Status:

COMPLETED

Suvorexant and Sleep/Delirium in ICU Patients

Lead Sponsor:

Beth Israel Deaconess Medical Center

Collaborating Sponsors:

Merck Sharp & Dohme LLC

Conditions:

Insomnia

Sleep Fragmentation

Eligibility:

All Genders

60+ years

Phase:

PHASE4

Brief Summary

Investigators will evaluate the efficacy of postoperative oral suvorexant treatment on nighttime wakefulness after persistent sleep onset (WASO) among adult cardiac surgical patients recovering in the...

Detailed Description

This is a prospective, randomized, placebo-controlled, blinded study. Participants will be enrolled preoperatively. After postoperative extubation, eligible patients will be randomly allocated in a 1:...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Age 60 years or older
  • Undergoing elective coronary artery bypass graft surgery with or without aortic and/or mitral valve replacement, who are expected to be transferred to the ICU postoperatively
  • Exclusion criteria:
  • Preoperative left ventricular ejection fraction of less than 30%
  • Renal failure (creatinine \>2 mg/dl or dialysis dependence)
  • Liver failure (CHILD-Pugh\>4)
  • Coma (RASS\<-1)
  • Signs and symptoms of delirium and agitation at time of enrollment (CAM-ICU positive)
  • Montreal Cognitive Assessment (MoCA) below 23 at time of consent
  • Psychiatric or neurologic diseases (including chronic benzodiazepine use, bipolar disorder, psychotic disorder, posttraumatic stress disorder, requirement of prophylactic psychiatric medication, evidence of acute depression on screening visit, preexisting cognitive impairment, Alzheimer disease, Parkinson's disease, medications for cognitive decline, history of recent seizures (within 1 year prior visit), alcoholism or documented history of alcohol abuse, and narcolepsy)
  • Severe sleep apnea requiring home continuous positive airway pressure treatment
  • Morbid obesity (BMI \>40)
  • Known or suspected pregnancy (there are no adequate and well-controlled studies of suvorexant in pregnant women. Based on animal data, Suvorexant may cause fetal harm).
  • Patients with known hypersensitivity to study medications
  • English language limitations (Sleep assessment and delirium assessment tools are only validated in English)
  • Patients enrolled in other interventional studies which could confound the primary endpoint.

Exclusion

    Key Trial Info

    Start Date :

    February 28 2020

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    July 1 2025

    Estimated Enrollment :

    100 Patients enrolled

    Trial Details

    Trial ID

    NCT04092894

    Start Date

    February 28 2020

    End Date

    July 1 2025

    Last Update

    October 27 2025

    Active Locations (2)

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    Page 1 of 1 (2 locations)

    1

    Beth Israel Deaconess Medical Center

    Boston, Massachusetts, United States, 02115

    2

    Montefiore Medical Center/Albert Einstein college of Medicine

    The Bronx, New York, United States, 10467