Trial Outcomes & Findings for Sleep, Hypertension, and Nocturia: a Multicomponent Approach for Comorbid Illnesses (NCT NCT05419830)

NCT ID: NCT05419830

Last Updated: 2024-12-17

Results Overview

The mean sleep time systolic blood pressure dip will be quantified by calculating the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value for each participant across the 48-hour recording period comparing baseline and post-intervention

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

30 participants

Primary outcome timeframe

Baseline and at 6 weeks

Results posted on

2024-12-17

Participant Flow

Recruitment started June 2022 through September 2023. The initial screening was completed telephonically and once screened eligible, the interested participants underwent study related assessments and procedures at the study research suite - Continence Research Unit at University of Pittsburgh Medical Center, Montefiore Hospital located in Pittsburgh, Pennsylvania

After the telephone screening, eligible participants were scheduled for the first in-person study visit. No study procedures were performed till informed consent was obtained.

Participant milestones

Participant milestones
Measure
AM (Morning) Antihypertensive Dosing- Control Arm
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
participants will receive the brief behavioral treatment for insomnia (BBTI) by the study nurse. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM (Evening) Antihypertensive Dosing or Chronotherapy Arm
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Overall Study
STARTED
10
10
10
Overall Study
COMPLETED
10
10
10
Overall Study
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Sleep, Hypertension, and Nocturia: a Multicomponent Approach for Comorbid Illnesses

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
AM Antihypertensive Dosing Arm
n=10 Participants
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
n=10 Participants
participants will receive the behavioral treatment for insomnia BBTI by the study RN. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM Antihypertensive Dosing or Chronotherapy Arm
n=10 Participants
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Total
n=30 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
>=65 years
10 Participants
n=5 Participants
10 Participants
n=7 Participants
10 Participants
n=5 Participants
30 Participants
n=4 Participants
Age, Continuous
73.9 years
STANDARD_DEVIATION 5 • n=5 Participants
69.4 years
STANDARD_DEVIATION 4.6 • n=7 Participants
71.5 years
STANDARD_DEVIATION 4.2 • n=5 Participants
71.6 years
STANDARD_DEVIATION 4.8 • n=4 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
7 Participants
n=7 Participants
6 Participants
n=5 Participants
17 Participants
n=4 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
3 Participants
n=7 Participants
4 Participants
n=5 Participants
13 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
3 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Race (NIH/OMB)
White
9 Participants
n=5 Participants
7 Participants
n=7 Participants
10 Participants
n=5 Participants
26 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Region of Enrollment
United States
10 participants
n=5 Participants
10 participants
n=7 Participants
10 participants
n=5 Participants
30 participants
n=4 Participants
Office systolic blood pressure
144.9 mm Hg
STANDARD_DEVIATION 13.3 • n=5 Participants
137.4 mm Hg
STANDARD_DEVIATION 9.5 • n=7 Participants
155.5 mm Hg
STANDARD_DEVIATION 14.6 • n=5 Participants
145.8 mm Hg
STANDARD_DEVIATION 12.5 • n=4 Participants
Office diastolic blood pressure
80.4 mm Hg
STANDARD_DEVIATION 8.3 • n=5 Participants
79.9 mm Hg
STANDARD_DEVIATION 11 • n=7 Participants
85.7 mm Hg
STANDARD_DEVIATION 11.7 • n=5 Participants
82 mm Hg
STANDARD_DEVIATION 10.5 • n=4 Participants
Office heart rate
66.5 beats per minute
STANDARD_DEVIATION 13.4 • n=5 Participants
63.6 beats per minute
STANDARD_DEVIATION 8.7 • n=7 Participants
68.5 beats per minute
STANDARD_DEVIATION 8.9 • n=5 Participants
66.2 beats per minute
STANDARD_DEVIATION 10.4 • n=4 Participants
Body mass index (BMI)
31.2 kg/m2
STANDARD_DEVIATION 2.8 • n=5 Participants
34 kg/m2
STANDARD_DEVIATION 8.7 • n=7 Participants
31.4 kg/m2
STANDARD_DEVIATION 6.5 • n=5 Participants
32.2 kg/m2
STANDARD_DEVIATION 6.4 • n=4 Participants
Post void residual
47 ml
STANDARD_DEVIATION 75.3 • n=5 Participants
15.7 ml
STANDARD_DEVIATION 11.4 • n=7 Participants
18.7 ml
STANDARD_DEVIATION 35 • n=5 Participants
35.4 ml
STANDARD_DEVIATION 63.1 • n=4 Participants
Calcium channel blocker
6 Participants
n=5 Participants
3 Participants
n=7 Participants
4 Participants
n=5 Participants
13 Participants
n=4 Participants
Beta-blocker
3 Participants
n=5 Participants
5 Participants
n=7 Participants
1 Participants
n=5 Participants
9 Participants
n=4 Participants
Angiotensin converting enzyme inhibitor/ Angiotensin receptor blocker
8 Participants
n=5 Participants
9 Participants
n=7 Participants
7 Participants
n=5 Participants
24 Participants
n=4 Participants
Thiazide diuretic
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
10 Participants
n=4 Participants
Loop diuretic
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
Alpha- blocker
2 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
4 Participants
n=4 Participants
Statin
9 Participants
n=5 Participants
4 Participants
n=7 Participants
6 Participants
n=5 Participants
19 Participants
n=4 Participants
Antidepressant
1 Participants
n=5 Participants
4 Participants
n=7 Participants
3 Participants
n=5 Participants
8 Participants
n=4 Participants
Nonsteroidal anti-inflammatory drugs (NSAIDs)
0 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
2 Participants
n=4 Participants
Antimuscarinic
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
oral hypoglycemic
3 Participants
n=5 Participants
5 Participants
n=7 Participants
3 Participants
n=5 Participants
11 Participants
n=4 Participants
Insulin
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Hypnotic
0 Participants
n=5 Participants
4 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants

PRIMARY outcome

Timeframe: Baseline and at 6 weeks

The mean sleep time systolic blood pressure dip will be quantified by calculating the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value for each participant across the 48-hour recording period comparing baseline and post-intervention

Outcome measures

Outcome measures
Measure
AM Antihypertensive Dosing Arm
n=10 Participants
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
n=10 Participants
participants will receive the behavioral treatment for insomnia BBTI by the study RN. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM Antihypertensive Dosing or Chronotherapy Arm
n=10 Participants
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Change in Mean Sleep Time Systolic Blood Pressure Dip Pre- vs Post-intervention
-0.4 percentage of daytime mean SBP
Standard Deviation 7.9
7.3 percentage of daytime mean SBP
Standard Deviation 13.5
3.9 percentage of daytime mean SBP
Standard Deviation 10.0

SECONDARY outcome

Timeframe: Baseline and at 6 weeks

change in nocturia frequency pre- vs post-intervention as determined by 3-day bladder diary completed at both time points

Outcome measures

Outcome measures
Measure
AM Antihypertensive Dosing Arm
n=10 Participants
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
n=10 Participants
participants will receive the behavioral treatment for insomnia BBTI by the study RN. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM Antihypertensive Dosing or Chronotherapy Arm
n=10 Participants
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Change in Nocturia Frequency Pre- vs Post-intervention
-0.3 number of episodes
Standard Deviation 1.0
-0.6 number of episodes
Standard Deviation 0.7
-0.3 number of episodes
Standard Deviation 0.8

SECONDARY outcome

Timeframe: Baseline and at 6 weeks

NPi is calculated using nighttime and daytime urine volumes as reported in 3-day bladder diary as follows: NPi=(nocturnal urine volume/24-hour volume)\*100

Outcome measures

Outcome measures
Measure
AM Antihypertensive Dosing Arm
n=10 Participants
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
n=10 Participants
participants will receive the behavioral treatment for insomnia BBTI by the study RN. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM Antihypertensive Dosing or Chronotherapy Arm
n=10 Participants
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Change in Nocturnal Polyuira Index (NPi) Pre vs Post-intervention
0.5 % of 24h urine output excreted at night
Standard Deviation 7.4
-6.0 % of 24h urine output excreted at night
Standard Deviation 9.7
-0.9 % of 24h urine output excreted at night
Standard Deviation 7.6

SECONDARY outcome

Timeframe: Baseline and at 6 weeks

PSQI is a self-rated questionnaire for evaluating subjective sleep quality. PSQI global scores range from 0-21, with higher scores indicating worse sleep quality and negative change indicates sleep improvement.

Outcome measures

Outcome measures
Measure
AM Antihypertensive Dosing Arm
n=10 Participants
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
n=10 Participants
participants will receive the behavioral treatment for insomnia BBTI by the study RN. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM Antihypertensive Dosing or Chronotherapy Arm
n=10 Participants
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Change in Global Pittsburgh Sleep Quality Index (PSQI) Score Pre- vs Post-intervention
0.5 score on a scale
Standard Deviation 2.9
-1.4 score on a scale
Standard Deviation 2.2
-1.2 score on a scale
Standard Deviation 3.7

SECONDARY outcome

Timeframe: Baseline and at 6 weeks

Sleep efficiency will be calculated as (total sleep time/time in bed)\*100 with time in bed and total sleep times obtained from Zmachine worn by participants pre- and post-intervention

Outcome measures

Outcome measures
Measure
AM Antihypertensive Dosing Arm
n=10 Participants
participants will be asked to continue taking their antihypertensive medication within an hour of awakening AM antihypertensive dosing: participants will be asked to continue taking their antihypertensive medication within an hour of awakening
BBTI Arm
n=10 Participants
participants will receive the behavioral treatment for insomnia BBTI by the study RN. Participants will also be asked to take their antihypertensive medication within an hour of awakening BBTI: Participants randomized to BBTI will receive 45- to 60-minute individual intervention session followed by a 30-minute follow-up session 2 weeks later, and 20-minute telephone calls after 1 and 3 weeks. BBTI will focus on four behaviors that promote sleep and discussion of homeostatic and circadian mechanisms of human sleep regulation. These four interventions are simple to conceptualize and implement, and constitute the core of efficacious multi-modal behavioral treatments for insomnia.
PM Antihypertensive Dosing or Chronotherapy Arm
n=10 Participants
participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime PM antihypertensive dosing or Chronotherapy: participants will be asked to switch their conventional once daily non-diuretic antihypertensive to bedtime
Change in Sleep Efficiency Pre- vs Post-intervention
-7 %: (total sleep time/time in bed)*100
Standard Deviation 15.3
12 %: (total sleep time/time in bed)*100
Standard Deviation 7.8
-3 %: (total sleep time/time in bed)*100
Standard Deviation 11.8

Adverse Events

AM Antihypertensive Dosing Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

BBTI Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

PM Antihypertensive Dosing or Chronotherapy Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Shachi Tyagi, MD, MS

University of Pittsburgh

Phone: 4126471274

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place