About this trial
The goal of this clinical trial is to learn about insomnia treatment among primary care patients with chronic insomnia.
The main question it aims to answer is:
• Does Sleep School (a therapy for insomnia) work well to decrease harm of insomnia? Participants will attend a group therapy intervention once a week for six weeks.
Researchers will compare Sleep School to treatment as usual (short counselling by an educated nurse) to see if the Sleep School works better than treatment as usual in decreasing the harm of insomnia.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Insomnia severity index (ISI) score at least 8
insomnia symptoms present at least for 3 months
Disqualifiers
diagnosed dementia based on medical records
acute suicidality
acute psychotic symptoms
Trial design
Parallel
Treatments tested in this trial
Sleep School
BehavioralSleep school is a structured method for the treatment of insomnia, which is based on cognitive behavioral therapy for insomnia (CBT-I). The central element of the method is a workbook for the patients. The essential parts of the method are strengthening the patient's self-efficacy, introducing the therapeutic exercises, and supporting the continued use of the exercises. The main themes of the Sleep school are information about sleep and the factors affecting it, behavioural components of CBT-I, like restricting the time spent in bed, cognitive components of CBT-I, like constructive worrying -exercise, and the exercises that aim to calm down mind and the autonomic nervous system. The Sleep School is held by an educated nurse.
Treatment as usual
BehavioralOral and written information about improving sleep habits given by an educated nurse.
Treatment groups
Trial outcomes
Primary outcomes
Mean Change from Baseline in Insomnia Severity Index (ISI) score at 8 weeks
The ISI is a validated self-report tool for assessing the severity, and impact of current insomnia symptoms. It consists of 7 Likert-scale questions with a total score ranging from 0 to 28 (with higher scores indicating more severe insomnia). Change = Week 8 score - Baseline score.
Secondary outcomes
Mean change from Baseline in Patient Health Questionnaire 9 (PHQ-9) at 8 weeks
PHQ-9 is a validated self-administered instrument assessing each of the 9 Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for depression as 0 (not at all) to 3 (nearly every day), and the severity of depression. Possible scores range from 0 to 27. Change = Week 8 score - Baseline score.
Mean change from Baseline in EUROHIS Quality of Life 8-item Index at 8 weeks
EUROHIS Quality of Life 8-item Index is a validated instrument for the assessment of general quality of life. There are altogether eight questions about the general, physical, psychological, social, and environmental aspects of quality of life. Every question is scored from 1 (very poor) to 5 (very good). All scores can be added together and divided by 8 (the sum of the questions) to obtain the EUROHIS-QOL mean score. Change = Week 8 score - Baseline score.
Mean change from Baseline in Work Ability Score (WAS) at 8 weeks
The WAS is the first item of the Work Ability Index (WAI), a validated instrument for the assessment of work ability. WAS is a single question "What is your current work ability compared to your lifetime best?" It has a 0-10 response scale, where 0 stands for "completely unable to work" and 10 stands for "work ability at its best." The WAS has been shown to have a strong association with the WAI and is reliable in evaluating work ability. Change = Week 8 score - Baseline score.
Other outcomes
Sleep Duration at Baseline
Information about sleep duration is collected with smart watches using a validated method. The method is based on assessment of biological signals with artificial intelligence algorithms. With a smart watch, the participant's heart rate, movements, oxygen saturation, and photoplethysmography signal is measured from the wrist. The photoplethysmography signal measures optically the changes in blood volume, which enables the assessment of the function of the sympathetic and parasympathetic nervous system. Albeit having different units, our previously developed deep learning applications utilize information from heart rate, movements, oxygen saturation, and photoplethysmography signals to assess sleep duration. Thus, regardless of the units of measured signals, information from all of these signals are combined by automatic algorithms to report one single value: sleep duration.
Sleep Stages at Baseline
Information about sleep stages is collected with smart watches using a validated method. The method is based on assessment of biological signals with artificial intelligence algorithms. With a smart watch, the participant's heart rate, movements, oxygen saturation, and photoplethysmography signal is measured from the wrist. The photoplethysmography signal measures optically the changes in blood volume, which enables the assessment of the function of the sympathetic and parasympathetic nervous system. Albeit having different units, our previously developed deep learning applications utilize information from heart rate, movements, oxygen saturation, and photoplethysmography signals to assess sleep stages. Thus, regardless of the units of measured signals, information from all of these signals are combined by automatic algorithms to report one single value: sleep stages.
Sleep Quality at Baseline
Information about objective sleep quality is collected with smart watches using a validated method. The method is based on assessment of biological signals with artificial intelligence algorithms. With a smart watch, the participant's heart rate, movements, oxygen saturation, and photoplethysmography signal is measured from the wrist. The photoplethysmography signal measures optically the changes in blood volume, which enables the assessment of the function of the sympathetic and parasympathetic nervous system. Albeit having different units, our previously developed deep learning applications utilize information from heart rate, movements, oxygen saturation, and photoplethysmography signals to assess sleep quality. Thus, regardless of the units of measured signals, information from all of these signals are combined by automatic algorithms to report one single value: sleep quality.
Sleep Duration at 8 weeks
Information about sleep duration is collected with smart watches using a validated method. The method is based on assessment of biological signals with artificial intelligence algorithms. With a smart watch, the participant's heart rate, movements, oxygen saturation, and photoplethysmography signal is measured from the wrist. The photoplethysmography signal measures optically the changes in blood volume, which enables the assessment of the function of the sympathetic and parasympathetic nervous system. Albeit having different units, our previously developed deep learning applications utilize information from heart rate, movements, oxygen saturation, and photoplethysmography signals to assess sleep duration. Thus, regardless of the units of measured signals, information from all of these signals are combined by automatic algorithms to report one single value: sleep duration.
Sponsors and contacts
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University of Turku
Lead sponsor
University of Eastern Finland
Collaborator