Cognitive Behavioral Therapy and Trazodone Effects on Sleep and Blood Pressure in Insomnia

NCT ID: NCT06281756

Last Updated: 2025-11-10

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

EARLY_PHASE1

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-20

Study Completion Date

2028-05-31

Brief Summary

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Individuals who have insomnia with short sleep duration (ISS) differ from individuals who have insomnia with normal sleep duration (INS) in terms of health risks (i.e., hypertension) and treatment response. This study will examine whether patients with ISS and INS demonstrate a differential response to two common insomnia treatments. One is behavioral, Cognitive Behavioral Therapy for Insomnia (CBT-I). The other is a widely prescribed, non-habit-forming medication, trazodone used at a low dose. The investigators' findings could lead to evidence-based treatment guidelines that help clinicians more effectively match treatments to insomnia patients and reduce associated health problems.

Detailed Description

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Conditions

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Insomnia Insomnia Chronic Insomnia, Primary Blood Pressure Blood Pressure, High

Keywords

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sleep sleep disorder insomnia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

A 4-site (Hershey, Pennsylvania; Pittsburgh, Pennsylvania; Denver, Colorado; and Quebec, Canada) cohort study will examine the effect of CBT-I as a recommended first-line treatment for insomnia. This will be followed by a placebo-controlled randomized controlled trial (RCT) in those who do not remit in the Cohort Study. The subsequent RCT will compare the efficacy of trazodone vs. placebo among CBT-I non-remitters.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
Both prescribing physicians and participants will be blind to phenotype and treatment groups.

Study Groups

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Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with placebo

Subjects with insomnia treated with Cognitive Behavior Treatment for Insomnia (CBT-I) for 8 weeks, then non-remitting subjects received placebo for 8 weeks.

Group Type PLACEBO_COMPARATOR

Cognitive Behavioral Treatment for Insomnia (CBT-I)

Intervention Type BEHAVIORAL

Subjects will receive therapy for 8 weeks

Placebo

Intervention Type OTHER

Non-remitting subjects will receive placebo for 8 weeks

Subjects treated with Cognitive Behavior Treatment for Insomnia (CBT-I) with Trazodone

Subjects with insomnia treated with Cognitive Behavior Treatment for Insomnia (CBT-I) for 8 weeks, then non-remitting subjects received trazodone for 8 weeks.

Group Type ACTIVE_COMPARATOR

Cognitive Behavioral Treatment for Insomnia (CBT-I)

Intervention Type BEHAVIORAL

Subjects will receive therapy for 8 weeks

Trazodone

Intervention Type DRUG

Non-remitting subjects will receive Trazodone (dosage) for 8 weeks

Interventions

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Cognitive Behavioral Treatment for Insomnia (CBT-I)

Subjects will receive therapy for 8 weeks

Intervention Type BEHAVIORAL

Trazodone

Non-remitting subjects will receive Trazodone (dosage) for 8 weeks

Intervention Type DRUG

Placebo

Non-remitting subjects will receive placebo for 8 weeks

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18 or older
* Able to read and effectively communicate in English at the United States sites or able to read and effectively communicate in English or French at the Canadian site.
* Meets criteria for chronic insomnia
* Body Mass Index (BMI) 18.5 kg/m2 and higher

Exclusion Criteria

* Age \< 18
* Unable to read and effectively communicate in English at the United States sites or able to read and effectively communicate in English or French at the Canadian site.
* Unwilling to share email address/cell phone number to accept survey links.
* Life time diagnosis of psychotic or bipolar disorder
* History of severe apnea or an Apnea Hypopnea Index (AHI) ≥15 that is not currently treated with Positive Airway Pressure (PAP) therapy, an oral device or an implanted device, or was not treated with surgery or weight loss.
* Started new or changed treatment for sleep apnea in the past three months
* Does not meet criteria for chronic insomnia
* Meets criteria for narcolepsy or hypersomnia disorder
* Meets criteria for circadian rhythm disorder (including night shift work)
* Unstable medical conditions that would make participation unsafe or unfeasible
* Falls resulting in hospitalization, significant injury or fracture within past 12 months
* 2 hospitalizations or emergency room visits within past 12 months for chronic conditions
* Active chemotherapy or radiation therapy for cancer
* Lifetime diagnoses/treatment of chronic renal failure, hepatic insufficiency, chronic heart failure
* Does not agree to refrain from other treatments for insomnia beyond what is offered in this study
* BMI less than 18.5
* Substance abuse or dependence in the past 12 months
* Current use of prescription or over the counter medications taken for sleep greater than 2 times per week
* Current use of systemic corticosteroids or opiate medications
* Current pregnancy or breastfeeding; plans to get pregnant or unwillingness to use birth control for the length of the study
* Current use of medications contraindicated with trazodone
* Sleep apnea or periodic leg movement disorder as determined by sleep study
* Blood Pressure levels defined as seated SBP greater than 180 or DBP greater than 110 mmHg
* EKG corrected QT interval greater than or equal to 500 ms
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Milton S. Hershey Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Alexandros Vgontzas

Professor, Department of Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alexandros Vgontzas, MD

Role: PRINCIPAL_INVESTIGATOR

Professor, Psychiatry

Locations

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National Jewish Health

Denver, Colorado, United States

Site Status RECRUITING

Penn State University

Hershey, Pennsylvania, United States

Site Status RECRUITING

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Université Laval

Québec, Quebec, Canada

Site Status RECRUITING

Countries

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United States Canada

Central Contacts

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Carrie Criley

Role: CONTACT

Phone: 717-531-4123

Email: [email protected]

Facility Contacts

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Roxane Horberg

Role: primary

Rachel Johnson

Role: backup

Carrie Criley

Role: primary

Laurie Brar

Role: primary

Manon Lamy

Role: primary

Other Identifiers

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1UG3HL161342-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY00022285

Identifier Type: -

Identifier Source: org_study_id