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Delayed Sleep-Wake Phase DisorderSIPNCT05177055

Sleep in Psychiatric Care (SIP): Treatment for Comorbid Delayed Sleep-Wake Phase Disorder (DSWPD)

A study testing Group-based light therapy at gradually advanced timing for DSWPD, Group-based light therapy at gradually advanced timing for DSWPD and additive bb-glasses and 6-week wait list for sleep-school in people with Delayed Sleep-Wake Phase Disorder and Sleep Disorder, run by Haukeland University Hospital at 2 sites in Norway.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Sleep disorders commonly co-occur with psychiatric disorders. Sleep disorders are often treated with medication or not at all in psychiatric care, although there exist a plethora of documentation of the effectiveness of sleep interventions. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Group-based light therapy at gradually advanced timing for DSWPD, Group-based light therapy at gradually advanced timing for DSWPD and additive bb-glasses and 6-week wait list for sleep-school
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
2 sitesNorway
Study dates
23 May 2022to 31 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients referred to the sleep-school at Bjørgvin DPS psychiatric hospital
  • Patients fulfilling the Diagnostic Manual for Mental Disorders (DSM-V) criteria for DSWPD comorbid to moderate to severe psychiatric illness (confirmed F-diagnosis based on the International Statistical Classification of Diseases and Related Health Problems (ICD-11) diagnostic system that are used in Norway in addition to DSWPD and/or scores of ≥19 on BDI and/or scores of ≥16 on BAI at the time of referral to the sleep school)

Who cannot join

  • Night work
  • Patients that do not fulfil the DSM-V criteria for DSWPD comorbid to moderate to severe psychiatric illness (confirmed F-diagnosis based on the ICD-10 diagnostic system that are used in Norway in addition to insomnia and/or scores of ≥19 on BDI and/or scores of ≥16 on BAI at the time of referral to the sleep school)

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Norway2 sites, 2 recruiting
  • Haukeland University Hospital

    Bergen, Tertnes, 5113

    Ane Wilhelmsen-Langeland, PhD, +47 92843253, ane.wilhelmsen-langeland@helse-bergen.no

    Veronika A Vågenes, BA, +47 90078867, veronika.alice.vågenes@helse-bergen.no

    Recruiting
  • Haukeland University Hospital

    Bergen, 5113

    Ane Wilhelmsen-Langeland, PhD, +47 92843253, ane.wilhelmsen-langeland@helse-bergen.no

    Berge Osnes, PhD, +47 92445081, berge.osnes@uib.no

    Recruiting

Other trials in Norway

About this study

Official title: Sleep in Psychiatric Care (SIP): A Transdiagnostic Group-based Sleep-school as Treatment for Comorbid Delayed Sleep-Wake Phase Disorder (DSWPD)

Sleep disorders commonly co-occur with psychiatric disorders. Sleep disorders are often treated with medication or not at all in psychiatric care, although there exist a plethora of documentation of the effectiveness of sleep interventions. There is also an increase in studies showing effectiveness of sleep-interventions when the sleep disorder co-occurs with psychiatric illness. The recommended treatment for Delayed Sleep-Wake phase disorder is light therapy at gradually advanced timing and/or melatonin administered in order to help phase-advance the circadian rhythm. There is a great gap in the knowledge on how sleep disorders can be treated effectively when they occur comorbid to moderate and severe psychiatric illness. In this project the we therefore seek to investigate the effect of psychological and behavioural, group-based treatment in a randomized controlled trial (RCT) where sleep and psychiatric symptoms are the primary outcome measures.

Read the detailed description

The recommended treatment for Delayed Sleep-Wake phase disorder is bright light therapy (LT) at gradually advanced timing and/or melatonin administered in order to phase-advance the circadian rhythm. Recent research has proven that dark therapy, or blocking light in wavelengths <530 nm by the use of for example orange blue-blocking glasses (bb-glasses), has shown the ability to maintain melatonin production comparable to darkness and to have an advancing effect on the circadian rhythm. The investigators therefore also want to test bb-glasses as an additive treatment to LT at gradually advanced timing.

The sleep-school at Bjørgvin District Psychiatric Hospital (DPS) is an already established treatment since 2017. The DSWPD-group gets together every other Monday from 1 pm until 3 pm. The group is open, which means that participants start at different dates and meet people in the group that might be at the end of their treatment, this often leads the group to function as a support for each other. Participants are patients at the general psychiatric outpatient clinic at Bjørgvin DPS in Bergen, Norway. Participants have been referred to the sleep-team by their psychologist or doctor. In this RCT the investigators will carry on the same structure for the group for participants that are recruited to the RCT, hence the project has high ecological validity.

All participants have an individual consultation before joining the group where the focus is on eligibility to participate in the group-based treatment, sleep-diagnostic evaluation, receive a standardized education on sleep-regulation and sleep hygiene advice and receive a date to start the group-based LT at gradually advanced timing. In a randomized manner, they will be allocated to the sleep-school group and start the treatment on the next possible date or to a 6 week wait-list and receive a date the treatment starts. All eligible participants will be informed that there may be a waitlist and receive a start-date without being informed that thay are on a waitlist group or not a waitlist group. All participants will be treated as usual (TAU) for their psychiatric problems parallel to either sleep-school or waitlist, hence both groups are in active treatment for their symptoms. Participants that start sleep-school as soon as possible, are also allocated to a) ordinary group-based LT at gradually advanced timing for 6 weeks or b) group-based group-based LT at gradually advanced timing for 6 weeks and bb-glasses. All participant will be followed up after 12 months.

Being tested
Group-based light therapy at gradually advanced timing for DSWPD, Group-based light therapy at gradually advanced timing for DSWPD and additive bb-glasses, 6-week wait list for sleep-school
Keywords
Sleep disorders, Delayed sleep-wake phase disorder, blue-blocking glasses, psychiatric disorders, group-based treatment for circadian rhythm sleep disorder
Medical subject headings
Sleep Disorders, Circadian Rhythm, Sleep Wake Disorders, Mental Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Group-based light therapy at gradually advanced timing for DSWPDBehavioural

    Also called Group-LT at gradually advanced timing

    Light therapy at gradually advanced timing, Sleep education, sleep hygiene, cognitive restructuring, relaxation techniques

  • Group-based light therapy at gradually advanced timing for DSWPD and additive bb-glassesBehavioural

    Also called Group-LT at gradually advanced timing & bb-glasses

    Light therapy (LT) at gradually advanced timing, bb-glasses 12 hrs after LT, Sleep education, sleep hygiene, cognitive restructuring, relaxation techniques

  • 6-week wait list for sleep-schoolOther

    Also called Treatment as usual (TAU)

    Treatment as usual in a psychiatric outpatient clinic

Study groups in NCT05177055
Study groupRoleWhat they receive
n=15, sleep-school 6 weeksExperimentalPatients receive treatment as usual in the psychiatric clinic combined with participation in the sleep-school. They have already been given education on sleep regulation and sleep hygiene advice in the first meeting with the sleep-school facilitator.
Receives: Behavioral: Group-based light therapy at gradually advanced timing for DSWPD
n=15, sleep-school 6 weeks and additive bb-glassesExperimentalPatients receive treatment as usual in the psychiatric clinic combined with participation in the sleep school and additive treatment with bb-glasses. They have already been given education on sleep regulation and sleep hygiene advice in the first meeting with the sleep-school facilitator.
Receives: Behavioral: Group-based light therapy at gradually advanced timing for DSWPD; Behavioral: Group-based light therapy at gradually advanced timing for DSWPD and additive bb-glasses
n=30 Six-week wait list for sleep-schoolActive comparatorPatients receive treatment as usual in the psychiatric clinic while they wait for participation in the sleep school. They have already been given education on sleep regulation and sleep hygiene advice in the first meeting with the sleep-school facilitator.
Receives: Other: 6-week wait list for sleep-school

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes (advancement) of sleep timing

    Measured by sleep diaries, Genactiv actigraphy and saliva samples (intraindividual variation of rise time (IIV), dim light melatonin onset (DLMO), rise /wake up time)

    Measured: baseline, post intervention after 6 weeks, follow-up after 12 months

Secondary outcomes (24)
  1. Changes in objective sleep onset latency (SOL)

    Measured by Genactive. The activity recorder is worn on the wrist for 7 consecutive days. The data is downloaded to a computer program that gives the data; a number of minutes of average sleep onset latency.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  2. Changes in Sleep efficiency (SE)

    Measured by sleep diary; total sleep time/time in bed x 100= percentage SE

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  3. Changes in Time in bed (TIB)

    Measured by sleep diary; time from bed-time to rise time

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  4. Changes in immediate sleepiness

    Measured by the Karolinska Sleepiness Scale (KSS). The KSS measure subjective sleepiness at a specific time point (noon). The scale gives a number from 1-9 where 9 indicates "trouble staying awake" and is the worst outcome.

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  5. Changes in objective total sleep length/time asleep (TST)

    Measured by Genactive. The activity recorder is worn on the wrist for 7 consecutive days. The data is downloaded to a computer program that gives the data; a number in minutes of average total sleep time.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  6. Work status

    Status of employment/unemployment, percentage disability benefits received

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  7. Changes in Total sleep length/time asleep (TST)

    Measured by sleep diary; time in minutes from bed-time to estimated sleep onset

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  8. Changes in Early morning awakening (EMA)

    Measured by sleep diary; minutes awake before rise time

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  9. Changes in objective sleep efficiency (SE)

    Measured by Genactive. The activity recorder is worn on the wrist for 7 consecutive days. The data is downloaded to a computer program that gives the data; a number from 0-100% that gives average sleep efficiency.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  10. Changes in objective early morning awakening (EMA)

    Measured by Genactive. The activity recorder is worn on the wrist for 7 consecutive days. The data is downloaded to a computer program that gives the data; a number of average minutes early morning awakening.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  11. Changes in well-being

    Measured by the World Health Organisation Five Well-Being Index (WHO-5)

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  12. Changes in sleepiness

    Measured by the Epworth Sleepiness Scale (ESS). The ESS is an 8-item scale where the respondent grades the likelihood of falling asleep or dozing off in different daily situations. The responses are graded on a 4-point likert scale 0=no likelihood to 3=very likely. A score of 11 or higher is considered an indication of excessive daytime sleepiness.

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  13. Changes in objective wake after sleep onset (WASO)

    Measured by Genactive. The activity recorder is worn on the wrist for 7 consecutive days. The data is downloaded to a computer program that gives the data; a number of average minutes awake after sleep onset.

    Measured: baseline and post intervention after 8 weeks, follow-up after 12 months

  14. Changes in beliefs about sleep

    Measured by Dysfunctional Beliefs About Sleep (DBAS-16). The DBAS-16 measures the degree of dysfunctional beliefs about sleep with 16 items. It has 4 subscales (1) sleep-related worry and helplessness; 2) beliefs about sleep medications; 3) expectations about sleep need; and 4) beliefs about the consequences/effects of insomnia and 1 total scale score. The higher the score, the more dysfunctional beliefs about sleep.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  15. Changes in Sleep onset latency (SOL)

    Measured by sleep diary; time in minutes from bed-time to estimated sleep onset

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  16. Changes in objective time in bed (TIB)

    Measured by Genactive. The activity recorder is worn on the wrist for 7 consecutive days. The data is downloaded to a computer program that gives the data; a number in minutes of average time in bed.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  17. Changes in fatigue

    Measured by the Chalders Fatigue Scale (CFS)

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  18. Changes in Sleep quality (SQ)

    Measured by sleep diary; subjective assesment of sleep quality on a scale from 1=very light to 5=very deep

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  19. Changes in Wake after sleep onset (WASO)

    Measured by sleep diary; minutes awake before rise time

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  20. Changes in anxiety symptoms

    Measured by The Beck Anxiety Inventory (BAI). The BAI measure subjective symptoms of anxiety on a scale ranging from 0-63. The higher the score, the worse the anxiety.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  21. Changes in depression symptoms

    Measured by The Beck Depression Inventory-2 (BDI-II). The BDI measure subjective symptoms of depression on a scale ranging from 0-63. The higher the score, the worse depression.

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  22. Changes in Daytime function (DF)

    Measured by sleep diary; subjective assesment of daytime function on a scale from 1=very good to 5=very poor

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

  23. Suicide attempts and admittances in psychiatric wards

    Whether or not suicide has been attempted, if applicable number og attempts and whether or nor the patient has been admitted to a psychitaric ward (voluntary/forced)

    Measured: baseline and post intervention after 6 weeks, follow-up after 12 months

  24. Changes in anxiety and depression

    Measured by the Hospital anxiety and depression scale (HADS), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI)

    Measured: baseline, bi-weekly assesment and post intervention after 6 weeks, follow-up after 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Jan 2022
  2. Study start23 May 2022
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05177055
Sponsor's protocol ID
66304-2
Acronym
SIP
Status last verified
Jun 2024
First submitted
15 Dec 2021
Last updated
11 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The investigators plan to share the following individual participant data (IPD); Study protocol and Informed Consent Form (ICF)

Publications

  • Wilhelmsen-Langeland A, Osnes B, Gradisar M, Vagenes VA, Sorensen L, Bjorvatn B, Fasmer OB, Koenig J, Pallesen S, Saxvig IW. Group bright light therapy compared to treatment as usual for delayed sleep-wake phase disorder among patients in psychiatric care (the SIP trials): a protocol for a pragmatic, randomised controlled trial. BMJ Open. 2025 Apr 17;15(4):e093091. doi: 10.1136/bmjopen-2024-093091.

    PubMed 40250869

Questions about this trial

What is this clinical trial studying?

A study testing Group-based light therapy at gradually advanced timing for DSWPD, Group-based light therapy at gradually advanced timing for DSWPD and additive bb-glasses and 6-week wait list for sleep-school in people with Delayed Sleep-Wake Phase Disorder and Sleep Disorder, run by Haukeland University Hospital at 2 sites in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Ane Wilhelmsen-Langeland, PhD (+47 55957000 ext. 7192, ane.wilhelmsen-langeland@helse-bergen.no), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes (advancement) of sleep timing (time frame: baseline, post intervention after 6 weeks, follow-up after 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05177055, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jun 2024.

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