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Knee OsteoarthristisSTOPPPNCT06976138

Sleep TO Prevent Post-surgical Pain

A study testing Cognitive-Behavioral Therapy for Insomnia, Bright Light therapy via the Re-Timer® and Negative Ion exposure via IonMi Device in people with Knee Osteoarthristis, run by Johns Hopkins University at 2 sites in United States.

Recruiting

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

Sites and contacts
Official record
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Trial summary

This research study is being done to compare different methods of addressing sleep problems before total knee replacement surgery. These methods include Cognitive Behavioral Therapy and light exposure. Read more about this study

Who is it for?
Ages 60 years and older
Conditions the study is for
Knee Osteoarthristis
What is being tested?
Cognitive-Behavioral Therapy for Insomnia, Bright Light therapy via the Re-Timer® and Negative Ion exposure via IonMi Device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
252 participants
Where
2 sitesUnited States
Study dates
13 Jun 2025to 31 Jul 2029
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 60 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • People with knee osteoarthritis,
  • 60 years old and older,
  • scheduled to have unilateral (one knee) total knee replacement surgery for osteoarthritis and
  • have trouble falling or staying asleep

Who cannot join

  • currently using medications to help sleep
  • have completed Cognitive Behavioral Therapy for Insomnia
  • used either Bright Light or Negative Ion exposures in the past year
  • have an inflammatory rheumatologic disorder, seizure disorder
  • serious mental health disorder, Bipolar I disorder, substance or alcohol use disorder
  • serious sleep or circadian rhythm disorder, untreated sleep apnea
Show all 12Show fewer
  • are pregnant or lactating
  • have retinal pathology
  • history of eye surgery (Lasik or cataract okay if more than 3 months ago)
  • are taking disease-modifying antirheumatic drugs
  • taking photosensitizing medications
  • are unwilling to discontinue over the counter sleep aids (for example, melatonin) for at least 2 weeks before enrolling

Trial locations and contacts

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

United States2 sites, 1 recruiting
  • Johns Hopkins School of Medicine

    Baltimore, Maryland, 21224

    Anna Kim-Dahl, 410-550-5704, akimdah1@jhu.edu

    Heavon Allen, 4105501000, hallen16@jhmi.edu

    Recruiting
  • Mass General Brigham

    Chestnut Hill, Massachusetts, 02467

    Active, not recruiting

Other trials in United States

About this study

This research study is being done to compare different methods of addressing sleep problems before total knee replacement surgery. These methods include Cognitive Behavioral Therapy and light exposure.

Read the detailed description

This research is being done to evaluate whether combining Cognitive Behavioral Therapy for Insomnia (talk therapy for insomnia) with Morning Bright Light exposure is more effective than Morning Negative Ion exposure combined with either Cognitive Behavioral Therapy for Insomnia or Sleep / Knee Osteoarthritis Education to reduce pain following total knee replacement surgery. This knowledge is needed to develop better ways to manage pain after surgery. Sleep problems are often not treated before or after surgery, so this may differ from the typical care received by adding a focus on sleep. People with knee osteoarthritis, who are 60 years old and older, who are scheduled to have unilateral (one knee) total knee replacement surgery for osteoarthritis and who have trouble falling or staying asleep, may join this study.

There are two possible devices that are being compared in this study.

  • If the participants are in the Morning Bright Light exposure group, the participants will use the Re-timer®, a wearable bright light exposure device. This device is commercially available and in use by the general population. This device meets international ultraviolet and blue light hazard safety standards. The light intensities used in this study are greater than most indoor light, but much dimmer than sunlight on a bright day.
  • If the participants are in the Negative Ionizer exposure group, the participants will use the IonPacific,"ionMi,"a wearable negative ionizer. This device is also commercially available and in use by the general population.

There have been reports of improved sleep and daytime symptoms associated with poor sleep for both Morning Bright Light and Negative Ionizer exposures. The use of Re-timer and IonMi in this research study is investigational. The word "investigational" means that the Re-timer and IonMi are not approved for marketing by the Food and Drug Administration (FDA).

Participation includes:

A virtual and in person screening and training visit 4, 1-hour long telehealth sessions scheduled each week before surgery 2, 30-minute telehealth sessions, 2-weeks after surgery and 3-months after surgery

This study will be using "blinding" which means only a few members of the study team will know what group / sleep program the participants have been assigned to until the study ends. In case of an emergency, the study doctor can quickly find out which sleep health program the participants have been assigned to receive.

During parts of the study, the device the participants are using may be deactivated in order to test the effects of an active study device compared to a deactivated device. At the end of the study, the team can provide information about the timing of device deactivation.

The participants will not be asked to change the clinical care currently being received for knee osteoarthritis.

Being tested
Cognitive-Behavioral Therapy for Insomnia, Bright Light therapy via the Re-Timer®, Negative Ion exposure via IonMi Device, Sleep / Knee Osteoarthritis Education
Keywords
total knee arthroplasty, knee replacement, koa, knee osteoarthritis
Medical subject headings
Osteoarthritis, Knee

What participants receive

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

  • Cognitive-Behavioral Therapy for InsomniaBehavioural

    This program will focus on changing the participant's sleep patterns, activities, and habits.

  • Bright Light therapy via the Re-Timer®Device

    Subjects will conduct light treatment in the mornings at home for one hour using Re-timer® The participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery

  • Negative Ion exposure via IonMi DeviceDevice

    This procedure involves wearing a light weight negative ionizer (IonMi Device) around neck for one hour in the morning. An ionizer gives off special negatively charged ions into the air. The participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery

  • Sleep / Knee Osteoarthritis EducationBehavioural

    Also called koa Education

    This program will focus on increasing The participant's knowledge about sleep, sleep disorders and knee osteoarthritis.

Study groups in NCT06976138
Study groupRoleWhat they receive
Cognitive Behavioral Therapy + Morning Bright Light exposureExperimentalCognitive-Behavioral Therapy for Insomnia. This program will focus on changing the participant's sleep patterns, activities, and habits. Morning Bright Light involves wearing glasses (Re-Timer Device) that give off a special type of bright light for one full hour in the morning. The participant will be asked to wear these glasses every morning for about four weeks before surgery, four weeks after surgery and again for 1-week , 3-months after surgery. The participant will fill out a log to note light on/off times, any interruptions to light treatment, and primary activity while receiving the light exposure. The participant will also receive daily reminders to charge the device and turn it on during the scheduled time.
Receives: Behavioral: Cognitive-Behavioral Therapy for Insomnia; Device: Bright Light therapy via the Re-Timer®
Cognitive Behavioral Therapy for Insomnia + Negative Ion exposureActive comparatorCognitive-Behavioral Therapy for Insomnia. This program will focus on changing the participant's sleep patterns, activities, and habits. Negative Ion exposure. This procedure involves wearing a light weight negative ionizer (IonMi Device) around the neck for one hour in the morning. An ionizer gives off special negatively charged ions into the air. the participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery The participant will also receive daily reminders to charge the device and turn it on during the scheduled time.
Receives: Behavioral: Cognitive-Behavioral Therapy for Insomnia; Device: Negative Ion exposure via IonMi Device
Sleep / Knee Osteoarthritis Education + Negative Ion exposureActive comparatorSleep / Knee Osteoarthritis Education. This program will focus on increasing the participant's knowledge about sleep, sleep disorders and knee osteoarthritis. Negative Ion exposure. This procedure involves wearing a light weight negative ionizer (IonMi Device) around the neck for one hour in the morning. An ionizer gives off special negatively charged ions into the air. The participant will be asked to wear the device every morning for about four weeks before surgery, four weeks after surgery and again for 1-week, 3-months after surgery The participant will also receive daily reminders to charge the device and turn it on during the scheduled time.
Receives: Device: Negative Ion exposure via IonMi Device; Behavioral: Sleep / Knee Osteoarthritis Education

What is being measured

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

  1. Chronic postsurgical pain as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index

    Higher scores indicate higher pain. Asked to rate pain in different situations from 0 (no pain) to 10 (extreme pain) on Visual Analog Scale.

    Measured: 3 and 6 months post-surgery

Secondary outcomes (5)
  1. Post-surgical pain as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index Pain Severity

    Higher scores indicate higher pain. Asked to rate pain in different situations from 0 (no pain) to 10 (extreme pain) on Visual Analog Scale.

    Measured: immediately post surgery, 6 weeks post surgery

  2. Number of participants with Post-surgical opioid use

    Opioid use after surgery reported in 7-day virtual diaries. Higher amounts mean higher intake of opioids. Participants will be asked to report prescribed opioids, how often being taken, and provide information via virtual pill count.

    Measured: 6-weeks post-surgery, 3 and 6 months post surgery

  3. Insomnia Severity as assessed by the Insomnia Severity Index

    Minimum score possible is 0, highest score 28. Higher scores indicate higher insomnia symptoms

    Measured: pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6-months

  4. Circadian Rest Activity Rhythm (RAR) assessed by actigraphy

    Motion data from actigraphy monitors will be used to estimate circadian rest activities within and across 24-hour intervals. The investigators will model standard circadian RAR parameters derived from actigraphy data using both an extended cosinor analysis as well as non-parametric methods. For example, Pseudo F-statistics, and index of circadian rest activity rhythm, will be derived, and lower Pseudo F-statistics are related to less robust rest activity rhythm strength

    Measured: pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6-months

  5. Depressed mood as assessed by the Patient Health Questionnaire (PHQ-9)

    Score range of 0-27. Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.

    Measured: pre-surgery, post-surgery 6-weeks, post surgery 3 months and 6 months

Timeline

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

  1. First posted16 May 2025
  2. Study start13 Jun 2025
  3. Primary completion31 Jul 2029 (estimated)
  4. Study completion31 Jul 2029 (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
Model description
randomized controlled, 3-parallel arm, trial
Masking
Single blind
Who is masked
Participant
Enrolment
252 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06976138
Sponsor's protocol ID
IRB00454253
Other IDs
1R01AG085712-01
Acronym
STOPPP
Status last verified
Aug 2026
First submitted
8 May 2025
Last updated
7 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Final de-identified, anonymized data sets underlying all publications resulting from the proposed research involving human subjects will be shared with legitimate academic researchers and other community members with a legitimate scientific interest in the research. Where practicable, sharing will take place under a written agreement between the principal investigators prohibiting the recipient from identifying or re-identifying (or taking steps to identify or re-identify) any individual whose data are included in the data sets. Study documentation (e.g., study protocols) will be made accessible via clinicaltrials.gov and via communication with the principal investigators to facilitate interpretation of the scientific data. Codebooks, other study documentation and deidentified data will be made available on the National Institute on Aging (NIA) National Archive of Computerized Data on Aging data (NACDA) repository.

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive-Behavioral Therapy for Insomnia, Bright Light therapy via the Re-Timer® and Negative Ion exposure via IonMi Device in people with Knee Osteoarthristis, run by Johns Hopkins University at 2 sites 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 4 inclusion and 12 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 7 Aug 2026. 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 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. 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 Anna Kim-Dahl (410-550-5704, akimdah1@jhu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Chronic postsurgical pain as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (time frame: 3 and 6 months post-surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 7 Aug 2026.

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