Online CBT-I for High Blood Pressure

• Sponsor: Emory University (Other)
• Overall Status: Completed
• CT.gov ID: NCT02299193
• Collaborator: American Heart Association (Other)
• Enrollment: 58
• Location: 1
• Arms: 2
• Duration (Months): 24
• Patients Per Site Per Month: 2.4

Study Details

Study Description

Brief Summary

The purpose of this study is to compare the effect of 6-weekly, 20 minute sessions of 2 online behavioral sleep interventions (cognitive behavioral therapy or healthy sleep habits) on blood pressure, sleep, depressive symptoms and anxiety in people with insomnia and prehypertension or hypertension.

Condition or Disease	Intervention/Treatment	Phase
Hypertension; Prehypertension; Insomnia	Behavioral: Cognitive Behavioral Therapy; Behavioral: Healthy Sleep Habits	N/A

Detailed Description

Approximately 30% of US adults have prehypertension (untreated blood pressure ≥120-139/80-89 mmHg) and 29% have hypertension (blood pressure ≥ 140/90 mmHg or antihypertensive medication use). Numerous factors contribute to the development of prehypertension and hypertension including age, genetics, obesity, and behavioral factors such as exercise and diet.However, the sleep disorder insomnia is another behavioral factor increasingly implicated with risk of hypertension. Insomnia, the most frequent sleep complaint in adults, is characterized by difficulty falling asleep, trouble maintaining sleep or non-restorative sleep coupled with significant daytime distress or functional impairment. Insomnia is a pervasive sleep disorder associated with decreased quality of life, reduced work productivity, and increased health care costs; it is increasingly identified as a cardiovascular disease risk factor. Lifestyle modifications recommended for pre-hypertension and hypertension do not address sleep. This pilot randomized clinical trial will test the preliminary efficacy of an online cognitive behavioral therapy intervention (N=40) versus an online healthy sleep habits intervention (N=20), to reduce blood pressure in a sample of untreated individuals with insomnia and prehypertension or hypertension. Participants will be followed for 12-weeks post-intervention. Primary outcome measures are systolic blood pressure. Secondary measures include sleep efficiency, insomnia severity, physical and mental function.

Study Design

• Study Type: Interventional
• Actual Enrollment: 58 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Supportive Care
• Official Title: Online CBT-I for High Blood Pressure
• Study Start Date: Aug 1, 2014
• Actual Primary Completion Date: Aug 1, 2016
• Actual Study Completion Date: Aug 1, 2016

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Cognitive Behavioral Therapy online sessions on how behaviors and thoughts that can affect sleep.	Behavioral: Cognitive Behavioral Therapy; 6 weekly, 20 minute online sessions about how thoughts and behaviors can affect sleep; Other Names: CBT-I
Sham Comparator: Healthy Sleep Habits online sessions about healthy sleep practices	Behavioral: Healthy Sleep Habits; 6 weekly, 20 minute online sessions about healthy sleep practices

Outcome Measures

Primary Outcome Measures

1. Change in Systolic Blood Pressure [8 and 20 weeks]

   Systolic blood pressure will be measured at baseline, 8 and 20 weeks

Secondary Outcome Measures

1. Change in Insomnia Severity Index [8 and 20 weeks]

   Insomnia Severity Index (ISI) questionnaire will be measured at baseline, 8 and 20 weeks

2. Changes in Sleep Efficiency [8 and 20 weeks]

   Actigraphy based sleep efficiency will be measured at baseline, 8 and 20 weeks

3. Change in Depressive Symptoms [8 and 20 weeks]

   Depressive symptoms measured at baseline, 8 and 20 weeks

4. Change in mental functioning [8 and 20 weeks]

   Mental function measured at baseline, 8 and 20 weeks

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• prehypertension or hypertension, insomnia (difficulty getting to sleep, staying asleep and/or early morning awakenings), internet access, current email use, willingness to be randomized to either intervention group, ability to read/write in English.

Exclusion Criteria:

• medication known to alter sleep, sleep disorder (other than insomnia), frequent travel over 2-3 time zones, currently receiving behavioral treatment for insomnia, major depression, anxiety disorders, PTSD or bipolar disorder, >14 alcoholic drinks/week, recreational drug use, prior diagnosis of: epilepsy, dementia/Alzheimer's disease, renal failure requiring dialysis, stroke, secondary hypertension, angina, peripheral artery disease, heart failure, myocardial infarction or cardiac surgery within the past 6 months

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Emory University	Atlanta	Georgia	United States	30322

Sponsors and Collaborators

• Emory University
• American Heart Association

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Faye Routledge, Professor, Emory University
• ClinicalTrials.gov Identifier: NCT02299193
• Other Study ID Numbers: IRB00073066
• First Posted: Nov 24, 2014
• Last Update Posted: Aug 31, 2016
• Last Verified: Aug 1, 2016

• Keywords provided by Faye Routledge, Professor, Emory University: cognitive behavioral therapy for insomnia; sleep hygiene
• Additional relevant MeSH terms: Sleep Initiation and Maintenance Disorders; Hypertension; Prehypertension

Study Results

No Results Posted as of Aug 31, 2016