AzTrials
AzTrials

InsomniaPhase 2NCT05908526

Insomnia Treatment and EMA (Ecological Momentary Assessment) Outcomes

A Phase 2 study testing Baseline surveys, Cognitive testing and EMAs and Actiwatch in people with Insomnia, run by University of Maryland, Baltimore at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The goal of this study is to examine the impact of suvorexant, an FDA-approved insomnia medication, on daytime symptoms (as measured by the Daytime Insomnia Symptoms Scale: cognition, positive mood, negative mood, and fatigue/sleepiness) among older adults with insomnia. Read more about this study

Who is it for?
Ages 60 to 85 years
Conditions the study is for
Insomnia
What is being tested?
Baseline surveys, Cognitive testing and EMAs and Actiwatch
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteUnited States
Study dates
9 Oct 2023to 8 Aug 2024
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 60 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Meets Diagnostic and Statistical Manual - Fifth Edition (DSM-5) diagnostic criteria for insomnia disorder.
  • Insomnia Severity Index total score >10.
  • Insomnia symptoms must include problems with wake after sleep onset.
  • Insomnia symptom duration > 6 months.
  • Baseline self-reported total sleep time < 6.5 hours per night.

Who cannot join

  • High risk for untreated organic sleep disorders other than insomnia (narcolepsy, periodic limb movement disorder, etc) as determined by structured clinical interview and investigator clinical judgment.
  • Current diagnosis of a major untreated psychiatric disorder(s).
  • History of serious suicide attempt within past 5 years.
  • History of alcohol or substance abuse (including prescription medication abuse) within past 5 years.
  • Heavy alcohol consumption (e.g., >5 drinks per day or > 14 drinks per week.
  • Heavy caffeine use [(>2 cups of coffee/day (equivalent).
Show all 10Show fewer
  • Current tobacco or nicotine use.
  • History of previous allergic reaction, sensitivity, or severe side effects to sedative hypnotics.
  • CYP3A inhibitors.
  • Refusal to discontinue or intention to initiate OTC or other sleep aids during study period.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Maryland, Baltimore

    Baltimore, Maryland, 21201

Other trials in United States

About this study

Official title: The Impact of Suvorexant on Cognitive Function and Daytime Symptoms Among Community-dwelling Older Adults With Insomnia: A Placebo-controlled, Randomized Clinical Trial Using Remote Monitoring and Ecological Momentary Assessment

The goal of this study is to examine the impact of suvorexant, an FDA-approved insomnia medication, on daytime symptoms (as measured by the Daytime Insomnia Symptoms Scale: cognition, positive mood, negative mood, and fatigue/sleepiness) among older adults with insomnia. The primary hypothesis is that relative to placebo, suvorexant will improve sleep and daytime symptoms. The word "placebo" refers to a harmless pill with no therapeutic effect.

Read the detailed description

The study will take about six to eight weeks to complete. Participants will have a home sleep apnea test (HSAT) and complete a clinical interview. Participants will also complete a baseline assessment, which will take place over one or two days (about 3 hours total).

During the study, participants will complete research questionnaires and cognitive testing at baseline and post-baseline (after treatment). Participants will also complete brief EMA surveys (sleep diary and Daytime Insomnia Symptoms Scale) via mobile device 4 times per day for approximately 16 days; each survey will take about 2 minutes or less to complete. Participants will also wear an actigraph on the non-dominant wrist. This device looks like a wristwatch and measures ambulatory movement, a validated proxy for sleep.

Conditions
Insomnia
Being tested
Baseline surveys, Cognitive testing and EMAs, Actiwatch, suvorexant (or placebo), Placebo
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.

  • Baseline surveys, Cognitive testing and EMAsBehavioural

    Also called ecological momentary assessment

    Outcome assessments are conducted at two weeks while participants are on study treatment or placebo and include self-report questionnaires and cognitive testing administered by computer.

  • ActiwatchDevice

    Also called actigraphy

    Participants will wear an actiwatch for 16 days while completing EMA surveys. It has a small sensor that tracks motion.

  • suvorexant (or placebo)Drug

    Also called Belsomra

    FDA approved which is an orexin receptor antagonist indicated for the treatment of insomnia, characterized by difficulties with sleep onset and/or sleep maintenance.

  • PlaceboOther

    Also called no drug

    An inactive substance that looks like the drug or treatment being tested.

Study groups in NCT05908526
Study groupRoleWhat they receive
TreatmentExperimentalParticipants will start on 10mg suvorexant, po, qhs, including instructions on dosage, expectations, and potential side effects, for two nights. Following this low-dose run-in period, individuals in the treatment condition will be increased to 20mg for a 14-day active treatment period (i.e.,16 nights taking a pill). Other assessments include self-report research questionnaires and cognitive testing (completed at baseline and post-treatment), as well as EMA surveys, daily sleep diaries, and actigraphy.
Receives: Behavioral: Baseline surveys, Cognitive testing and EMAs; Device: Actiwatch; Drug: suvorexant (or placebo)
PlaceboPlacebo comparatorParticipants in the control condition will take placebo (no drug) pill form, po, qhs, including instructions on dosage, expectations, and potential side effects for (16 nights taking a pill). Other assessments include self-report research questionnaires and cognitive testing, daily sleep diaries, and actigraphy.
Receives: Behavioral: Baseline surveys, Cognitive testing and EMAs; Device: Actiwatch; Other: Placebo

What is being measured

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

  1. Change in Daytime Insomnia Symptoms Scale (DISS)

    This measure assesses daytime symptoms and functional impairments in five domains: alert cognition, fatigue, sleepiness, negative mood, and positive mood. Participants will complete this survey four times per day on their smart phone for approximately 16 days. The possible score range is 0-100, with higher scores indicating greater levels of a given construct.

    Measured: Baseline (start of study) and end of study (before day 16).

  2. Change in Insomnia Severity as Assessed by Insomnia Severity Index

    The Insomnia Severity Index is a brief self-report instrument that measures subjective symptoms and consequences of insomnia as well as the degree of distress caused by those difficulties. Total scores range from 0 to 28, with higher scores indicating greater insomnia severity.

    Measured: Baseline (start of study) and end of study (before day 16).

Secondary outcomes (9)
  1. Change in Sleepiness as Assessed by Epworth Sleepiness Scale

    The Epworth Sleepiness Scale is a brief self-report instrument that measures daytime sleepiness. Total scores range from 0 to 24, with higher scores indicating greater severity of sleepiness.

    Measured: Baseline (start of study) and end of study (before day 16).

  2. Change in Depression as Assessed by Patient Health Questionnaire-9

    The Patient Health Questionnaire-9 is a brief self-report instrument that measures depressive symptoms. Total scores range from 0 to 27, with higher scores indicating greater levels of depressive symptoms.

    Measured: Baseline (start of study) and end of study (before day 16).

  3. Change in Anxiety as Assessed by Generalized Anxiety Disorder-7

    The Generalized Anxiety Disorder-7 is a brief self-report instrument that measures anxiety symptoms. Total scores range from 0 to 21, with higher scores indicating greater levels of depressive symptoms.

    Measured: Baseline (start of study) and end of study (before day 16).

  4. Change in Cognitive Performance Assessed by the PVT (Psychomotor Vigilance Test): Lapses

    PVT is a computer-based, chronometric test to measure reactions to specified small changes in a changing environment. Response time is scored in seconds. Response accuracy is scored numerically, with lower numbers indicating better response accuracy.

    Measured: Baseline (start of study) and end of study (before day 16).

  5. Change in Cognitive Performance Assessed by the PVT (Psychomotor Vigilance Test): Median Reaction Time

    PVT is a computer-based, chronometric test to measure reactions to specified small changes in a changing environment. Response time is scored in seconds. Response accuracy is scored numerically, with lower numbers indicating better response accuracy.

    Measured: Baseline (start of study) and end of study (before day 16).

  6. Change in Cognitive Performance Assessed by the Stroop Test: Accuracy

    Stroop test is a computer-based test of colors and words to measure cognitive interference. Response time is scored in seconds. Response accuracy is scored numerically, with lower numbers indicating better response accuracy.

    Measured: Baseline (start of study) and end of study (before day 16).

  7. Change in Cognitive Performance Assessed by the Stroop Test: Response Time in Milliseconds

    Stroop test is a computer-based test of colors and words to measure cognitive interference. Response time is scored in milliseconds. Response accuracy is scored numerically, with lower numbers indicating better response accuracy.

    Measured: Baseline (start of study) and end of study (before day 16).

  8. Change in Cognitive Performance Assessed by the Task-switching: Response Time in Milliseconds

    Task-switching is a computer-based, chronometric test to measure response time and response accuracy. Response time is scored in milliseconds. Response accuracy is scored numerically, with lower numbers indicating better response accuracy.

    Measured: Baseline (start of study) and end of study (before day 16).

  9. Change in Cognitive Performance Assessed by the Task-switching

    Task-switching is a computer-based, chronometric test to measure response time and response accuracy. Response time is scored in seconds. Response accuracy is scored numerically, with lower numbers indicating better response accuracy.

    Measured: Baseline (start of study) and end of study (before day 16).

Timeline

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

  1. First posted18 Jun 2023
  2. Study start9 Oct 2023
  3. Primary completion8 Aug 2024
  4. Study completion8 Aug 2024

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The study employs a two-group (suvorexant, 20mg, qhs, versus placebo) parallel design and involves a baseline assessment, 2-day low-dose run-in, and approximately 14-day active treatment phase with intensive ambulatory monitoring via wrist actigraphy and ecological momentary assessment (EMA). Outcome assessments are conducted at two weeks while participants are on study treatment or placebo and include self-report questionnaires and objective cognitive testing administered by computer.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05908526
Sponsor's protocol ID
HP-00100622
Status last verified
Sep 2025
First submitted
11 May 2023
Last updated
30 Oct 2025
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No: No plan to make individual participant data (IPD) available to other researchers at this time.

Publications

  • Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1-32. doi: 10.1146/annurev.clinpsy.3.022806.091415.

    PubMed 18509902
  • Buysse DJ, Thompson W, Scott J, Franzen PL, Germain A, Hall M, Moul DE, Nofzinger EA, Kupfer DJ. Daytime symptoms in primary insomnia: a prospective analysis using ecological momentary assessment. Sleep Med. 2007 Apr;8(3):198-208. doi: 10.1016/j.sleep.2006.10.006. Epub 2007 Mar 23.

    PubMed 17368098
  • Herring WJ, Connor KM, Snyder E, Snavely DB, Zhang Y, Hutzelmann J, Matzura-Wolfe D, Benca RM, Krystal AD, Walsh JK, Lines C, Roth T, Michelson D. Suvorexant in Elderly Patients with Insomnia: Pooled Analyses of Data from Phase III Randomized Controlled Clinical Trials. Am J Geriatr Psychiatry. 2017 Jul;25(7):791-802. doi: 10.1016/j.jagp.2017.03.004. Epub 2017 Mar 8.

    PubMed 28427826
  • Wickwire EM, Verceles AC, Chen S, Zhao Z, Rogers VE, Wilckens KA, Buysse DJ. Smart Phone/Ecological Momentary Assessment of Sleep and Daytime Symptoms Among Older Adults With Insomnia. Am J Geriatr Psychiatry. 2023 May;31(5):372-378. doi: 10.1016/j.jagp.2023.01.020. Epub 2023 Feb 1.

    PubMed 36813640
  • Wickwire EM, Zhou J, Chen S, Wilckens KA, Steenbergh TA, Buysse DJ, Verceles AC. Smartphone-Based Real-Time Assessment of Daytime Insomnia Symptoms With Suvorexant: A Randomized Clinical Trial. JAMA Netw Open. 2026 Jan 2;9(1):e2550186. doi: 10.1001/jamanetworkopen.2025.50186.

    PubMed 41490112

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Baseline surveys, Cognitive testing and EMAs and Actiwatch in people with Insomnia, run by University of Maryland, Baltimore at 1 site in United States.

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 5 inclusion and 10 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: finished, as of the sponsor's last update on 30 Oct 2025. 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 United States. 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.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 30 Oct 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Daytime Insomnia Symptoms Scale (DISS) (time frame: Baseline (start of study) and end of study (before day 16).). The study lists 2 primary outcomes in all. 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 NCT05908526, which also lists 5 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 30 Oct 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in