baltimore, Maryland, 21224, United States

RECRUITING

Mass General Brigham

Chestnut Hill, Massachusetts, 02467, United States

ACTIVE NOT RECRUITING

MeSH Terms

Conditions

Osteoarthritis, Knee

Interventions

Cognitive Behavioral TherapySleep

Condition Hierarchy (Ancestors)

OsteoarthritisArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic Diseases

Intervention Hierarchy (Ancestors)

Behavior TherapyPsychotherapyBehavioral Disciplines and ActivitiesNervous System Physiological PhenomenaMusculoskeletal and Neural Physiological Phenomena

Study Officials

  • Michael T Smith, PhD

    Johns Hopkins University

    PRINCIPAL INVESTIGATOR
  • Helen Burgess, PhD

    University of Michigan

    PRINCIPAL INVESTIGATOR
  • Robert R Edwards, PhD

    Brigham and Women's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Masking Details
Only the interventionist and biostatistician will have access to group assignment
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: randomized controlled, 3-parallel arm, trial
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 8, 2025

First Posted

May 16, 2025

Study Start

June 13, 2025

Primary Completion (Estimated)

July 31, 2029

Study Completion (Estimated)

July 31, 2029

Last Updated

June 18, 2025

Record last verified: 2025-06

Data Sharing

IPD Sharing
Will share

Final de-identified, anonymized data sets underlying all publications resulting from the proposed research involving human subjects will be shared with legitimate academic researchers and other community members with a legitimate scientific interest in the research. Where practicable, sharing will take place under a written agreement between the principal investigators prohibiting the recipient from identifying or re-identifying (or taking steps to identify or re-identify) any individual whose data are included in the data sets. Study documentation (e.g., study protocols) will be made accessible via clinicaltrials.gov and via communication with the principal investigators to facilitate interpretation of the scientific data. Codebooks, other study documentation and deidentified data will be made available on the National Institute on Aging (NIA) National Archive of Computerized Data on Aging data (NACDA) repository.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
The research community will have access to the data when the award ends. De-identified data will be provided after the requesters sign a Letter of Agreement detailing the purpose of the sharing request, information about the requesters and the requesters affiliations, mechanisms by which the data will be kept secure, and access restricted to the study team. The agreements will also state the recipient will not attempt to identify any individual whose data are included and will not share the data with anyone outside of the research team. NACDA make data available via public-use files (which would require agreement to NACDA's Terms of Use) or via restricted-use files (which would require a signed Restricted Data Use Agreement between the requestor's institution and the Johns Hopkins University as well as an application to request access).
Access Criteria
Pll data sharing will follow the guidelines and rules of the NIH and Johns Hopkins University's Institutional Review Board (IRB). Deidentified data will be managed as indicated in the informed consent. The Informed Consent will notify participants that the data will be shared. De-identified data will be share to the extent indicated in the informed consent. Final curated, de-identified, anonymized data sets underlying publications resulting from the proposed research involving human subjects will be generated and will be shared only to the extent indicated in the informed consent. Requesters will sign a Letter of Agreement with the Johns Hopkins University detailing the requesters planned uses of the data and mechanisms by which the data will be kept secure, and access restricted to the requesters study team with appropriate credentials and training in data security. NACDA's application for restricted-use data will be followed.

Locations