Sleep for Health Study on the Effects of Cognitive Behavioral Therapy for Insomnia on Diabetes Risk

NCT ID: NCT06067139

Last Updated: 2025-12-15

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

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-01

Study Completion Date

2027-12-31

Brief Summary

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This study tests whether providing cognitive behavioral therapy for insomnia (CBT-I) to people with prediabetes results in a reduction in glucose levels compared to a patient education control program.

Detailed Description

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Type 2 diabetes mellitus (T2D) is a major cause of blindness, kidney failure, cardiovascular disease, amputations, reduced quality of life, and premature death in the United States, and it is expected that one in three Americans will have T2D by 2050. To stem the tide of this health crisis, new strategies are needed to prevent the progression to T2D from prediabetes-elevated glucose levels that are not yet in the diabetes range. A growing body of research suggests that insomnia is a major modifiable risk factor for progression to diabetes. The proposed study would build off a promising feasibility study to test whether providing cognitive behavioral therapy for insomnia (CBT-I) to patients with prediabetes results in a reduction in glucose levels compared to a patient education control program. If so, this insomnia treatment could be an effective tool to prevent diabetes.

Individuals with prediabetes and insomnia will be randomized to receive six sessions of a deployment-ready digital CBT-I program, providing standard-of-care treatment for insomnia (intervention arm, n = 150), or a patient education website providing nontailored material about insomnia (control arm, n = 150). The investigators will complete assessments at baseline, at 11 weeks (after the conclusion of the intervention and control programs), and at 33 weeks post-baseline, measuring hyperglycemia, objective and subjective measures of sleep, and potential mediating variables including diet, exercise, and mood.

The investigators will assess (1) whether individuals randomized to the intervention arm have lower rates of hyperglycemia, as measured by oral glucose tolerance testing and various secondary measures, than individuals randomized to the control arm at 11 weeks and 33 weeks after baseline; (2) whether improvements in sleep after baseline are associated with decreases in hyperglycemia, regardless of study arm; and (3) whether any effects of the intervention on hyperglycemia are mediated by improvements in sleep, diet, exercise, and/or mood.

This research will serve as a critical step in identifying a potentially dramatic tool for improving health outcomes for Americans at risk of T2DM. Sleep interventions can lead to sustained improvements that are intrinsically rewarding to patients. If effective, digital CBT-I could provide a powerful pathway to preventing diabetes for millions of patients with prediabetes.

Conditions

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Diabetes Mellitus, Type 2 Prediabetic State Sleep Initiation and Maintenance Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Digital cognitive behavioral therapy (dCBT-I)

CBT-I is designed to change sleep habits and scheduling factors that affect sleep, and to address misconceptions about sleep and insomnia that perpetuate sleep difficulties. The investigators will employ SHUTi, which is an extensively studied dCBT-I program. SHUTi is intended to improve insomnia symptoms by providing neurobehavioral intervention (cognitive behavioral therapy for insomnia - CBT-I) in adults with chronic insomnia. It is a six-core internet-delivered CBT-I web-based app that is run through a browser. It is accessible via iPhone/iPad, Android phone/tablet, computer or laptop (any device with a browser). SHUTi follows evidence-based CBT-I principles.

Group Type EXPERIMENTAL

SHUTi

Intervention Type OTHER

Each core includes a variety of interactive features, such as animations, vignettes, "myth" and "reality" buttons that reveal common misperceptions and facts about sleep, "learn more" buttons that provide in-depth information about a topic, and quizzes. All cores follow a similar structure with objectives, main content, homework, and review. Participants are free to revisit cores as many times as they like.

Patient Education (PE)

Participants will be given access to a patient education website. It will provide nontailored material about insomnia symptoms; the impact, prevalence, and causes of insomnia; and basic lifestyle, environmental, and behavioral strategies to improve sleep.

Group Type ACTIVE_COMPARATOR

Patient Education

Intervention Type OTHER

The PE website will present content in a simple, static form, without interactive components; and all content on the website will be provided at once, rather than in modules that unlock over time. The PE website will also not provide personalized or individually tailored treatment recommendations.

Interventions

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SHUTi

Each core includes a variety of interactive features, such as animations, vignettes, "myth" and "reality" buttons that reveal common misperceptions and facts about sleep, "learn more" buttons that provide in-depth information about a topic, and quizzes. All cores follow a similar structure with objectives, main content, homework, and review. Participants are free to revisit cores as many times as they like.

Intervention Type OTHER

Patient Education

The PE website will present content in a simple, static form, without interactive components; and all content on the website will be provided at once, rather than in modules that unlock over time. The PE website will also not provide personalized or individually tailored treatment recommendations.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 22 years and \< 80 years of age
* Prediabetes
* Insomnia
* Regular access to device with internet access
* Adequate data at baseline

Exclusion Criteria

* BMI \> 40 kg/m2
* Sleep comorbidities detected in medical record or via medical history
* Shift work or significant, externally imposed irregular sleep schedule
* moderate to severe OSA by home sleep apnea test as part of trial protocol
* Received a full course of CBT-I in the last 12 months
* Current use of medication with glycemic effects:
* History of type 1 or type 2 diabetes or recent/planned use of hypoglycemic agents (e.g., metformin, insulin)
* Recent history of bariatric surgery or planning bariatric surgery in the next year
* Current or recent use of weight loss meds
* Unstable sleep medication regimen (recent change to schedule or dosage)
* Significant comorbidity that may interfere with CBT-I uptake or increase risks
* Unwilling or unable to limit heavy machinery use/long bouts of driving or unstable illness that would be worsened by sleep restriction
* High risk of falls
* Epilepsy
* Medical conditions that interfere with dCBT-I or contribute to insomnia or diabetes risk (e.g., hyperthyroidism, significant kidney disease, active cancer treatment, any medical condition that requires chronic steroid use)
* Significant alcohol or substance use disorder
* Active or recent history of eating disorder, recent weight change of \>10%
* Women: pregnancy (current or planned), breastfeeding, \< 1 year postpartum
* Use of hydroxyurea
* Extensive skin changes or adhesive allergy making CGM sensor use problematic
Minimum Eligible Age

22 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Erin LeBlanc, MD

Role: PRINCIPAL_INVESTIGATOR

Kaiser Permanente

Locations

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Kaiser Permanente Center for Health Research

Portland, Oregon, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Stefan Massimino, MS

Role: CONTACT

971-232-9343

Chris Catlin

Role: CONTACT

971-369-0655

Facility Contacts

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Stefan Massimino, MS

Role: primary

971-232-9343

Chris Catlin

Role: backup

971-369-0655

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Related Links

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http://dbcms.s3.amazonaws.com/media/files/80cc1018-d357-49de-91df-2bd298499dc2/what%20is%20prediabetes.pdf

Diabetes Care and Education Dietetic Practice Group. What is pre-diabetes?

http://professional.diabetes.org/

American Diabetes Association. All about pre-diabetes. Toolkit No. 3 2012

Other Identifiers

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1R01DK132229-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

R01DK132229

Identifier Type: NIH

Identifier Source: org_study_id

View Link

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