Mechanisms of Change in Cognitive Behavioral Therapy for Insomnia (CBTi)

NCT ID: NCT05226585

Last Updated: 2025-04-16

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

93 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-26

Study Completion Date

2024-12-17

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to investigate the mechanisms of change in Cognitive Behavioral Therapy for insomnia (CBTi) in a sample of adults aged 50-65. This study aims to evaluate the pre-post treatment change in sleep, circadian rhythms, biomarkers, cognitive performance, and structural and functional magnetic resonance imaging scans (MRI).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Baseline Part 1:

* Online demographic and contact information
* Schedule Baseline Part 2 with the investigators via online link
* 1 week of daily sleep diaries

Baseline Part 2:

* Internet-based interview with the investigators to confirm study eligibility requirements
* Online self-report questionnaires
* 2 weeks of daily sleep diaries
* 2 weeks of sleep/wake assessment wearing a watch-like activity monitor (Actiwatch)

Objective Baseline:

* Single-night, diagnostic in-home sleep study, including and the following equipment:

* Adhesive patch which will adhere to the arm
* Sensor belts worn around the chest, fitted with nasal canula, pulse oximeter, and 3 electrodes which will adhere to the back of the neck and behind each ear
* Next-day appointment:

* Neuropsychological assessment
* Structural and functional magnetic resonance imaging scan (MRI)
* Non-invasive blood pressure readings
* Low-volume Blood draw (used to obtain genetic biomarkers)
* Removal of adhesive patch
* Next-day evening (2-nights):

* Consumable capsule
* Sensor belt worn around the chest/abdomen Random Assignment: If it is determined the participant is eligible for the study, participants will be randomly assigned to one of the treatment groups (in-person, telehealth or internet delivered) or asked to wait to start treatment.

Treatment Phase I:

* Participants will complete up to 12 weeks of insomnia treatment or wait for treatment ("waitlist") 12-Week Post-treatment Part 1:
* Complete 2 weeks of an online daily sleep diary and actigraphy
* Complete online self-report questionnaires

Objective 12-Week Post-treatment:

• Repeat "Objective Baseline" outlined above

Treatment Phase II (WLC):

* Treatment will start for participants who had been assigned to the waitlist condition 3-Month Follow-Up:
* Complete online self-report questionnaires

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Sleep Initiation and Maintenance Disorders

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Three treatment arms and a waitlist control
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The participant and outcomes assessor will not be aware of participant study conditions.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

In-person CBTi

CBTi of variable treatment length will be administered by trained study staff in-person.

Group Type ACTIVE_COMPARATOR

In-Person Cognitive Behavioral Therapy for Insomnia

Intervention Type BEHAVIORAL

Cognitive behavioral therapy is recommended as a first-line treatment for insomnia (CBTi). CBTi contains the following well-validated components of cognitive behavioral treatment for insomnia: stimulus control, sleep compression, sleep hygiene, relaxation training, and cognitive restructuring.

Telehealth CBTi

CBTi of variable treatment length will be administered by trained study staff via HIPAA-compliant tele-video conference.

Group Type ACTIVE_COMPARATOR

Telehealth Cognitive Behavioral Therapy for Insomnia

Intervention Type BEHAVIORAL

Telehealth cognitive behavioral therapy is recommended as a first-line treatment for insomnia (CBTi) conducted via audio-video communication. tCBTi contains the following well-validated components of cognitive-behavioral treatment for insomnia: stimulus control, sleep compression, sleep hygiene, relaxation training, and cognitive restructuring.

Internet CBTi

Self-paced CBTi of variable treatment length will be administered via Sleep Healthy Using The Internet (SHUTi).

Group Type ACTIVE_COMPARATOR

Internet Cognitive Behavioral Therapy for Insomnia

Intervention Type BEHAVIORAL

Sleep Healthy Using The Internet (SHUTi; aka iCBTi) is a self-guided, fully automated, online CBTi program that includes interactive features: personalized goal setting, graphical feedback based on inputted data, animations/illustrations to enhance comprehension, patient vignettes, and video-based expert explanations.

Waitlist Control

Treatment will be postponed by 12 weeks.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

In-Person Cognitive Behavioral Therapy for Insomnia

Cognitive behavioral therapy is recommended as a first-line treatment for insomnia (CBTi). CBTi contains the following well-validated components of cognitive behavioral treatment for insomnia: stimulus control, sleep compression, sleep hygiene, relaxation training, and cognitive restructuring.

Intervention Type BEHAVIORAL

Telehealth Cognitive Behavioral Therapy for Insomnia

Telehealth cognitive behavioral therapy is recommended as a first-line treatment for insomnia (CBTi) conducted via audio-video communication. tCBTi contains the following well-validated components of cognitive-behavioral treatment for insomnia: stimulus control, sleep compression, sleep hygiene, relaxation training, and cognitive restructuring.

Intervention Type BEHAVIORAL

Internet Cognitive Behavioral Therapy for Insomnia

Sleep Healthy Using The Internet (SHUTi; aka iCBTi) is a self-guided, fully automated, online CBTi program that includes interactive features: personalized goal setting, graphical feedback based on inputted data, animations/illustrations to enhance comprehension, patient vignettes, and video-based expert explanations.

Intervention Type BEHAVIORAL

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

CBTi tCBTi iCBTi

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Aged 50-65
* Normal hearing with or without hearing aids
* Ability to speak and read English and ability to give informed consent
* Possession of a computer with video and audio capabilities
* Meets DSM-5 Criteria for Insomnia Disorder
* Internet speed sufficient for participating in teletherapy (e.g., Zoom Health) or SHUTi (for iCBTi group)
* MoCA scores ≥24 will be deemed normal cognitive status and considered eligible for study participation and/or assessed by the ability to comprehend the baseline screening questionnaires
* Willing to refrain from new external behavioral health or medication treatment for issues pertaining to sleep during participation in the study
* Indication that the individual plans to be in the area for the 6 months following the first baseline assessment

* Current circadian rhythm disorder, sleep deprivation, or hypersomnia and related sleep disorders (assessed with clinical interview and/or self-report) as CBTi has not been validated in these populations. Verified by self-report and/or clinical interview (SCISD-R)
* Untreated sleep disordered breathing (e.g., obstructive sleep apnea) assessed by self-report, clinical interview, and/or diagnostic sleep study (i.e., baseline sleep study PSG)
* Failing to meet criteria for MRI scan (e.g., having metallic implants); see Pre-screen MRI Checklist for full list of exclusions for MRI scans.
* Fear/phobia of needles (conflict with blood draw) and/or small spaces (conflict with MRI scanner)
* Current suicide risk meriting crisis intervention as assessed by the Patient Health Questionnaire (PHQ-9) and/or disclosure of serious suicidal ideation
* Pregnancy (self-report, proposed instruments and treatments have not been validated in this population)
* Sleep efficiency \> 85%, assessed by the sleep diary
* Serious mental health diagnosis (e.g., bipolar disorder or psychosis) assessed by structured interview (M.I.N.I.)
* Currently engaged in evidence-based psychotherapy for Insomnia (i.e., Cognitive Behavioral Therapy) by self-report
* Failure to follow protocol (e.g., consistent "no show" for appointments, answering questionnaires dishonestly, refusal to complete more than 2 assessments \[e.g., fMRI and Neuropsych\])
Minimum Eligible Age

50 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Arizona

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Daniel J Taylor, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

The University of Arizona

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

The University of Arizona

Tucson, Arizona, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2107024013

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Optimizing Sleep Health in Nurses
NCT05965609 RECRUITING NA
Smartphone-delivered CBT-I
NCT05065242 COMPLETED NA
CBT-I in Older African American Adults
NCT06791356 NOT_YET_RECRUITING NA