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Trial record 18 of 2095 for:    Symptoms | Parasomnias

Sleep and Pain in Sickle Cell Disease

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ClinicalTrials.gov Identifier: NCT03150433
Recruitment Status : Recruiting
First Posted : May 12, 2017
Last Update Posted : December 22, 2017
Sponsor:
Collaborator:
University of Maryland
Information provided by (Responsible Party):
Johns Hopkins University

Brief Summary:
This is a study testing the effects of behavioral sleep interventions on pain and brain function in sickle cell disease.

Condition or disease Intervention/treatment Phase
Sickle Cell Disease Sleep Disturbance Pain Behavioral: Behavioral symptom management Other: Sickle cell disease management Not Applicable

Detailed Description:
The investigators propose to examine whether changes in sleep alter pain and pain-related outcomes in adults with Sickle Cell Disease (SCD). As many as 70% of adults with SCD experience various sleep disturbances. Pain and sleep are inter-related, such that pain disturbs sleep and disturbed sleep amplifies pain and increases risk for developing chronic pain. Pain processing occurs in the central nervous system, where nociceptive input can be inhibited or facilitated and which can undergo both functional and structural plasticity. When plasticity results in amplification of pain, this central sensitization (CS) manifests as hyperalgesia, allodynia, and spreading of pain and is an important treatment target in its own right. A growing literature implicates central sensitization in SCD, and the investigators find a strong association between laboratory-evoked CS and sleep disturbance in SCD. The neural substrates involved in pain modulation are often disrupted in chronic pain, likely due to the demands pain places on cognitive resources, and similar effects are seen with chronic insomnia. It remains unclear whether these changes occur in SCD and if improving sleep improves central modulation of pain. The potential for improved sleep to reduce pain and CS requires additional investigation, particularly given the significance of sleep disturbance as a mutable risk factor. The investigators will conduct a randomized trial in which it will be determined whether improvements in sleep reduce pain and alter brain processing of pain and cognitive stimuli. The aims are to determine whether treatment of sleep improves pain outcomes in SCD and to determine whether treatment of sleep alters functional connectivity of cognitive and pain modulatory networks using brain imaging in SCD.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 120 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Masking Description: Outcome assessors will be masked to treatment condition
Primary Purpose: Treatment
Official Title: Sleep and Pain in Sickle Cell Disease
Actual Study Start Date : November 5, 2017
Estimated Primary Completion Date : July 31, 2020
Estimated Study Completion Date : May 30, 2021

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Behavioral symptom management
Five sessions working one-on-one with a study interventionist, either in person or by telephone. Includes monitoring of the individual's sleep pattern, feedback and goals for improving sleep and pain management, and addressing cognitive and emotional strategies for managing sleep and pain.
Behavioral: Behavioral symptom management
Individual sessions focused on behavioral and cognitive strategies for managing sleep disturbance, pain, and other symptoms of sickle cell disease

Sickle cell disease management
Five sessions working one-on-one with a study interventionist, either in person or by telephone. Includes monitoring of the individual's sleep pattern, information about sickle cell disease and its management, and information about improving sleep and managing pain.
Other: Sickle cell disease management
Individual sessions focused on understanding and managing sickle cell disease




Primary Outcome Measures :
  1. Change in Clinical pain [ Time Frame: baseline and 23 weeks ]
    Average of 4 items from the Brief Pain Inventory; each rated on a 0 (no pain) to 10 (pain as bad as you can imagine); ratings are made of pain right now, typical pain, worst pain, and least pain during the past week


Secondary Outcome Measures :
  1. Change in Clinical pain [ Time Frame: baseline and 35 weeks ]
    Average of 4 items from the Brief Pain Inventory; each rated on a 0 (no pain) to 10 (pain as bad as you can imagine); ratings are made of pain right now, typical pain, worst pain, and least pain during the past week

  2. Change in Central Sensitization Index [ Time Frame: baseline and 11 weeks ]
    Index of thermal temporal summation, mechanical temporal summation, and aftersensations

  3. Change in functional connectivity/cognitive task [ Time Frame: baseline and 11 weeks ]
    Functional magnetic resonance imaging, functional connectivity during cognitive testing



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Ages Eligible for Study:   18 Years to 100 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • African American;
  • Diagnosis of sickle cell hemoglobinopathy (Homozygous sickle cell disease, Hemoglobin SC disease, or Sickle/beta-thalassemia);
  • Adequate facility with English;
  • Stable dosing of medications for pain and sleep;
  • Reports symptoms of insomnia;
  • Reports chronic pain

Exclusion Criteria:

  • Cognitive impairment;
  • Unstable sickle cell disease;
  • Unstable psychiatric disorder;
  • Seizure disorder;
  • Positive pregnancy or drug test

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03150433


Contacts
Contact: Claudia Campbell, PhD 410-550-7989 ccampb41@jhmi.edu
Contact: Jennifer Haythornthwaite, PhD 410-550-7000 jhaytho1@jhmi.edu

Locations
United States, Maryland
Johns Hopkins Recruiting
Baltimore, Maryland, United States, 21224
Contact: Adrianna Tilton    410-550-1217      
Sponsors and Collaborators
Johns Hopkins University
University of Maryland
Investigators
Principal Investigator: Claudia Campbell, PhD Johns Hopkins University

Responsible Party: Johns Hopkins University
ClinicalTrials.gov Identifier: NCT03150433     History of Changes
Other Study ID Numbers: IRB00100060
First Posted: May 12, 2017    Key Record Dates
Last Update Posted: December 22, 2017
Last Verified: December 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Individual participant data will not be shared with other researchers

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
Sleep Wake Disorders
Parasomnias
Signs and Symptoms
Anemia, Sickle Cell
Dyssomnias
Anemia, Hemolytic, Congenital
Anemia, Hemolytic
Anemia
Hematologic Diseases
Hemoglobinopathies
Genetic Diseases, Inborn
Nervous System Diseases
Mental Disorders
Neurologic Manifestations