A Multicomponent Intervention for Prevention and Treatment of Sleep Disturbances in a Psychiatric Intensive Care Unit

NCT ID: NCT04995263

Last Updated: 2022-09-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-22

Study Completion Date

2023-08-01

Brief Summary

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Hospitalized adult patients suffer from sleep deprivation, which has been associated with multiple negative consequences, both in short and in the long term. Many factors have been attributed to poor sleep quality, including excessive noise, inappropriate lighting, interactions with the healthcare team, administration of drugs, patients' symptoms, among others. There is scarce evidence reporting multicomponent interventions aimed at ensuring and improving sleep quality in hospitalized patients. The following before-after, randomized controlled trial will evaluate and determine the feasibility, acceptability and effectivity of a multicomponent intervention in improving sleep quality and reducing the consequences of poor sleep in a psychiatric intensive care unit (PICU). The intervention is comprised of changes in health personnel habits, improvements in the PICU environment, patient's psychoeducation and continuous sleep and activity monitoring through a validated wearable device.

Detailed Description

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Conditions

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Dyssomnias

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Before-after design for the implementation of unit-wide intervention, with a later randomization for individualized interventions.
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
Two investigators will work on-site collecting data for each of the variables, uploading them to a secure database (REDCap) as anonymous data. Afterwards, data and outcomes will be analyzed by a blinded investigator.

Study Groups

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Pre-intervention, control group

A basal measurement of primary and secondary outcomes of the target population, prior to the implementation the intervention. Estimated duration 3 months, n = 30.

Group Type NO_INTERVENTION

No interventions assigned to this group

Post-intervention, SUEÑA half bundle, active group 1

Post-intervention, environmental and behavioral modifications in patient care interventions.

Implementation of components 1 through 4 of SUEÑA intervention in the entire PICU unit. All participants will be exposed to the intervention. Estimated duration: 3 months, n = 30.

Group Type EXPERIMENTAL

Sueña component 1: Sleep Hygiene Promotion

Intervention Type BEHAVIORAL

The nursery staff will be instructed to promote sleep hygiene. Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy. Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e. blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM. A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.

Sueña component 2: Periodic Anxiety and Pain Screening

Intervention Type BEHAVIORAL

Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one. If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.

Sueña component 3: Hypnotics and Caffeine Regulation

Intervention Type BEHAVIORAL

The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM. Caffeinated drinks will be prohibited after 15:00 PM.

Sueña component 4: Sleep Masks and Ear Plugs

Intervention Type BEHAVIORAL

Sleep masks and ear plugs will be available to all patients if they wish to use them. The nursery team will reinforce its use between 23:00 PM and 07:00 AM.

Post-intervention, randomization for SUEÑA half bundle plus, active group 2

Randomization for full SUEÑA bundle: environmental and behavioral modifications in patient care interventions plus sleep informed treatment.

Participants will be randomized to receive SUEÑA components 1 through 5 Estimated duration: 6 months, n = 30

Group Type EXPERIMENTAL

Sueña component 1: Sleep Hygiene Promotion

Intervention Type BEHAVIORAL

The nursery staff will be instructed to promote sleep hygiene. Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy. Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e. blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM. A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.

Sueña component 2: Periodic Anxiety and Pain Screening

Intervention Type BEHAVIORAL

Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one. If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.

Sueña component 3: Hypnotics and Caffeine Regulation

Intervention Type BEHAVIORAL

The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM. Caffeinated drinks will be prohibited after 15:00 PM.

Sueña component 4: Sleep Masks and Ear Plugs

Intervention Type BEHAVIORAL

Sleep masks and ear plugs will be available to all patients if they wish to use them. The nursery team will reinforce its use between 23:00 PM and 07:00 AM.

Sueña component 5: Personalized Psychoeducation

Intervention Type OTHER

Two individualized, nurse-led psychoeducation PowerPoint presentations on sleep hygiene will be presented to patients, supported by educational material aimed at the patient and their families.

Post-intervention, randomization for SUEÑA full bundle, active group 3

Randomization for full SUEÑA bundle: environmental and behavioral modifications in patient care interventions plus sleep informed treatment and personalized psychoeducation.

. Participants will be randomized to receive SUEÑA components 1 through 6. Estimated duration: 6 months, n = 30

Group Type EXPERIMENTAL

Sueña component 1: Sleep Hygiene Promotion

Intervention Type BEHAVIORAL

The nursery staff will be instructed to promote sleep hygiene. Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy. Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e. blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM. A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.

Sueña component 2: Periodic Anxiety and Pain Screening

Intervention Type BEHAVIORAL

Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one. If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.

Sueña component 3: Hypnotics and Caffeine Regulation

Intervention Type BEHAVIORAL

The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM. Caffeinated drinks will be prohibited after 15:00 PM.

Sueña component 4: Sleep Masks and Ear Plugs

Intervention Type BEHAVIORAL

Sleep masks and ear plugs will be available to all patients if they wish to use them. The nursery team will reinforce its use between 23:00 PM and 07:00 AM.

Sueña component 5: Personalized Psychoeducation

Intervention Type OTHER

Two individualized, nurse-led psychoeducation PowerPoint presentations on sleep hygiene will be presented to patients, supported by educational material aimed at the patient and their families.

Sueña component 6: Sleep Reports

Intervention Type DEVICE

Objective and subjective reports of sleep quality will be handed to attending psychiatrist, using data gathered with wearable devices (Fitbit Charge 4) and self-report questionnaires regarding perceived sleepiness and overall sleep. The psychiatrist in charge uses said information in the routine case management

Interventions

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Sueña component 1: Sleep Hygiene Promotion

The nursery staff will be instructed to promote sleep hygiene. Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy. Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e. blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM. A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.

Intervention Type BEHAVIORAL

Sueña component 2: Periodic Anxiety and Pain Screening

Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one. If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.

Intervention Type BEHAVIORAL

Sueña component 3: Hypnotics and Caffeine Regulation

The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM. Caffeinated drinks will be prohibited after 15:00 PM.

Intervention Type BEHAVIORAL

Sueña component 4: Sleep Masks and Ear Plugs

Sleep masks and ear plugs will be available to all patients if they wish to use them. The nursery team will reinforce its use between 23:00 PM and 07:00 AM.

Intervention Type BEHAVIORAL

Sueña component 5: Personalized Psychoeducation

Two individualized, nurse-led psychoeducation PowerPoint presentations on sleep hygiene will be presented to patients, supported by educational material aimed at the patient and their families.

Intervention Type OTHER

Sueña component 6: Sleep Reports

Objective and subjective reports of sleep quality will be handed to attending psychiatrist, using data gathered with wearable devices (Fitbit Charge 4) and self-report questionnaires regarding perceived sleepiness and overall sleep. The psychiatrist in charge uses said information in the routine case management

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Hospitalized in the last 72 hours.
* Capacity to consent
* Approval by treating physician

Exclusion Criteria

* Active psychosis
* Active eating disorder
* Delirium
* Major cognitive disorder
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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UC CHRISTUS

UNKNOWN

Sponsor Role collaborator

Pontificia Universidad Catolica de Chile

OTHER

Sponsor Role lead

Responsible Party

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Constanza Caneo

Clinical Assistant Professor, C-L Psychiatrist, SUEÑA Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Constanza Caneo Robles, MD

Role: STUDY_DIRECTOR

Pontifica Universidad Católica de Chile

Juan C Rodríguez, MD

Role: STUDY_DIRECTOR

Pontifica Universidad Católica de Chile

María Rodríguez Fernández, PhD

Role: STUDY_CHAIR

Pontifica Universidad Católica de Chile

Marcela Babul, MD

Role: STUDY_CHAIR

Pontifica Universidad Católica de Chile

Locations

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Clínica San Carlos de Apoquindo UC

Santiago, Santiago Metropolitan, Chile

Site Status RECRUITING

Countries

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Chile

Central Contacts

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Constanza Caneo Robles, MD

Role: CONTACT

+56 9 4290 9250

Juan C Rodríguez, MD

Role: CONTACT

+56 9 4448 9732

References

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Other Identifiers

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0

Identifier Type: -

Identifier Source: org_study_id

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