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137 active trials for Insomnia

Acceptance and Commitment Therapy for Insomnia

Insomnia is a frequent complaint and is associated with impairments in physical and psychological health. Although Cognitive-Behavioral Therapy (CBT) demonstrates effective results for insomnia, there are those who do not respond to this type of intervention or present difficulties in adherence. Acceptance and Commitment Therapy (ACT) presents itself as a potentially useful intervention for the treatment of insomnia, for which, instead of focusing on controlling the symptoms, the respective approach focuses on accepting the feelings and thoughts associated, through value-based actions. The aim of this study is to evaluate the effectiveness of ACT for chronic insomnia in adults. Participants will be 150 adults aged between 18 and 59 years, diagnosed with chronic insomnia who will be randomly assigned to the ACT, CBT and wait list (WL) groups. For both groups (ACT and CBT), the intervention will be performed in six group and weekly sessions. Assessments of sleep patterns, insomnia, depression, anxiety, psychological flexibility, acceptance of sleep, beliefs about sleep, personality traits will be performed in the pre-treatment, post-treatment and six-month follow-up. After the intervention is completed, participants will respond to an inventory of compliance and satisfaction. The results will be compared using mixed ANOVA, followed by multiple comparison tests, where appropriate. For the primary and secondary outcomes, the magnitude of the effect will be calculated. The size of the effect will be calculated using the square partial eta and d of Cohen.

Start: March 2021
Sleep Deficiency and Stroke Outcome

Deficient sleep duration and sleep disturbances - such as insomnia, sleep disordered breathing (SDB) and restless legs syndrome (RLS)- are associated with hypertension and cardio-cerebrovascular morbidity and mortality. Several studies suggest that sleep disorders are frequent after stroke and detrimental for stroke outcome. However, more prospective studies in a large unselected sample of stroke survivors are needed to better investigate the short- and long-term consequences of sleep disturbances on mortality and occurrence of new cardio-cerebrovascular events. Also their pathophysiological mechanisms and their influence on stroke recovery should be better understood. Therefore, the aim of this study is to assess the impact of sleep deficiency and sleep fragmentation on the frequency of new cerebro- and cardiovascular events and death after stroke or transient ischemic attacks, and clinical outcome within one and two years after stroke. The working hypotheses are that stroke survivors with sleep deficiency and sleep fragmentation due to insomnia, sleep-disordered breathing or restless leg syndrome will present: (1) higher mortality from all causes and higher frequency of new cardio-/ cerebrovascular events; and (2) a less favorable clinical outcome. Outcomes will be compared between patients with and without sleep deficiency and fragmentation. Since current clinical practice in cerebrovascular patients does not sufficiently consider sleep disorders in patient's management, this study can help to bring attention to a still overlooked medical problem and change the current standard of management of stroke survivors.

Start: July 2015
Effects of Self-help Versus Group Cognitive Behavioural Therapy for Insomnia in Youth

Insomnia is the most prevalent sleep problem in both the general and clinical populations. Insomnia symptoms, presented as the problems initiating sleep or maintaining sleep, have been reported in association with adverse outcomes in adolescents, including an increased risk of developing depression, anxiety, interpersonal problems, somatic health problems, self-harm and suicidal ideation. Moreover, adolescent insomnia has been found to predict the development of mental health problems in young adulthood. Currently there is no medication specifically approved for use as hypnotics in children under age 18 by the US Food and Drug Administration (FDA). Although cognitive behavioural therapy for insomnia (CBT-I) has been regarded as the first-line treatment for insomnia in adults, there exists limited evidence for the efficacy of CBT-I among adolescents and young adults. Given the high prevalence and profound consequences of insomnia among youth, further research on the short-term and long-term effects of CBT-I for adolescents is warranted. To address the limitations of the existing literature, this randomised controlled trial aims to examine whether face-to-face (group-based CBT-I) versus self-help insomnia treatment benefit adolescents with insomnia, for improving sleep and other clinical and daytime symptoms as well as overall functional improvement in both the short and long term.

Start: May 2017
A Mixed Method Pilot Study for Patients With Mild Cognitive Impairment and Insomnia.

This study is proposed to address the research gap identified by the investigation team. The investigators are currently conducting a randomized controlled trial (RCT) to examine the effects of a new volunteer-supported model to improve cognitive function in MCI persons through the promotion of an active lifestyle. The investigators noticed that sleep problems are highly prevalent among this vulnerable group, and their motivation is low. As such, this team of investigators, which has a strong research track record and expertise in delivering psychosocial interventions, care of persons with MCI and dementia and chronic disease management using the empowerment-based educational model, developed an evidenced-based Cognitive behavioral therapy for insomnia (CBT-I) intervention featuring the empowerment approach to improve sleep quality and cognition in persons with MCI. The PI and the Co-I (D. Yu) have successfully used the empowerment model to promote self-care among patients with heart failure. Indeed, the co-investigators have extensive research and clinical experience in working with people with MCI and dementia. The Co-I (D. Yu), a nursing academician specializing in gerontology, has established an online CBT-based website (Sweet Dream) to fight against insomnia in the older population in Hong Kong and has tested the effects of an activity-based intervention for older people with sleep complaints. Another Co-I (A. Wong) is a psychologist with substantial research experience working with people with MCI and dementia. This study proposes to address a neglected area in the literature and to test the effects of an empowerment-based CBT-I for MCI persons on their sleep and cognition.

Start: May 2021