Improving Sleep in Rehabilitation After Stroke

NCT ID: NCT04272892

Last Updated: 2025-09-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

86 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-14

Study Completion Date

2022-01-01

Brief Summary

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This study evaluates the efficacy of digital cognitive behavioural therapy for insomnia (Sleepio) in chronic stroke survivors. Half of the participants will receive access to the digital (online) programme, half will receive a leaflet with sleep hygiene information. The primary outcome will be changes in sleep quality, assessed as the score on the Sleep Condition Indicator.

Detailed Description

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Stroke is one of the leading causes of adult disability. Many stroke survivors report difficulties with sleep and our current research confirms this, indicating that chronic community dwelling stroke survivors experience poorer self-reported and objective sleep quality than age matched healthy controls.

"Sleepio" is an online Cognitive Behavioural Therapy for Insomnia (CBT-I) programme. The efficacy of this intervention has been demonstrated in people with chronic insomnia but has not yet been tested in people with stroke. The study therefore aims to determine whether digital CBT-I is effective for improving sleep quality in chronic stroke survivors. Participants will be randomised to receive either digital (online) CBT-I or a leaflet with sleep hygiene information. The primary outcome is the change in self-reported sleep quality, assessed using the Sleep Condition Indicator. Secondary outcomes include changes in sleep fragmentation and wake after sleep onset assessed with actigraphy, self-reported sleep onset latency from the sleep diaries, anxiety and depression using the PHQ9 and GAD7, quality of life using the SIS-8 and EQ-5D-5L as well as changes in healthcare costs during the 8 week follow up.

Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomised (1:1 ratio) to the intervention or control group, using a computer generated minimisation method, with minimisation of between groups differences in age and baseline self-reported sleep quality (sleep condition indicator score)
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Participants will be told that they will be assigned to one of two groups but will not be told whether one is hypothesised to be superior over another

Study Groups

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Digital CBT-I

6 weeks digital (online) cognitive behavioural therapy for insomnia

Group Type EXPERIMENTAL

Digital cognitive behavioural therapy for insomnia

Intervention Type BEHAVIORAL

6 weeks of cognitive behavioural therapy for insomnia (Sleepio) delivered online

Sleep hygiene information

Leaflet of sleep hygiene information

Group Type ACTIVE_COMPARATOR

Sleep hygiene information

Intervention Type BEHAVIORAL

A leaflet detailing advice to improve sleep through changes in sleep hygiene

Interventions

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Digital cognitive behavioural therapy for insomnia

6 weeks of cognitive behavioural therapy for insomnia (Sleepio) delivered online

Intervention Type BEHAVIORAL

Sleep hygiene information

A leaflet detailing advice to improve sleep through changes in sleep hygiene

Intervention Type BEHAVIORAL

Other Intervention Names

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Sleepio

Eligibility Criteria

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Inclusion Criteria

* Participant is willing and able to give informed consent for participation in the study.
* At least 18 years of age
* At least 3 months post stroke
* Interest in improving sleep
* Can understand verbal and written English well enough to engage with the programme and study procedures (with assistance from carer if needed).
* Reliable access to internet
* Currently living in the United Kingdom
* Current stable health

Exclusion Criteria

* Serious physical health concerns with surgery scheduled in the next 5 months
* Undergoing a psychological treatment programme for insomnia (with a health professional or online)
* Pregnancy
* Uncontrolled seizures
* Untreated diagnosed obstructive sleep apnoea
* Habitual night shift, evening or rotating shift-workers
* Other serious clinical condition that may affect participation in the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Big Health Inc.

INDUSTRY

Sponsor Role collaborator

University of Oxford

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Heidi Johansen-Berg, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Oxford, UK

Locations

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Wellcome Centre for Integrative Neuroimaging (WIN)

Oxford, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Fleming MK, Smejka T, Macey E, Luengo-Fernandez R, Henry AL, Robinson B, Kyle SD, Espie CA, Johansen-Berg H. Improving sleep after stroke: A randomised controlled trial of digital cognitive behavioural therapy for insomnia. J Sleep Res. 2024 Apr;33(2):e13971. doi: 10.1111/jsr.13971. Epub 2023 Jul 5.

Reference Type DERIVED
PMID: 37407096 (View on PubMed)

Provided Documents

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Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

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INSPIRES

Identifier Type: -

Identifier Source: org_study_id

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