OPTImizing CArdiac REhabilitation by REfining Sleep and STress

NCT ID: NCT06505109

Last Updated: 2025-06-19

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

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-28

Study Completion Date

2027-01-31

Brief Summary

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The primary objective of this project is to investigate the effectiveness and costs of integrating a behavioural program targeting sleep and stress (the RESST intervention) into cardiac rehabilitation (CR). In addition, the investigators will also study whether parameters regarding diversity (e.g., sex, ethnicity, socioeconomic position) are associated with intervention effectiveness. Furthermore, the investigators aim to explore the (bidirectional) relation between sleep and stress on the one hand, and other lifestyle components and health outcomes on the other hand.

Detailed Description

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CR focuses on the secondary prevention of cardiovascular disease (CVD) by promoting a healthy lifestyle and is a valuable approach to improve quality of life, mortality and hospital readmissions. However, optimization of CR is necessary. Current CR programs pay insufficient attention to sleep and stress problems, despite more than 50% of CVD patients experiencing sleep problems and high stress levels. Both sleep and stress are associated with adverse cardiovascular health and a decreased quality of life. The hypothesis for this study is that adding a behavioural intervention will improve sleep and perceived stress (primary outcomes), along with positive outcomes on biomarkers of chronic stress, QoL, cardiometabolic risk factors, physical fitness, lifestyle components, and psychosocial well-being.

The project involves a multicenter randomized controlled trial. The intervention group (100 patients) will receive standard CR along with the RESST intervention, consisting of 5-6 on-site group sessions integrating principles from Acceptance and Commitment Therapy and Cognitive Behavioral Therapy and focused on improving sleep and stress. The control group (100 patients) will receive standard multidisciplinary CR only.

The primary outcomes of the study include both objective and subjective measures of sleep, as well as perceived stress. Secondary outcomes encompass quality of life, chronic stress biomarkers, cardiometabolic risk factors, physical fitness, lifestyle components and psychosocial wellbeing. These outcomes will be assessed before and after the intervention, as well as at a 6-month follow-up.

Conditions

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Cardiovascular Diseases Cardiac Rehabilitation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients are randomized to treatment or control.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention group

The intervention group will receive standard CR along with the RESST intervention, consisting of 5-6 on-site group sessions, focused on sleep and stress, integrating principles from Acceptance and Commitment Therapy and Cognitive Behavioral Therapy.

Group Type EXPERIMENTAL

RESST

Intervention Type BEHAVIORAL

Subjects randomized to the RESST intervention will receive on top of standard rehabilitation a behavioural group intervention focussing on improving sleep and stress. This intervention will consist of 5 till 6 meetings of 90 till 120 minutes in the local rehabilitation centre during a time period of 3 till 4 months.

Control group

The control group will receive standard CR only. Standard CR programs last around 3-4 months and include two supervised exercise sessions per week. In addition, educational sessions are provided, covering topics such as medical information, cardiovascular risk factors, adopting a heart-healthy lifestyle, and coping with emotions. Depending on the patient's specific needs, counselling sessions on stress management, smoking cessation, and healthy diet are available, and individual counselling can be provided by a social worker, dietician, or psychologist/psychiatrist.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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RESST

Subjects randomized to the RESST intervention will receive on top of standard rehabilitation a behavioural group intervention focussing on improving sleep and stress. This intervention will consist of 5 till 6 meetings of 90 till 120 minutes in the local rehabilitation centre during a time period of 3 till 4 months.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age at or above 18 years
* Proficient in the Dutch language
* Experiencing sleep and/or stress problems as indicated by a high score on the Pittsburgh Sleep Quality Index (PSQI score \>5) or Perceived Stress Scale-10 (PSS-10 score \>13)
* Signed informed consent

Exclusion Criteria

* Severe psychiatric, cognitive or physical comorbidity that would impede CR participation
* Active treatment for sleep disorders, stress, or other forms of (behavioural) therapy at the start of the study or expected to start within the first 6 months of the study, that could interfere with the RESST intervention. Note: Participants with previously diagnosed sleep disorders are eligible if they still experience sleep or stress problems, unless they fall under the above criteria. Participants who received a prior treatment that is still ongoing but has resulted in a stable sleep and stress condition in the 3 months before the cardiovascular event (e.g., Continuous Positive Airway Pressure (CPAP)) are eligible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Capri Hartrevalidatie

UNKNOWN

Sponsor Role collaborator

Maxima Medical Center

OTHER

Sponsor Role collaborator

ZonMw: The Netherlands Organisation for Health Research and Development

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role lead

Responsible Party

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N. (Nienke) ter Hoeve PhD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Máxima Medisch Centrum

Eindhoven, North Brabant, Netherlands

Site Status RECRUITING

Capri Hartrevalidatie

Rotterdam, South Holland, Netherlands

Site Status RECRUITING

Capri Hartrevalidatie

The Hague, South Holland, Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Nienke ter Hoeve, PhD

Role: CONTACT

+31107033190

Facility Contacts

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Esmée Ooms, MSc

Role: primary

+31622366387

Inge van Loon, MSc

Role: backup

+31622366387

Esmée Ooms, MSc

Role: primary

+31622366387

Inge van Loon, MSc

Role: backup

+31622366387

Esmée Ooms, MSc

Role: primary

+31622366387

Inge van Loon, MSc

Role: backup

+31622366387

Other Identifiers

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10930012310027

Identifier Type: OTHER

Identifier Source: secondary_id

NL86677.078.24

Identifier Type: -

Identifier Source: org_study_id

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