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InsomniaPhase 4NCT03312517

Study to Compare the Awakening Threshold Effects of Belsomra 10 mg and 20 mg to Placebo in Non-elderly Insomniacs

A Phase 4 study testing Suvorexant 10 mg and Suvorexant 20 mg in people with Insomnia, run by Henry Ford Health System 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
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Trial summary

Phase IV 3-Way Double-blind, Randomized, Crossover Study to Compare the Awakening Threshold Effects (responsivity) of Belsomra 10 mg and 20 mg to Placebo in non-elderly Insomniacs Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Insomnia
What is being tested?
Suvorexant 10 mg and Suvorexant 20 mg
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
12 participants
Where
1 siteUnited States
Study dates
15 Apr 2018to 25 Oct 2018
Phase
Phase 4
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 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Meets DSM-5 ( Diagnostic and statistical manual) diagnostic criteria for insomnia disorder
  • ISI ( Insomnia Severity Index) > 10
  • Age >18 and < 65
  • Negative audiological screening exam

Who cannot join

  • BMI >35 kg/m2
  • Have symptoms consistent with the diagnosis of any sleep disorder other than insomnia (e.g., sleep apnea, narcolepsy, periodic leg movements, or restless leg syndrome).
  • Have a known or suspected diagnosis of Acquired Immune Deficiency Syndrome (AIDS), or have tested seropositive for human immunodeficiency virus (HIV) antibody or antigen previously.
  • Have any clinically significant abnormal finding in physical examination, neurological assessment, vital signs, elevated body temperature, or clinical laboratory tests, as determined by the Investigator.
  • Have a known or exaggerated pharmacological sensitivity, hypersensitivity, or intolerance to Belsomra.
  • Currently taking CYP3A inhibitors.
Show all 15Show fewer
  • Positive breathalyzer test for alcohol at Screening, PSG Screening or any Treatment night, or a positive urine drug screen (for amphetamines, barbiturates, benzodiazepines, cocaine, opiates, or cannabinoids) at Screening;
  • History of hearing difficulty (e.g., use of a hearing aid).
  • Intends to use any medication including over-the-counter (OTC) medications that would interfere with normal sleep architecture (such as systemic steroids, beta-adrenergic blockers, amphetamines, modafinil, etc.);
  • Self-reports use of products containing nicotine of greater than 15 cigarettes daily, or cannot avoid products containing nicotine during the normal sleep periods;
  • Self report consumption of more than five alcoholic beverages on any one day or > 14 alcoholic beverages weekly over the past week;
  • Have a history of epilepsy or serious head injury
  • Average Time in Bed < 6.5 hrs.
  • Have used prescribed or OTC medications within 7 days of screening (Day 0) or intend to use any prescription or OTC medication during the study that may interfere with the evaluation of the study drug. This restriction includes taking medications that affect the Central nervous system. Any chronic maintenance therapy should have been maintained at a stable dosing regimen for at least 30 days before screening and subjects must continue this regimen throughout the study.
  • Have used an investigational drug within 30 days or five half lives (whichever is longer) before screening, or plans to use an investigational drug during the study or have used belsomra or zolpidem

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Henry Ford Medical Center - Columbus

    Novi, Michigan, 48377

Other trials in United States

About this study

Official title: A Phase IV 3-Way Double-blind, Randomized, Crossover Study to Compare the Awakening Threshold Effects (Responsivity) of Belsomra 10 mg and 20 mg to Placebo in Non-elderly Insomniacs

Phase IV 3-Way Double-blind, Randomized, Crossover Study to Compare the Awakening Threshold Effects (responsivity) of Belsomra 10 mg and 20 mg to Placebo in non-elderly Insomniacs

Read the detailed description

The study is an interventional single site study using a double blind, randomized 3-way crossover design with Belsomra 10 mg and 20 mg compared to a placebo. The total number of enrolled patients proposed is 12. A cross-over design is utilized so participants will be exposed to all treatment conditions in a controlled order (Belsomra 10 mg, 20 mg and placebo). Both men and women with insomnia will be utilized as the study population to improve the generalizability of outcome data. Subjects with other sleep disorders or unstable medical/psychiatric disorders will be excluded from the trial. Inclusion criteria will be men and women >18 and < 65 years of age.

Subjects will be randomly assigned to treatment sequences using a Latin square design. After a subject has qualified for the study, the next sequentially available randomization number will be assigned. The subject will be administered study drug corresponding with this assigned number.

During the night of each respective Polysomnography (PSG) assessments, subjects will be awoken at the approximate T-max of the active drug (2.5 hrs), with a matching placebo condition at the same time point using an identical responsivity protocol for each condition. The rationale for this is that t-max represents the time of greatest potential risk for a hypnotic in terms of balance, responsivity, and memory. Responsivity will be assessed using the Auditory Awakening Threshold test (AAT) and will be measured at 2.5 hours post dose for the Belsomra 10 and 20 mg (BEL), and placebo (PBO) conditions. Responsivity will be assessed at the approximate time above immediately after 5 minutes of consolidated (without arousals) NREM ( Non- rapid eye movement) stage 2 sleep has occurred.

Conditions
Insomnia
Being tested
Suvorexant 10 mg, Suvorexant 20 mg, Placebo oral capsule
Keywords
insomnia, belsomra, suvorexant
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.

  • Suvorexant 10 mgDrug

    Also called belsomra 10mg

    Subject will receive suvorexant 10mg

  • Suvorexant 20 mgDrug

    Also called Belsomra 20mg

    Subject will receive suvorexant 20mg

  • Placebo oral capsuleDrug

    Also called placebo

    Subject will receive placebo.

Study groups in NCT03312517
Study groupRoleWhat they receive
Suvorexant 10mgActive comparatorSubjects will receive belsomra 10mg before bedtime. In the middle of the night, subjects will be awakened to auditory awakening tones.
Receives: Drug: Suvorexant 10 mg
Suvorexant 20mgActive comparatorSubjects will receive belsomra 20mg before bedtime. In the middle of the night, subjects will be awakened to auditory awakening tones.
Receives: Drug: Suvorexant 20 mg
Placebo oral capsuleSham comparatorSubjects will receive placebo before bedtime. In the middle of the night, subjects will be awakened to auditory awakening tones.
Receives: Drug: Placebo oral capsule

What is being measured

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

  1. Auditory Awakening Threshold

    Subjects will be awakened during the night to auditory awakening tones.

    Measured: 2.5 hours post-dose of each Study Drug administration

Timeline

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

  1. First posted17 Oct 2017
  2. Study start15 Apr 2018
  3. Primary completion25 Oct 2018
  4. Study completion25 Oct 2018

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
double-blind, randomized 3-way crossover design
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03312517
Sponsor's protocol ID
MISP 57338
Status last verified
Oct 2019
First submitted
12 Oct 2017
Last updated
1 Nov 2019
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Greenblatt DJ, Harmatz JS, Shader RI. Update on Psychotropic Drug Prescribing in the United States: 2014-2015. J Clin Psychopharmacol. 2018 Feb;38(1):1-4. doi: 10.1097/JCP.0000000000000831. No abstract available.

    PubMed 29215384
  • Bonnet MH, Webb WB, Barnard G. Effect of flurazepam, pentobarbital, and caffeine on arousal threshold. Sleep. 1979 Spring;1(3):271-9. doi: 10.1093/sleep/1.3.271.

    PubMed 504872
  • Johnson LC, Church MW, Seales DM, Rossiter VS. Auditory arousal thresholds of good sleepers and poor sleepers with and without flurazepam. Sleep. 1979 Spring;1(3):259-70. doi: 10.1093/sleep/1.3.259.

    PubMed 228373
  • Johnson LC, Spinweber CL, Webb SC, Muzet AG. Dose level effects of triazolam on sleep and response to a smoke detector alarm. Psychopharmacology (Berl). 1987;91(4):397-402. doi: 10.1007/BF00216003.

    PubMed 3108921
  • Drake CL, Durrence H, Cheng P, Roth T, Pillai V, Peterson EL, Singh M, Tran KM. Arousability and Fall Risk During Forced Awakenings From Nocturnal Sleep Among Healthy Males Following Administration of Zolpidem 10 mg and Doxepin 6 mg: A Randomized, Placebo-Controlled, Four-Way Crossover Trial. Sleep. 2017 Jul 1;40(7). doi: 10.1093/sleep/zsx086.

    PubMed 28575467
  • Bettica P, Squassante L, Zamuner S, Nucci G, Danker-Hopfe H, Ratti E. The orexin antagonist SB-649868 promotes and maintains sleep in men with primary insomnia. Sleep. 2012 Aug 1;35(8):1097-104. doi: 10.5665/sleep.1996.

    PubMed 22851805
  • Herring WJ, Snyder E, Budd K, Hutzelmann J, Snavely D, Liu K, Lines C, Roth T, Michelson D. Orexin receptor antagonism for treatment of insomnia: a randomized clinical trial of suvorexant. Neurology. 2012 Dec 4;79(23):2265-74. doi: 10.1212/WNL.0b013e31827688ee. Epub 2012 Nov 28.

    PubMed 23197752
  • Michelson D, Snyder E, Paradis E, Chengan-Liu M, Snavely DB, Hutzelmann J, Walsh JK, Krystal AD, Benca RM, Cohn M, Lines C, Roth T, Herring WJ. Safety and efficacy of suvorexant during 1-year treatment of insomnia with subsequent abrupt treatment discontinuation: a phase 3 randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2014 May;13(5):461-71. doi: 10.1016/S1474-4422(14)70053-5. Epub 2014 Mar 27.

    PubMed 24680372
  • Tannenbaum PL, Stevens J, Binns J, Savitz AT, Garson SL, Fox SV, Coleman P, Kuduk SD, Gotter AL, Marino M, Tye SJ, Uslaner JM, Winrow CJ, Renger JJ. Orexin receptor antagonist-induced sleep does not impair the ability to wake in response to emotionally salient acoustic stimuli in dogs. Front Behav Neurosci. 2014 May 16;8:182. doi: 10.3389/fnbeh.2014.00182. eCollection 2014.

    PubMed 24904334
  • Tannenbaum PL, Tye SJ, Stevens J, Gotter AL, Fox SV, Savitz AT, Coleman PJ, Uslaner JM, Kuduk SD, Hargreaves R, Winrow CJ, Renger JJ. Inhibition of Orexin Signaling Promotes Sleep Yet Preserves Salient Arousability in Monkeys. Sleep. 2016 Mar 1;39(3):603-12. doi: 10.5665/sleep.5536.

    PubMed 26943466
  • Manber R, Harvey A. Historical perspective and future directions in Cognitive Behavioral Therapy for insomnia and behavioral sleep medicine. Clin Psychol Rev. 2005 Jul;25(5):535-8. doi: 10.1016/j.cpr.2005.04.002. No abstract available.

    PubMed 15950345
  • Allen RP, Burchell BJ, MacDonald B, Hening WA, Earley CJ. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Med. 2009 Dec;10(10):1097-100. doi: 10.1016/j.sleep.2008.10.007. Epub 2009 Feb 4.

    PubMed 19195928
  • Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, Khajehdehi A, Shapiro CM. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008 May;108(5):812-21. doi: 10.1097/ALN.0b013e31816d83e4.

    PubMed 18431116
  • Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001 Jul;2(4):297-307. doi: 10.1016/s1389-9457(00)00065-4.

    PubMed 11438246
  • Keefe FB, Johnson LC, Hunter EJ. EEG and autonomic response pattern during waking and sleep stages. Psychophysiology. 1971 Mar;8(2):198-212. doi: 10.1111/j.1469-8986.1971.tb00451.x. No abstract available.

    PubMed 4326132

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Suvorexant 10 mg and Suvorexant 20 mg in people with Insomnia, run by Henry Ford Health System 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 4 inclusion and 15 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 1 Nov 2019. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 1 Nov 2019). 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?

Auditory Awakening Threshold (time frame: 2.5 hours post-dose of each Study Drug administration). 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 NCT03312517, which also lists 20 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 1 Nov 2019.

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