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Sleep QualityISMED CLIM PWNCT07609433

Mitigation of Health Effects in Pregnant Women by Reducing Exposure to Heat and Air Pollution

A study testing Heat intervention and Heat and air pollution mitigation intervention in people with Sleep Quality, run by University of Cyprus at 3 sites in 2 countries.

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

The goal of this clinical trial is to assess the effectiveness of an intervention (combination of behavioural recommendations and technical measures) in reducing personal exposure to heat and air pollution and related health effects in pregnant women. Read more about this study

Who is it for?
Ages 20 to 35 years, women onlyHealthy volunteers can take part
Conditions the study is for
Sleep Quality
What is being tested?
Heat intervention and Heat and air pollution mitigation intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
102 participants
Where
3 sitesin 2 countries
Study dates
1 May 2026to 31 Jul 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 20 to 35 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Pregnant Women (PW) aged 20 to 35 years
  • being in the 2nd trimester of a singleton pregnancy (15th-27th week of gestation)
  • Living in Catania (Italy) or Limassol (Cyprus) districts
  • Clinically healthy
  • No Gestational diabetes
  • No pre-eclampsia
  • No severe pregnancy complications

Who cannot join

  • Currently smoking
  • Presence of any smoking residents in the household
  • Not residing at the household for at least 5 days a week
  • Planning to move from the current home within the next two months
  • No access to Wi-Fi or 4G/5G mobile phone
  • Severe chronic conditions (congestive heart failure, ischemic heart disease, significant valvular heart disease, DM2, inflammatory diseases, renal failure, or active cancer)
Show all 10Show fewer
  • Drugs abuse
  • Alcohol abuse
  • Psychiatric disorders
  • Severe mental disability that interferes with answering questions or following instructions

Trial locations and contacts

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

Panayiotis Yiallouros, Professor contact

+35722895212

yiallouros.panayiotis@ucy.ac.cy

Panayiotis Kouis, PhD contact

+35722895243

kouis.panayiotis@ucy.ac.cy

3 sites in 2 countries

Italy2 sites, 2 recruiting
  • Azienda Ospedaliera Di Rilievo Nazionale Garibaldi Catania

    Catania

    Giuseppe Ettore, Dr, +390957595944, giuseppe.ettore@gmail.com

    Antonella Agodi, Professor, antonella.agodi@unict.it

    Recruiting
  • Azienda Ospedaliera Di Rilievo Nazionale Garibaldi Catania

    Catania

    Antonella Agodi, +390953782183, antonella.agodi@unict.it

    Recruiting

Other trials in Italy

Cyprus1 site, 1 recruiting
  • Medical School, University of Cyprus

    Limassol

    Panayiotis Kouis, +35722895243, kouis.panayiotis@ucy.ac.cy

    Recruiting

Other trials in Cyprus

About this study

Official title: Innovative Solutions Across the MEDiterranean for Mitigation of Climate Change-related heaLth rIsks and Enhancing Health systeM Resilience in Pregnant Women

The goal of this clinical trial is to assess the effectiveness of an intervention (combination of behavioural recommendations and technical measures) in reducing personal exposure to heat and air pollution and related health effects in pregnant women.

The main questions it aims to answer are:

Read more
  • Does the intervention (combination of behavioral recommendations for heat mitigation) reduce personal ambient temperature exposure, measured using a wearable device (iButton)?
  • Does the intervention (combination of behavioral recommendations for air pollution mitigation and use of indoor air cleaners) reduce indoor exposure to air pollution, measured using indoor air quality sensors (Purple Air)?
  • Does the intervention (combination of behavioral recommendations for heat mitigation) reduce sleep difficulties experienced by pregnant women, measured using the Pittsburgh Sleep Quality Index?

Researchers will compare measurements between pregnant women carrying out their daily activities in the absence of intervention (control group), those carrying out their daily activities with behavioural recommendations (recommendation intervention group) and those carrying out their daily activities with both behavioural recommendations for heat mitigation and continuous use of indoor air cleaners in their house (heat and air pollution mitigation intervention group) to see if changes in temperature exposure and sleep are different between intervention groups.

Participants will:

  • Wear the wearable devise for continuous personal ambient temperature monitoring (ibutton) daily for a period of three months
  • Have their core temperature measured using an eCelsius medical capsule in three repeated assessments
  • Complete the Pittsburgh Sleep Quality Index questionnaire in three repeated assessments
  • Provide samples of urine and blood biomarkers in three repeated assessments.
Conditions
Sleep Quality
Being tested
Heat intervention, Heat and air pollution mitigation intervention
Keywords
Pregnancy, intervention, Sleep quality, personal ambient temperature exposure
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.

  • Heat interventionOther

    Also called Behavioral intervention to reduce exposure to heat

    The participants in this group of intervention will receive timely personal alerts for high temperatures and specific recommendations to reduce exposure to heat by changing patterns of time spent and physical activity performed outdoors, regulating indoor temperature using fans and/or air conditioning devices, as well as recommendations for mitigation of heat-related health effects (hydration, body cooling) in written and animated format, through mobile phones, web application and online tools to be developed by the project research team

  • Heat and air pollution mitigation interventionOther

    Also called Behavioral intervention to reduce exposure to heat and air-pollution

    The participants in this intervention group will receive alerts and recommendations as in group "Heat intervention" and, in addition, continuously use air cleaners with HEPA filters for removing PM from indoor air in their residences and workplaces.

Study groups in NCT07609433
Study groupRoleWhat they receive
Control groupNo interventionSubjects in this arm will receive no alerts forhigh temperatures nor recommendations formitigation of heat-related health effects.
Heat intervention - Personal Alerts and Specific RecommendationsExperimentalSubjects in this group will receive timelypersonal alerts for high temperatures and specific recommendations to reduce exposure to heat and mitigation of heat-related health effects in written and animated format through mobile phones ,mobile applications and online tools.
Receives: Other: Heat intervention
Heat and air pollution intervention - Group Alerts, Recommendations and Air CleanersExperimentalSubjects in this group will receive alerts and recommendations as in group "Heat intervention" and in addition, continuously use of air cleaners with HEPA filter for removing PM from indoor air in their residences and workplaces to provide evidence for health benefits.
Receives: Other: Heat and air pollution mitigation intervention

What is being measured

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

  1. Pittsburgh Sleep Quality Index (PSQI)

    The Pittsburgh Sleep Quality Index (PSQI) is a self-report questionnaire that assesses sleep quality over a one-month time interval. The PSQI is commonly used in both clinical and research settings to evaluate various aspects of sleep. It is a valuable tool for assessing sleep quality as it captures multiple dimensions of sleep, including both subjective experiences and objective parameters. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties.

    Measured: The PSQI will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

Secondary outcomes (27)
  1. Sleep-wake pattern

    Sleep-wake pattern will be estimated based on measurements of movement and heart rate obtained from a wearable device (wristband).

    Measured: Daily measurements - for the whole duration of follow-up (2 months)

  2. Sleep-Wake self-reported evaluation

    The sleep-wake self-reported evaluation will be carried out using a predefined sleep diary which will be completed by the participant on the morning after he/she wakes up. Each assessment of sleep-wake self-reported evaluation will be carried out for a whole week.

    Measured: The sleep-wake self-reported evaluation will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  3. Hamilton Anxiety Rating Scale

    The Hamilton Anxiety Rating Scale will be carried out to assess the severity of a person's anxiety. The Hamilton Anxiety Rating Scale ranges from 0 to 56, where higher scores indicate greater anxiety severity. The scoring is divided into severity tiers: <17 (mild), 18-24 (mild to moderate), and 25-56 (moderate to severe). The scale consists of 14 items, each rated from 0 to 4 points. It evaluates both psychic anxiety (e.g., tension, fears, mood) and somatic anxiety (physical complaints).

    Measured: The Hamilton Anxiety Rating Scale will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  4. Daily heart rate

    Heart rate measurements taken throughout the day by a wearable device (wristband).

    Measured: Daily measu.ments - for the whole duration of follow-up (2 months) .

  5. Systolic/Diastolic Blood Pressure

    Measurements of Systolic/Diastolic Blood Pressure will be recorded.

    Measured: Systolic/Diastolic blood pressure will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  6. Heart Rate

    Heart rate will be measured using ECG.

    Measured: Heart Rate will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  7. Heart Rate Variability

    Heart rate variability will be measured using ECG.

    Measured: The heart rate variability will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  8. Serum C-reactive Protein Levels

    Serum levels of C-reactive protein (mg/L), as a marker of systemic inflammation, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Serum levels of C-reactive protein will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  9. Serum Urea Levels

    Serum levels of urea (mg/dL), as a marker of renal function, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Serum levels of urea will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  10. Serum Creatinine Levels

    Serum levels of creatinine (mg/dL), as a marker of renal function, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Serum levels of creatinine will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  11. Serum Sodium levels

    Serum levels of sodium (mmol/L), as a marker of hydration, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Serum levels of sodium will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  12. Serum Potassium Levels

    Serum levels of potassium (mmol/L), as a marker of hydration, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Serum levels of potassium will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  13. Serum Osmolality

    Serum osmolality (mOsm/kg), as a marker of hydration, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Serum osmolality will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  14. Urine Creatinine Levels

    Urine levels of creatinine (mg/dL), as a marker of renal function, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Urine levels of creatinine will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  15. Urine Sodium levels

    Urine levels of sodium (mmol/L), as a marker of hydration, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Urine levels of sodium will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  16. Urine Potassium levels

    Urine levels of potassium (mmol/L), as a marker of hydration, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Urine levels of potassium will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  17. Urine Osmolality

    Urine osmolality (mOsm/kg), as a marker of hydration, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Urine osmolality will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months).

  18. The personal ambient temperature profile of all participants

    Personal exposures of participants will be monitored continuously during the two observation months with wearable sensors to be always worn and assess personal exposure to ambient (indoor and outdoor) temperature (iButton).

    Measured: Daily measurements - for the whole duration of follow-up (2 months)

  19. Wet-bulb globe temperature (WGBT)

    Wet-bulb globe temperature, will be assessed as a thermal stress indicator.

    Measured: Daily measurements - for the whole duration of follow-up (2 months).

  20. Humidity

    Humidity will be measured using iButton.

    Measured: Daily measurements - for the whole duration of follow-up (2 months).

  21. Indoor concentration levels of Particulate Matter 2.5 (PM 2.5) at residence

    Indoor concentration levels of PM2.5 (micrograms per cubic meter of air) at participants' residences will be measured continuously indoors using commercial lightweight sensors (Alpha sense).

    Measured: Daily measurements - for the whole duration of follow-up (2 months).

  22. Indoor concentration levels of Particulate Matter 2.5 (PM 2.5) at work

    Indoor concentration levels of PM2.5 (micrograms per cubic meter of air) at participants' work place will be measured continuously indoors using commercial lightweight sensors (Alpha sense).

    Measured: Daily measurements - for the whole duration of follow-up (2 months).

  23. Indoor concentration levels of Particulate Matter 10 (PM 10) at residence

    Indoor concentration levels of PM10 (micrograms per cubic meter of air) at participants' residences will be measured continuously indoors using commercial lightweight sensors (Alpha sense).

    Measured: Daily measurements - for the whole duration of follow-up (2 months).

  24. Indoor concentration levels of Particulate Matter 10 (PM 10) at work

    Indoor concentration levels of PM10 (micrograms per cubic meter of air) at participants' work place will be measured continuously indoors using commercial lightweight sensors (Alpha sense).

    Measured: Daily measurements - for the whole duration of follow-up (2 months).

  25. Number of daily steps

    Number of daily steps will be measured throughout the day by a wearable device (wristband).

    Measured: Daily measurements - for the whole duration of follow-up (2 months)

  26. Hair cortisol levels

    Hair cortisol levels (pg/mg), as a marker of stress, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Hair cortisol levels will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months)

  27. Saliva alpha-amylase levels

    Saliva levels of alpha-amylase (U/mL), as a marker of stress, will be measured from each participant at baseline, middle (after 1 month), and at end of observation period (after 2 months).

    Measured: Saliva levels of alpha-amylase will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 months)

Timeline

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

  1. First posted27 May 2026
  2. Study start1 May 2026
  3. Primary completion31 Jul 2027 (estimated)
  4. Study completion31 Jul 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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized into three parallel study groups to a) receive no alerts for high temperatures nor recommendations for mitigation of health effects (business as usual scenario, control group), b) receive timely personal alerts for high temperatures and specific recommendations to reduce exposure to heat by changing patterns of time spent and physical activity performed outdoors, regulating indoor temperature using fans and or A/C devices, as well as recommendations for mitigation of health effects (hydration, body cooling) in written and animated format, through mobile phone and web application tools (heat mitigation intervention), and c) receive alerts and recommendations as in group (b) and in addition continuously use air cleaners with HEPA filter for removing PM from indoor air in their residences (heat and air pollution mitigation intervention)
Masking
None (open label)
Enrolment
102 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07609433
Sponsor's protocol ID
101156653.LL2.PW
Other IDs
101156653
Acronym
ISMED CLIM PW
Status last verified
Jun 2026
First submitted
29 Apr 2026
Last updated
5 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • HAMILTON M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50-5. doi: 10.1111/j.2044-8341.1959.tb00467.x. No abstract available.

    PubMed 13638508
  • Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.

    PubMed 2748771

Questions about this trial

What is this clinical trial studying?

A study testing Heat intervention and Heat and air pollution mitigation intervention in people with Sleep Quality, run by University of Cyprus at 3 sites in 2 countries.

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 7 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: looking for participants now, as of the sponsor's last update on 5 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Italy, Cyprus. 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 Panayiotis Yiallouros, Professor (+35722895212, yiallouros.panayiotis@ucy.ac.cy), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pittsburgh Sleep Quality Index (PSQI) (time frame: The PSQI will be assessed at baseline, middle (after 1 month), and at end of observation period (after 2 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 NCT07609433, which also lists 2 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 5 Jun 2026.

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