Status:

ACTIVE_NOT_RECRUITING

An Evaluation of Insomnia Treatment to Reduce Cardiovascular Risk in Patients With Posttraumatic Stress Disorder

Lead Sponsor:

Duke University

Conditions:

Insomnia

Posttraumatic Stress Disorder

Eligibility:

All Genders

40-59 years

Phase:

NA

Brief Summary

Posttraumatic stress disorder (PTSD) is a chronic, debilitating psychiatric disorder that is associated with an increased risk of death due to cardiovascular disease (CVD). Most individuals with PTSD ...

Detailed Description

Posttraumatic stress disorder (PTSD) is a disabling and costly psychiatric disorder that is estimated to occur in 20% of individuals who are exposed to a traumatic event and is chronic in one third of...

Eligibility Criteria

Inclusion

  • Is between 40-59 years old;
  • Has a current diagnosis of chronic PTSD (at least 3 months duration) based on the Clinician Administered PTSD Scale DSM-5 version (Weathers et al., 2013);
  • Has a current diagnosis of ID as defined in the International Classification of Sleep Disorders (ICSD-3; American Academy of Sleep Medicine, 2014)

Exclusion

  • Has a history of CVD events, including myocardial infarction, stroke, transient ischemic attack, or coronary revascularization;
  • Has diagnosis of congestive heart failure or coronary artery disease based on results of diagnostic testing;
  • Has a current alcohol use or substance use disorder (those who meet lifetime but not current alcohol or substance use disorder will be included);
  • Is currently participating in or has recently (past 6 months) participated in an evidence-based trauma focused therapy for PTSD;
  • Has cognitive impairment as evidenced by less than 20 on the Montreal Cognitive Assessment scale (M0CA; Nasreddine et al., 2005);
  • Meets criteria for a psychotic spectrum disorder or bipolar disorder;
  • Has severely impaired hearing or speech;
  • Is pregnant;
  • Does not use benzodiazepines for sleep, and if prescribed benzodiazepines for some other use (e.g., anxiety, panic attacks), uses them fewer than four times in a one month period.;
  • Is not stable (medications and dose stable for one month) on any other current psychoactive and/or cardiovascular medications or will not be stable on these medications during the course of the study;
  • Works night shift;
  • Is participating in another interventional study to address insomnia;
  • Has prominent suicidal or homicidal ideation (as assessed through a clinical interview);
  • Has a serious/terminal illness or other health problem that would prohibit participation in the study;
  • Has nonclinically significant or sub-threshold insomnia as indicated by a score of \<8 on the Insomnia Severity Index;
  • Has seizures (based on clinical interview and self-report);
  • Has a body mass index of 45 or greater;
  • Has sleep apnea (based on the overnight assessment described below) or a positive sleep apnea screen;
  • Has restless leg syndrome (based on the Duke Structured Interview for Sleep Disorders (DSISD); Edinger, Wyatt, \& Olsen, 2009), and that sleep disorder is the primary cause of their sleep complaint (participants with restless legs syndrome who also have insomnia disorder can be included in the study);
  • Has an organic cause of sleep disruption that cannot be addressed by cognitive-behavioral changes (e.g., hyperthyroidism), as determined by the DSISD;
  • Has excessive daytime sleepiness, defined as a score \>15 on the Epworth Sleepiness Scale (ESS) or as determined by the DSISD;
  • Does not complete sleep diary assessments within 6 hours of rising on at least 5 of the 7 days of the initial assessment period; or
  • Cancels or no-shows for two or more Time 1 assessment appointments
  • Has uncontrolled hypertension (screening office BP \> 160/100 mm Hg)

Key Trial Info

Start Date :

March 15 2021

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 30 2025

Estimated Enrollment :

140 Patients enrolled

Trial Details

Trial ID

NCT04498754

Start Date

March 15 2021

End Date

December 30 2025

Last Update

July 3 2025

Active Locations (1)

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Duke University Medical Center

Durham, North Carolina, United States, 27706