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Sleep Initiation and Maintenance DisordersNCT05257317

Efficacy of Cranial Manual Therapy in the Treatment of Chronic Insomnia Disorder

A study testing Osteopathic Medicine in people with Sleep Initiation and Maintenance Disorders, run by Escoles Universitaries Gimbernat at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Insomnia is the most prevalent sleep disorder in society. The first treatment of choice is pharmacology, although it can have secondary effects such as tolerance and dependence, or alter the structure of sleep; therefore, new pathways towards other adjuvant treatments are being established. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
Osteopathic Medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
50 participants
Where
1 siteSpain
Study dates
Feb 2022to Sep 2023
Phase
Interventional
Are there results?
None posted in the registry

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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosed with chronic insomnia disorder according to the criteria defined by the ICSD-III (International Classification of Sleep Disorders-3rd edition):
  • Problems initiating or maintaining sleep, associated with daytime consequences; and not attributable to environmental circumstances.
  • Insomnia lasting more than 3 months, with episodes of at least 3 times a week.
  • Regarding the pharmacology or medication indicated for sleep:
  • They do not want to take the medication recommended by the doctor who is treating them.
  • Do not change their usual drug regimen, if they were already taking medication to sleep.
Show all 13Show fewer
  • They are not taxed to take medication.
  • Having ruled out other pathologies related to sleep through:
  • Respiratory polygraphy to rule out sleep-related respiratory pathologies (SAHS).
  • screening to rule out motor sleep disorders.
  • screening to rule out circadian sleep disorders.
  • screening to rule out serious psychiatric disorders (depression, anxiety, general psychopathology): BDI-II (Beck Depression Inventory), BAI (Beck Anxiety Inventory), SCL-90.
  • Obtain a score greater than 7 points (clinical-subclinical insomnia).

Who cannot join

  • Obtain a score of less than 7 (clinically insignificant insomnia) in the ISI test (Insomnia Severity Index).
  • The result of the respiratory polygraphy is positive, confirming a sleep-disordered breathing.
  • The screening tests for the detection of motor sleep disorders, respiratory sleep disorders or circadian disorders are positive.
  • The Screening detects serious psychiatric illnesses such as major depressive disorder or bipolar disorders is positive.
  • Suffering or having suffered from any central neurological pathology, stroke, aneurysm...
  • Having suffered skull fractures.
  • Having undergone surgery in the last 6 months and that insomnia has started as a result of it.

Trial locations and contacts

1 site in 1 country.

Maider Sánchez-Padilla, MSc contact

0034 93 589 37 27 ext. 216

maider.sanchez@eug.es

Jordi Esquirol-Caussa, PhD contact

0034 93 589 37 27 ext. 238

jordi.esquirol@eug.es

Spain1 site, 1 recruiting
  • Escoles Universitaries Gimbernat

    Sant Cugat del Vallès, Barcelona, 08174

    Maider Sánchez-Padilla, MSc, 0034 93 589 37 27 ext. 216, maider.sanchez@eug.es

    Recruiting

Other trials in Spain

About this study

Insomnia is the most prevalent sleep disorder in society. The first treatment of choice is pharmacology, although it can have secondary effects such as tolerance and dependence, or alter the structure of sleep; therefore, new pathways towards other adjuvant treatments are being established. OBJECTIVES: The main objective is "To assess the effectiveness of manual cranial therapy on the quantity and quality of sleep in patients with chronic insomnia." MATERIAL AND METHODS: A randomized clinical trial is designed, with two groups, intervention and placebo, to assess the effectiveness of manual therapy applied to the skull, in the severity of insomnia, and quantity and quality of sleep in patients with sleep disorder. chronic insomnia. Health professionals will be selected from the Department of Occupational Health, with characteristics of chronic insomnia described by the ICSD-III, who do not modify their usual medication regimen (if they take it) and without other pathologies related to sleep that may be causing the insomnia. insomnia Demographic data (age, sex, profession), clinical (BMI, history of previous and family insomnia pathologies, and taking medication for sleep and related disorders), sleep quality questionnaires (PSQI, COS, ISI) will be collected. , stress-insomnia relationship (FISRST-S), and quality of life (SF12), in addition to filling out a sleep diary (through the mobile App) and recording activity through actigraphy, hypnogram (Sleep ProfilerTM); before and after the intervention, and at one and three month follow-up. Each group will receive the offered intervention: cranial manual therapy (intervention) or cranial massage (placebo). The data will be coded and analyzed with the IBM SPSS® version 20 program (or similar)

Being tested
Osteopathic Medicine, Placebo therapy
Keywords
Sleep Iniciation and Maintenane Disorders, Autonomic Nervous System, Osteopathic Medicine, Muskuloeskeletal Manipulation, Dysominias
Medical subject headings
Sleep Initiation and Maintenance Disorders

What participants receive

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

  • Osteopathic MedicineOther

    Where compression and traction movements will be carried out on these structures.

    Technique called CV4, applied on the occipital, and Technique called asynchronous rolling of the temporal bones.

  • Placebo therapyOther

    Circular movements will be induced in a frontal and parietal bones

Study groups in NCT05257317
Study groupRoleWhat they receive
InterventionExperimentalIt will consist of osteopathic manual therapy techniques applied to the occipital and temporal bones.
Receives: Other: Osteopathic Medicine
PlaceboPlacebo comparatorIt consists of a light contact applied to the cranial vault (frontal and parietal bones) where circular movements will be induced.
Receives: Other: Placebo therapy

What is being measured

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

  1. Insomnia Severity

    With an "Insomnia Severity Index" (ISI). There are seven items. Each item is rated on a scale from 0 to 4 from less to more severe. The total score is the sum of each individual item and can range from 0 to 28 (28 = most severe insomnia).

    Measured: 18 weeks

Secondary outcomes (8)
  1. Sleep Quality

    With a "Pittsburgh Sleep Quality Index (PSQI)" It consists of 19 items that analyze: quality, latency, duration, efficiency and sleep disturbances, use of sleeping medication and daytime dysfunction. The scores of the questions allows between 0 and 3 points for each of the seven subscales, where in all cases a score of "0" indicates ease, while a score of "3" indicates severe difficulty within its respective area. The sum of the seven subscales allows obtaining a global score between 0 and 21 for the entire scale, where "0" indicates ease of sleeping and "21" severe difficulty in all areas.

    Measured: 18 weeks

  2. Sleep Quality

    With a "Cuestionario del Sueño de Oviedo (COS)". It consists of 15 items, 13 of which are grouped into 3 scales:

    • Subjective sleep satisfaction (1 item): score from 1 to 7.
    • Insomnia (9 items) The scoring range is from 9 to 45, higher score indicate greater severity.
    • Hypersomnia (3 items): from 3 to 15 points, higher score indicate greater daytime disability.

    Measured: 18 weeks

  3. Vulnerability to stress-related insomnia

    With FORD INSOMNIA RESPONSE TO STRESS spanish (FIRST-S). It is a scale that assesses vulnerability to stress-related insomnia. It is a standardized questionnaire with high test-retest reliability, which has been validated as a predictive measure of sleep vulnerability using polysomnographically measured sleep. It is made up of nine items and requires the individual to rate between 1 (not at all common) and 4 (very common) the probability of having sleep disturbance in association with specific and common stressful events or periods of stress that occur during the day or at night .

    The total score of the answers obtained is quantified. High scores are indicative of increased vulnerability to stress-related insomnia. The cut-off score to detect individuals with this vulnerability is 19 points or higher, indicating "high-FIRST sleep reactivity."

    Measured: 9 weeks

  4. Quality of Life of patients with insomnia

    With a 12-items Short-Form Health Survey (SF12). It consists of 12 items from the 8 dimensions of the SF-36 Physical Function (2), Social Function (1), Physical Role (2), Emotional Role (2), Mental Health (2), Vitality (1), Body Pain (1), General Health (1). The response options form Likert-type scales that assess intensity or frequency. The number of response options ranges from three to six, depending on the item.

    For each of the 8 dimensions that it identifies, the items are coded, aggregated and transformed into a scale ranging from 0 (the worst state of health for that dimension) to 100 (the best state of health).

    Measured: 18 weeks

  5. Quantity, latency and efficiency of sleep

    With a "Sleep Diary"

    Measured: 18 weeks

  6. Quantity, latency and efficiency of sleep

    With an "Actigraphy record"

    Measured: 18 weeks

  7. Hypnogram-Polysomnography - Macro and microstructure of sleep

    With a "WachPAt(R) device"

    Measured: 18 weeks

  8. Heart Rate Variability

    With a "Polar H10 band" and "EliteHRV" app

    Measured: 4 weeks

Timeline

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

  1. First posted25 Feb 2022
  2. Study startFeb 2022 (estimated)
  3. Primary completionDec 2022 (estimated)
  4. Study completionSep 2023 (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
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05257317
Sponsor's protocol ID
2019/302
Status last verified
Feb 2022
First submitted
24 Jan 2022
Last updated
25 Feb 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The pandemic has delayed the completion of the study and no publication date for the information has been proposed

Publications

  • Equihua-Benitez AC, Guzman-Vasquez K, Drucker-Colin R. Understanding sleep-wake mechanisms and drug discovery. Expert Opin Drug Discov. 2017 Jul;12(7):643-657. doi: 10.1080/17460441.2017.1329818. Epub 2017 May 22.

    PubMed 28511597
  • Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, Nissen C. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010 Feb;14(1):19-31. doi: 10.1016/j.smrv.2009.04.002. Epub 2009 May 28.

    PubMed 19481481
  • Durmer JS, Dinges DF; New Collective Author. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2005 Mar;25(1):117-29. doi: 10.1055/s-2005-867080.

    PubMed 15798944
  • Riemann D, Nissen C, Palagini L, Otte A, Perlis ML, Spiegelhalder K. The neurobiology, investigation, and treatment of chronic insomnia. Lancet Neurol. 2015 May;14(5):547-58. doi: 10.1016/S1474-4422(15)00021-6. Epub 2015 Apr 12.

    PubMed 25895933
  • Merino-Andreu M, Alvarez-Ruiz de Larrinaga A, Madrid-Perez JA, Martinez-Martinez MA, Puertas-Cuesta FJ, Asencio-Guerra AJ, Romero Santo-Tomas O, Jurado-Luque MJ, Segarra-Isern FJ, Canet-Sanz T, Gimenez-Rodriguez P, Teran-Santos J, Alonso-Alvarez ML, Garcia-Borreguero Diaz-Varela D, Barriuso-Esteban B. [Healthy sleep: evidence and guidelines for action. Official document of the Spanish Sleep Society]. Rev Neurol. 2016 Oct 3;63(s02):1. Spanish.

    PubMed 27699758
  • Nofzinger EA, Buysse DJ, Germain A, Price JC, Miewald JM, Kupfer DJ. Functional neuroimaging evidence for hyperarousal in insomnia. Am J Psychiatry. 2004 Nov;161(11):2126-8. doi: 10.1176/appi.ajp.161.11.2126.

    PubMed 15514418
  • Halasz P, Bodizs R, Parrino L, Terzano M. Two features of sleep slow waves: homeostatic and reactive aspects--from long term to instant sleep homeostasis. Sleep Med. 2014 Oct;15(10):1184-95. doi: 10.1016/j.sleep.2014.06.006. Epub 2014 Jul 8.

    PubMed 25192672
  • Bastien CH, St-Jean G, Morin CM, Turcotte I, Carrier J. Chronic psychophysiological insomnia: hyperarousal and/or inhibition deficits? An ERPs investigation. Sleep. 2008 Jun;31(6):887-98. doi: 10.1093/sleep/31.6.887.

    PubMed 18548835
  • Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014 Nov;146(5):1387-1394. doi: 10.1378/chest.14-0970.

    PubMed 25367475
  • Morgenthaler T, Alessi C, Friedman L, Owens J, Kapur V, Boehlecke B, Brown T, Chesson A Jr, Coleman J, Lee-Chiong T, Pancer J, Swick TJ; Standards of Practice Committee; American Academy of Sleep Medicine. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep. 2007 Apr;30(4):519-29. doi: 10.1093/sleep/30.4.519.

    PubMed 17520797
  • Riha RL. Diagnostic approaches to respiratory sleep disorders. J Thorac Dis. 2015 Aug;7(8):1373-84. doi: 10.3978/j.issn.2072-1439.2015.08.28.

    PubMed 26380763
  • Thorpy MJ. Classification of sleep disorders. Neurotherapeutics. 2012 Oct;9(4):687-701. doi: 10.1007/s13311-012-0145-6.

    PubMed 22976557
  • D'Alonzo GE, Krachman SL. Circadian rhythm sleep disorders. J Am Osteopath Assoc. 2000 Aug;100(8 Suppl):S15-21.

    PubMed 11002615
  • Medrano-Martinez P, Ramos-Platon MJ. [Cognitive and emotional alterations in chronic insomnia]. Rev Neurol. 2016 Feb 16;62(4):170-8. Spanish.

    PubMed 26860722
  • Nijs J, Mairesse O, Neu D, Leysen L, Danneels L, Cagnie B, Meeus M, Moens M, Ickmans K, Goubert D. Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice. Phys Ther. 2018 May 1;98(5):325-335. doi: 10.1093/ptj/pzy020.

    PubMed 29425327

Questions about this trial

What is this clinical trial studying?

A study testing Osteopathic Medicine in people with Sleep Initiation and Maintenance Disorders, run by Escoles Universitaries Gimbernat at 1 site in Spain.

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 13 inclusion and 7 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: status not confirmed, as of the sponsor's last update on 25 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. 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. Some participants in this study may receive a placebo. 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?

Results are not available in the source record.

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

Contact Maider Sánchez-Padilla, MSc (0034 93 589 37 27 ext. 216, maider.sanchez@eug.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Insomnia Severity (time frame: 18 weeks). 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 NCT05257317, which also lists 48 linked publications.

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 25 Feb 2022.

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