Behavioral Insomnia Treatment in Mild Traumatic Brain Injury

NCT ID: NCT06551987

Last Updated: 2024-12-19

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

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-03

Study Completion Date

2027-09-01

Brief Summary

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This is a single site, two-armed random controlled trials (RCT) comparing six sessions of Cognitive Behavioral Therapy for Insomnia (CBT-I) with four sessions of Brief Behavioral Therapy for Insomnia (BBT-I) in service members with comorbid insomnia and prolonged postconcussive symptoms present for at least 3 months after Mild Traumatic Brain Injury (mTBI).

Detailed Description

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The purpose of this study is to identify the optimal behavioral treatment for insomnia in service members with comorbid insomnia and prolonged postconcussive symptoms following Mild Traumatic Brain Injury (mTBI). The study will compare Cognitive Behavioral Therapy for Insomnia (CBT-I) and Brief Behavioral Therapy for Insomnia (BBT-I) and determine the impact of behavioral insomnia treatment on insomnia symptom severity. This study will explore the impact of insomnia treatment on prolonged postconcussive symptoms and blood-based biomarkers. The overall objective is to determine if behavioral insomnia therapy can improve outcomes in service members with prolonged postconcussive symptoms following mTBI.

Both in-person and telehealth treatment formats will be offered to adapt to the service members schedule. The minimum acceptable number of sessions to the interventions in order to have evaluable data will be 4 sessions for CBT-I and 3 sessions for BBT-I. A participant is considered to have completed the study if he or she has completed the baseline assessment, at least 4 sessions for CBT-I and 3 sessions for BBT-I, and the 7-week and 12-week follow-up assessments.

Participants will be seen and treated at the Intrepid Spirit Center and/or the STRONG STAR offices both part of the Carl R. Darnall Army Medical Center (CRDAMC) located on the Fort Cavazos. Active duty service members at least 18 years of age who are seeking clinical care for persisting mTBI symptoms at the Intrepid Spirit Center located on Fort Cavazos. Women will be actively recruited into the study.

Conditions

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Insomnia Mild Traumatic Brain Injury

Keywords

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Cognitive Behavioral Therapy for Insomnia Brief Behavioral Therapy for Insomnia Insomnia Mild Traumatic Brain Injury Active Duty Military Personnel

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cognitive Behavioral Therapy for Insomnia

6 weekly, 50-minute sessions delivered individually using in-person or telehealth format by a trained behavioral health provider.

Group Type ACTIVE_COMPARATOR

Cognitive Behavioral Therapy for Insomnia

Intervention Type BEHAVIORAL

6 weekly, 50-minute sessions delivered individually using in-person or telehealth format by a trained behavioral health provider.

Brief Behavioral Therapy for Insomnia

4 weekly, 30-minute sessions delivered individually using in-person or telehealth format by a trained behavioral health provider.

Group Type ACTIVE_COMPARATOR

Brief Behavioral Therapy for Insomnia

Intervention Type BEHAVIORAL

4 weekly, 30-minute sessions delivered individually using in-person or telehealth format by a trained behavioral health provider.

Interventions

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Cognitive Behavioral Therapy for Insomnia

6 weekly, 50-minute sessions delivered individually using in-person or telehealth format by a trained behavioral health provider.

Intervention Type BEHAVIORAL

Brief Behavioral Therapy for Insomnia

4 weekly, 30-minute sessions delivered individually using in-person or telehealth format by a trained behavioral health provider.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Active duty U.S. military service members.
* At least 18 years of age.
* Ability to provide informed consent and follow study-related instructions.
* Self-report of a Mild Traumatic Brain Injury (mTBI) at least 3 months prior to enrollment based on self-report.
* At least 2 postconcussive symptoms scored \> 2 (moderate) on the Neurobehavioral Symptom Inventory (NSI), with at least 1 of these symptoms from the cognitive domain in addition to the sleep disturbances item.
* Clinically significant chronic insomnia disorder assessed by an independent evaluator using the Structured Clinical Interview for Sleep Disorders-Revised (SCISD-R)\_No Split Week Self-Assessment of Sleep Survey (SASS-Y).
* Minimum score of 15 on the Insomnia Severity Index (ISI).
* Plans to be in the area for the next 3 months.
* Stable on psychotropic and hypnotic medications for at least 1 month.
* Stable on continuous positive airway pressure therapy if diagnosed with sleep apnea for at least 1 month.

Exclusion Criteria

* Moderate TBI (e.g., skull fracture, brain hemorrhage, hematoma) indicated by self-report or medical record.
* Any sleep, medical, or psychiatric disorder requiring urgent treatment (e.g., suicide risk, substance use, insomnia with occupational impairment in high risk professions; very short sleep duration of less than 4 hours on average; bipolar disorder or psychosis) or that otherwise interferes with the completion of the baseline assessment.
* Working night shifts (i.e., duty later than 9:00 pm or before 5:30 am) more than 3 times per month.
* Planned major surgery.
* Pregnancy, assessed by self-report and review of medical record.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Congressionally Directed Medical Research Programs

FED

Sponsor Role collaborator

Hope Health Research Institute

UNKNOWN

Sponsor Role collaborator

The University of Texas Health Science Center at San Antonio

OTHER

Sponsor Role lead

Responsible Party

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Kristi Pruiksma

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kristi E Pruiksma, PhD

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Health Science Center at San Antonio

Locations

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Carl R. Darnall Army Medical Center

Fort Cavazos, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ethan A Olson, B.S.

Role: CONTACT

Phone: 5203120863

Email: [email protected]

Kristi E. Pruiksma, Ph.D.

Role: CONTACT

Phone: 210 562 6700

Email: [email protected]

Facility Contacts

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Scot D Engel, PsyD

Role: primary

Kristi E Pruiksma, PhD

Role: backup

References

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Bramoweth AD, Lederer LG, Youk AO, Germain A, Chinman MJ. Brief Behavioral Treatment for Insomnia vs. Cognitive Behavioral Therapy for Insomnia: Results of a Randomized Noninferiority Clinical Trial Among Veterans. Behav Ther. 2020 Jul;51(4):535-547. doi: 10.1016/j.beth.2020.02.002. Epub 2020 Feb 20.

Reference Type BACKGROUND
PMID: 32586428 (View on PubMed)

Pruiksma KE, Hale WJ, Mintz J, Peterson AL, Young-McCaughan S, Wilkerson A, Nicholson K, Dondanville KA, Fina BA, Borah EV, Roache JD, Litz BT, Bryan CJ, Taylor DJ; STRONG STAR Consortium. Predictors of Cognitive Behavioral Therapy for Insomnia (CBTi) Outcomes in Active-Duty U.S. Army Personnel. Behav Ther. 2020 Jul;51(4):522-534. doi: 10.1016/j.beth.2020.02.001. Epub 2020 Feb 14.

Reference Type BACKGROUND
PMID: 32586427 (View on PubMed)

Mysliwiec V, Martin JL, Ulmer CS, Chowdhuri S, Brock MS, Spevak C, Sall J. The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. Ann Intern Med. 2020 Mar 3;172(5):325-336. doi: 10.7326/M19-3575. Epub 2020 Feb 18.

Reference Type BACKGROUND
PMID: 32066145 (View on PubMed)

Other Identifiers

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TP220139

Identifier Type: OTHER

Identifier Source: secondary_id

STUDY00000222

Identifier Type: -

Identifier Source: org_study_id