Role of Sleep Reactivity in Shift Work Disorder
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Active phototherapy, Control phototherapy, Cognitive Behavioral Therapy (CBT), Sleep education control.
- Who it may be relevant to
- Registry conditions: Shift-work Disorder. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Sleep Reactivity as a Novel Mechanism in Shift Work Disorder
Overview
The purpose of this project is to test sleep reactivity as an independent cause of Shift Work Disorder (SWD). The primary hypothesis is that those with high sleep reactivity will show persistent SWD symptoms after experimental reduction of circadian misalignment, which will then be mitigated with CBT.
Detailed description
The first aim of this study is to establish sleep reactivity as a predictor of insomnia in SWD independent from circadian misalignment. The second aim of this study is to establish sleep reactivity as a predictor of sleepiness in SWD independent from circadian misalignment. The third aim of this study is to probe sleep reactivity as a cause of insomnia in SWD. The fourth aim of this study is to probe sleep reactivity as a cause of sleepiness in SWD.
Participants with Shift Work Disorder (SWD, N=150) with high and low sleep reactivity will be enrolled. This study will use a two-step mechanistic randomized controlled trial design stratified by high and low sleep reactivity to examine the independent effect of sleep reactivity in SWD after experimental reduction of circadian misalignment. The first step will experimentally reduce circadian misalignment compared to a control. Those who achieve reduced circadian misalignment (melatonin onset at or later than 4am, i.e., compromised phase position) and remain symptomatic will continue to the second step where sleep reactivity will be probed with CBT compared to a sleep education control.
Interventions
- Behavioral Active phototherapy
Timed bright light exposure delivered in a controlled laboratory setting (10,000 photopic lux) designed to delay the DLMO to 4 am or later. - Behavioral Control phototherapy
Timed less intense light exposure delivered in a controlled laboratory setting (100 photopic lux) that still has a perceptible alerting effect but is not designed to shift circadian phase. - Behavioral Cognitive Behavioral Therapy (CBT)
Cognitive strategies will identify stressors (e.g., dysfunctional beliefs about sleep) and intervene on worry and rumination with cognitive reappraisal and active coping. Sessions will be conducted by a trained behavioral sleep medicine provider via telemedicine to increase accessibility. - Behavioral Sleep education control
Sleep duration recommendations will be equivalent to the CBT group (8 hours of sleep opportunity) to ensure that outcomes are not confounded by time in bed. Materials in the sleep education control condition will be separated into weekly electronic materials monitored for engagement and completion.
Primary outcome measures
- Dim light melatonin onset [Time frame: Within two days of treatment for a duration of 24 hours]
- Sleep reactivity [Time frame: Within two weeks of treatment]
Secondary outcome measures (2)
- Insomnia [Time frame: Within one week of post-treatment]
- Sleepiness [Time frame: Within one week of post-treamtnet]
Eligibility criteria
Inclusion criteria
- Participants must be working a fixed nightshift schedule, operationalized as: a) working at least three night shifts a week, b) shifts must begin between 18:00 and 02:00, and last between 8 to 12 hours, and c) must also plan to maintain the nightshift schedule for the duration of the study
- Participants must have Shift Work Disorder, which will be diagnosed based on ICSD-3 criteria
- Participants must show circadian misalignment, operationalized as a baseline melatonin onset between 18:00 and 01:00.
- Participants must be at least 18 years old
Exclusion criteria
- Insomnia disorder or excessive sleepiness predating the onset of shift work
- Termination of nightshift schedule
- Presence of other sleep disorders (e.g. obstructive sleep apnea, narcolepsy) determined by standard clinical polysomnography
- Diagnosis of bipolar disorder
- History of neurological disorders determined by self-report and medical history
- Pregnancy
- Alcohol use disorder
- Illicit drug use via self-report and urine drug screen if reasonable suspicion to test
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Sequential
- Masking
- Double blind
- Primary purpose
- Other
Study locations
United States · 1 center
- Henry Ford Columbus Medical Center — Novi
Identifiers
NCT: NCT05424406 · 15661 · R01HL160870