Online COgnitive Behavioural Therapy for Sleep and Mental Health for Older Adults With Insomnia and Subjective Cognitive Complaints

NCT ID: NCT06032377

Last Updated: 2025-06-10

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

RECRUITING

Clinical Phase

NA

Total Enrollment

275 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-15

Study Completion Date

2025-12-31

Brief Summary

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The goal of this randomized controlled clinical trial is to assess a novel cognitive-behavioral program for sleep and mental health using a multidomain web platform (eCBTi+) in participants with insomnia and subjective cognitive complaint. The main questions it aims to answer are:

* Whether the eCBTi+ intervention improves sleep (subjective: Insomnia severity index \[ISI\], objective: EEG-based sleep efficiency) sleep and mental health (Geriatric Anxiety Index \[GAI\] and Geriatric Depression Scale \[GDS\]) compared to the control intervention
* Whether the eCBTi+ intervention improves cognitive abilities (subjective: Cognitive Failure Questionnaire \[CFQ\], objective: CANTAB executive functions composite score) compared to the control intervention

Detailed Description

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Participants with insomnia disorder will complete:

* A phone interview
* Two video conferences (assessment of eligibility and tutorial to set up sleep monitoring devices)
* 9 nights of at-home polysomnography with an EEG headband (3 times x 3 nights)
* 42 sleep diaries (3 times x 14 days)
* 42 days wearing an actigraphy device (3 times x 14 days)
* Online questionnaires
* Phone call for a check-in with a psychologist
* 3 cognitive testing sessions
* 10 modules of online information on health, over the course of 10 weeks
* In MRI subgroup: 2 in-person testing

Good sleeper participants will complete:

* A phone interview
* Two video conferences (assessment of eligibility and tutorial to set up sleep monitoring devices)
* 3 nights of at-home polysomnography with an EEG headband
* 14 sleep diaries
* 14 days wearing an actigraphy device
* Online questionnaires
* 1 cognitive testing session
* 1 in person session for MRI.

In addition, researchers will compare outcomes from participants with insomnia and subjective cognitive complaint to a group of good sleepers to have normative values for imaging data.

Conditions

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Insomnia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants with insomnia and subjective cognitive complaint are randomized into 2 groups with a 1:1 allocation ratio, after the pre-treatment assessment. Allocation will be stratified based on a composite mental health score and hypnotic medication intake. Follow-up assessments will occur 10 weeks and 24 weeks after the start of the intervention.

One group will receive the online CBT for sleep and mental health after the baseline assessment and the other group will receive the control intervention. The group receiving the control intervention will access the CBT intervention after completion of the study.

A good sleepers group, matched on age and gender, will also be recruited and assessed at baseline only to provide a normative reference group.

A subgroup of participants from the insomnia group and the good sleepers group will undergo MRI and classical neuropsychological testing at baseline and 24 weeks after the start of the intervention.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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online cognitive behavioral therapy for insomnia, anxiety and depression

10 self-directed modules of cognitive behavioral therapy for insomnia, anxiety and depression, delivered online, once a week

Group Type EXPERIMENTAL

cognitive behavioral therapy for sleep, anxiety, and depression

Intervention Type BEHAVIORAL

This intervention addresses insomnia, anxiety and depression via modules covering all the core CBTi components: psychoeducation about insomnia, relaxation, cognitive restructuring, stimulus control, sleep restriction and stress management; as well as psychoeducation about anxiety and low mood, behavioral activation strategies, and strategies to better manage ruminations. The modules are adapted to older adults and include short texts, pictures, quizzes with feedback, interactive exercises, logbooks, audio and video recordings.

online intervention on nutrition and communication in older age

10 self-directed modules on healthy nutrition habits and communication strategies, delivered online, once a week

Group Type ACTIVE_COMPARATOR

education about healthy nutrition habits and communication in older age

Intervention Type BEHAVIORAL

This intervention addresses healthy nutrition habits as well as communication and aging. The modules are adapted to older adults and include short texts, pictures, quizzes with feedback, interactive exercises, logbooks, audio and video recordings

Interventions

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cognitive behavioral therapy for sleep, anxiety, and depression

This intervention addresses insomnia, anxiety and depression via modules covering all the core CBTi components: psychoeducation about insomnia, relaxation, cognitive restructuring, stimulus control, sleep restriction and stress management; as well as psychoeducation about anxiety and low mood, behavioral activation strategies, and strategies to better manage ruminations. The modules are adapted to older adults and include short texts, pictures, quizzes with feedback, interactive exercises, logbooks, audio and video recordings.

Intervention Type BEHAVIORAL

education about healthy nutrition habits and communication in older age

This intervention addresses healthy nutrition habits as well as communication and aging. The modules are adapted to older adults and include short texts, pictures, quizzes with feedback, interactive exercises, logbooks, audio and video recordings

Intervention Type BEHAVIORAL

Other Intervention Names

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eCBTi+ active control

Eligibility Criteria

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Inclusion Criteria

* age 60 years or older at the time of enrolment
* Sleep Condition Indicator, SCI ≤ 16 and/or meeting DSM-V criteria based on the symptoms assessed by the SCI
* subjective cognitive complaints (self-report version of Everyday Cognition scale (ECog), score ≥ 2 on any item)
* ability to read and understand French or English
* ability to use a smartphone or tablet, and access to home internet connection
* If on hypnotic or psychotropic medication (including cannabis), being on stable dosage for at least 2 months prior to study entry
* Score on the STOP-BANG questionnaire \< 3 corresponding to participants with low risk of obstructive sleep apnea

Exclusion

* located outside of Québec or Ontario
* current hospitalization or planned major surgery
* uncorrected severe hearing or vision impairment
* reported diagnosis of major neurocognitive disorder or mild cognitive impairment (MCI)
* performance suggestive of major neurocognitive disorder or MCI on T-MoCA \< 17
* reported diagnosis of schizophrenia or bipolar disorder
* reported diagnosis or positive screen on the MINI for psychotic or bipolar disorders
* high suicidal risk, as assessed by the modified Columbia-Suicide Severity Rating Scale
* reported diagnosis or positive screening (apnea-hypopnea index \>30 on a level 3 home sleep apnea test) for another untreated sleep disorder (e.g., sleep disordered breathing (OSA), REM sleep behavior disorder (RBD), restless legs syndrome (RLS); individuals with treated and controlled OSA (residual apnea-hypopnea index \<30 and good therapeutic compliance) or RLS will not be excluded
* current shift work
* currently receiving CBT, having received CBTi in the past
* frequent alcohol consumption having an impact on functionning (\>10 glasses/week and having a significant impact on functionning)
* illicit drugs use (more than once a month)

Exclusion Criteria

* psychotropic (including hypnotic) medication in the past 2 weeks
* contraindications for MRI (e.g., pacemaker, metallic implant, claustrophobia)
* unable or unwilling to come to one of the participating MRI centers (Montreal, Ottawa)
* medical conditions likely to affect sleep; in particular:
* current neurological disorder (e.g., epilepsy with any seizure in the past year, concussion in the past 3 months, multiple sclerosis, Parkinson's disease)
* past history of brain lesion (e.g., brain hemorrhage, brain tumor, any condition having required brain surgery)
* major surgery (i.e., requiring general anesthesia) in the past 3 months
* untreated thyroid disorder
* chronic pain syndrome self-reported as interfering with sleep (e.g., migraine, fibromyalgia, rheumatoid arthritis)
* recent and severe infection in the past 3 months (e.g., pneumonia, kidney infection)
* active cancer or treated cancer with post-cancer treatment for less than 2 years
Minimum Eligible Age

60 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal

OTHER

Sponsor Role lead

Responsible Party

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Thien Thanh Dang-Vu

Professor, Neurologist; Director, Sleep, Cognition & Neuroimaging Laboratory (SCNLab)

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The Royal's Institute of Mental Health Research (IMHR)

Ottawa, Ontario, Canada

Site Status RECRUITING

Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de l'Île-de-Montréal. CCSMTL - IUGM

Montreal, Quebec, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Thien Thanh Dang-Vu, MD PhD

Role: CONTACT

+1 (514) 340-3540 ext. 3540

Rebecca Robillard, PhD

Role: CONTACT

+1 (613) 722-6521 ext. 6279

Facility Contacts

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Rébecca Robillard, PhD

Role: primary

+1 613-722-6521 ext. 6095

Florence Pomares, PhD

Role: primary

+1 514-340-3540 ext. 4790

Other Identifiers

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BH210177

Identifier Type: -

Identifier Source: org_study_id

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