SleepCLASS-DNCT04206059
Closed Loop Acoustic Stimulation During Sedation With Dexmedetomidine
A study testing MRI, Quantitative Sensory Testing (QST) and Home sleep study in people with Sleep and Sedation Complication, run by Washington University School of Medicine at 1 site in United States.
Trial summary
Prospective within-subject study of dexmedetomidine sedation paired with CLAS conditions in repeated blocks. Intervention will consist of CLAS in-phase with EEG slow waves. Anti-phase stimulation will serve as an active control while sham stimulation will serve as a passive control. Read more about this study
- Who is it for?
- Ages 18 to 40 yearsHealthy volunteers can take part
- Conditions the study is for
- Sleep, Sedation Complication
- What is being tested?
- MRI, Quantitative Sensory Testing (QST) and Home sleep study
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 18 participants
- Where
- 1 siteUnited States
- Study dates
- 20 Jan 2021to 1 Jul 2023
- Phase
- Interventional
- 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 40 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Age 18-40 years
- Healthy volunteers (American Society of Anesthesiologists Physical Status 1-2).
Who cannot join
- Diagnosed sleep disorders
- Habitually short sleepers
- Diagnosed psychiatric disorders
- Use of psychoactive medication (e.g., antidepressants, mood stabilizers or antipsychotics), diagnosed hearing disorder
- Neck circumference > 40 cm
- Body Mass Index > 30
Show all 10Show fewer
- Acknowledged recreational drug or nicotine use
- Resting heart rate during slow wave sleep < 40 beats per minute
- Pregnancy or nursing
- Persistently inconsistent or elevated QST heat pain tolerance thresholds (>50 ºC).
Trial locations and contacts
1 site in 1 country.
United States1 site
Washington University School of Medicine/Barnes-Jewish Hospital
St Louis, Missouri, 63110
About this study
Prospective within-subject study of dexmedetomidine sedation paired with CLAS conditions in repeated blocks. Intervention will consist of CLAS in-phase with EEG slow waves. Anti-phase stimulation will serve as an active control while sham stimulation will serve as a passive control.
Read the detailed description
Both nonpharmacologic and pharmacologic interventions augment expression of EEG slow waves that mimic those of natural sleep. Closed loop auditory stimulation (CLAS) is a noninvasive inexpensive approach to augment the spectral power and duration of these slow waves. Whether in-phase CLAS may address this need is unknown, since acoustic potentiation of pharmacologically-induced slow waves has not been investigated. This prospective within-subject study of dexmedetomidine sedation paired with CLAS will assess the feasibility of augmenting EEG slow waves during sedation.
- Conditions
- Sleep, Sedation Complication
- Being tested
- MRI, Quantitative Sensory Testing (QST), Home sleep study, Acoustic stimulation (65 decibels or db) up-slope of EEG with QST, Acoustic stimulation (65db) down-slope of EEG with QST
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MRIRadiation
Also called Structural magnetic resonance imaging
A non-contrast brain MRI will be acquired for localizing EEG slow waves
Quantitative Sensory Testing (QST)Diagnostic test
Also called Quantitative Sensory Testing
Quantitative sensory testing (QST) using increasing ramp thermal stimulation (32-52 ºC) will be delivered to compare arousal thresholds between conditions.
Home sleep studyDiagnostic test
Also called Unattended polysomnography
Unattended home sleep studies will be conducted on the night preceding sedation and on the night following sedation to assess changes in slow wave homeostasis.
Acoustic stimulation (65 decibels or db) up-slope of EEG with QSTOther
Also called In-phase CLAS with sensory testing
Acoustic stimulation (65 db) synchronized in-phase with the up-slope of EEG slow waves
Acoustic stimulation (65db) down-slope of EEG with QSTOther
Also called Anti-phase CLAS with sensory testing
65 dB acoustic stimulation synchronized with the down-slope of the EEG slow waves (anti-phase)
0 db with QSTOther
Also called Sham CLAS with sensory testing
sham stimulation (0 dB volume)
DexmedetomidineDrug
Also called Dexmedetomidine hydrochloride
All participants will receive dexmedetomidine with sedation titrated step-wise to 2, 3 or 4 ng/ml
Breathe-Squeeze TaskOther
Also called Internally directed behavioral task
All participants will be asked to perform the breathe-squeeze task throughout the experiment. This will allow us to determine loss and return of responsiveness.
| Study group | Role | What they receive |
|---|---|---|
| CLASS-D Cohort - In-phase | Experimental | Within-subject crossover cohort with intervention, acoustic stimulation delivered in phase with the anticipated peak of EEG slow wave oscillation Receives: Radiation: MRI; Diagnostic Test: Quantitative Sensory Testing (QST); Diagnostic Test: Home sleep study; Other: Acoustic stimulation (65 decibels or db) up-slope of EEG with QST; Drug: Dexmedetomidine; Other: Breathe-Squeeze Task |
| CLASS-D Cohort - Anti-phase | Active comparator | Within-subject crossover cohort with intervention, acoustic stimulation delivered in phase with the anticipated trough of EEG slow wave oscillation Receives: Radiation: MRI; Diagnostic Test: Quantitative Sensory Testing (QST); Diagnostic Test: Home sleep study; Other: Acoustic stimulation (65db) down-slope of EEG with QST; Drug: Dexmedetomidine; Other: Breathe-Squeeze Task |
| CLASS-D Cohort - Sham | Sham comparator | Within-subject crossover cohort with intervention, acoustic stimulation anticipated in phase with the anticipated peak of EEG slow wave oscillation but no acoustic stimulation delivered. Receives: Radiation: MRI; Diagnostic Test: Quantitative Sensory Testing (QST); Diagnostic Test: Home sleep study; Other: 0 db with QST; Drug: Dexmedetomidine; Other: Breathe-Squeeze Task |
What is being measured
The primary outcome is the main question the study is designed to answer.
Difference in EEG Slow Wave Activity From Sham to In-phase Stimulation
EEG slow waves activity (power) relative to the timing of the stimulation. Values are log-transformed All participants serve in the same arm but experience both sham and in-phase blocks.
Measured: Sham stimulation and in-phase stimulation blocks during the intervention
Difference in EEG Slow Wave Activity From Anti-phase to In-phase Stimulation
EEG slow waves activity (power) relative to the timing of the stimulation. Values are log-transformed All participants serve in the same arm but experience both anti-phase and in-phase blocks.
Measured: Anti-phase and in-phase blocks during the intervention
Difference in EEG Slow Wave Density From Anti-phase to In-phase Stimulation
Difference in EEG slow wave density from anti-phase to in-phase stimulation by looking at EEG slow waves duration relative to the timing of the stimulation All participants serve in the same arm but experience both anti-phase and in-phase blocks.
Measured: anti-phase and in-phase blocks during the intervention
Difference in EEG Slow Wave Density From Sham to In-phase Stimulation
Difference in EEG slow wave density from sham to in-phase stimulation by looking at EEG slow waves relative to the timing of the stimulation All participants serve in the same arm but experience both sham and in-phase blocks.
Measured: Sham stimulation and in-phase stimulation blocks during the intervention
Secondary outcomes (3)
Difference of Reactivity to Thermal Stimulation From Anti-phase to In-phase Stimulation
Difference of reactivity to thermal stimulation from anti-phase to in-phase stimulation by measuring the threshold for responsiveness to thermal stimulation All participants serve in the same arm but experience both anti-phase and in-phase blocks.
Measured: Anti-phase and in-phase blocks of the intervention
Difference of Reactivity to Thermal Stimulation From Sham to In-phase Stimulation
Difference of reactivity to thermal stimulation from sham to in-phase stimulation by measuring the threshold for responsiveness to thermal stimulation All participants serve in the same arm but experience both sham and in-phase blocks.
Measured: Sham and in-phase blocks during intervention
Slow Wave Activity Calculated During N3 Sleep
Change in slow wave activity on the night of the intervention will be compared to that on the night prior to the study session. Calculated as power
Measured: on the nights before and the night of the intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Dec 2019
- Study start20 Jan 2021
- Primary completion1 Jun 2022
- Study completion1 Jul 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for SleepStudies of the same condition, open and under way.
- More trials run by Washington University School of MedicineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 18 participants (actual)
Sponsor and investigators
- Lead sponsor
- Washington University School of Medicine
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ben J.A. Palanca, Washington University School of Medicine
- Investigators
- Ben J Palanca, MD PhD, Principal investigator, Washington University School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04206059
- Sponsor's protocol ID
- 201907086
- Acronym
- CLASS-D
- Status last verified
- Apr 2026
- First submitted
- 9 Dec 2019
- Last updated
- 1 May 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
Publications
Prerau MJ, Brown RE, Bianchi MT, Ellenbogen JM, Purdon PL. Sleep Neurophysiological Dynamics Through the Lens of Multitaper Spectral Analysis. Physiology (Bethesda). 2017 Jan;32(1):60-92. doi: 10.1152/physiol.00062.2015.
PubMed 27927806Leger D, Debellemaniere E, Rabat A, Bayon V, Benchenane K, Chennaoui M. Slow-wave sleep: From the cell to the clinic. Sleep Med Rev. 2018 Oct;41:113-132. doi: 10.1016/j.smrv.2018.01.008. Epub 2018 Feb 5.
PubMed 29490885Neske GT. The Slow Oscillation in Cortical and Thalamic Networks: Mechanisms and Functions. Front Neural Circuits. 2016 Jan 14;9:88. doi: 10.3389/fncir.2015.00088. eCollection 2015.
PubMed 26834569Smith SK, Kafashan M, Rios RL, Brown EN, Landsness EC, Guay CS, Palanca BJA. Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults. BJA Open. 2024 Mar 28;10:100276. doi: 10.1016/j.bjao.2024.100276. eCollection 2024 Jun.
PubMed 38571816Guay CS, Hight D, Gupta G, Kafashan M, Luong AH, Avidan MS, Brown EN, Palanca BJA. Breathe-squeeze: pharmacodynamics of a stimulus-free behavioural paradigm to track conscious states during sedation☆. Br J Anaesth. 2023 May;130(5):557-566. doi: 10.1016/j.bja.2023.01.021. Epub 2023 Mar 24.
PubMed 36967282
Study at a glance
From the registry record, last updated by the sponsor on 1 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Closed Loop Acoustic Stimulation During Sedation With Dexmedetomidine
- ClinicalTrials.gov ID
- NCT04206059
- Acronym / sponsor ID
- CLASS-D / 201907086
- Conditions
- Sleep, Sedation Complication
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 18 participants (actual)
- Lead sponsor
- Washington University School of MedicineUniversity, hospital or other
- Study start
- 20 Jan 2021 (actual)
- Primary completion
- 1 Jun 2022 (actual)
- Study completion
- 1 Jul 2023 (actual)
- First posted
- 20 Dec 2019 (actual)
- Results
- Posted 1 May 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Prospective within-subject study of dexmedetomidine sedation paired with CLAS conditions in repeated blocks. Intervention will consist of CLAS in-phase with EEG slow waves. Anti-phase stimulation will serve as an active control while sham stimulation will serve as a passive control.
Detailed description
Both nonpharmacologic and pharmacologic interventions augment expression of EEG slow waves that mimic those of natural sleep. Closed loop auditory stimulation (CLAS) is a noninvasive inexpensive approach to augment the spectral power and duration of these slow waves. Whether in-phase CLAS may address this need is unknown, since acoustic potentiation of pharmacologically-induced slow waves has not been investigated. This prospective within-subject study of dexmedetomidine sedation paired with CLAS will assess the feasibility of augmenting EEG slow waves during sedation.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| CLASS-D Cohort - In-phase | Experimental | Radiation: MRI, Diagnostic Test: Quantitative Sensory Testing (QST), Diagnostic Test: Home sleep study, Other: Acoustic stimulation (65 decibels or db) up-slope of EEG with QST, Drug: Dexmedetomidine, Other: Breathe-Squeeze TaskWithin-subject crossover cohort with intervention, acoustic stimulation delivered in phase with the anticipated peak of EEG slow wave oscillation |
| CLASS-D Cohort - Anti-phase | Active comparator | Radiation: MRI, Diagnostic Test: Quantitative Sensory Testing (QST), Diagnostic Test: Home sleep study, Other: Acoustic stimulation (65db) down-slope of EEG with QST, Drug: Dexmedetomidine, Other: Breathe-Squeeze TaskWithin-subject crossover cohort with intervention, acoustic stimulation delivered in phase with the anticipated trough of EEG slow wave oscillation |
| CLASS-D Cohort - Sham | Sham comparator | Radiation: MRI, Diagnostic Test: Quantitative Sensory Testing (QST), Diagnostic Test: Home sleep study, Other: 0 db with QST, Drug: Dexmedetomidine, Other: Breathe-Squeeze TaskWithin-subject crossover cohort with intervention, acoustic stimulation anticipated in phase with the anticipated peak of EEG slow wave oscillation but no acoustic stimulation delivered. |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- Age 18-40 years
- Healthy volunteers (American Society of Anesthesiologists Physical Status 1-2).
Key exclusion criteria (10 listed)
- Diagnosed sleep disorders
- Habitually short sleepers
- Diagnosed psychiatric disorders
- Use of psychoactive medication (e.g., antidepressants, mood stabilizers or antipsychotics), diagnosed hearing disorder
- Neck circumference > 40 cm
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MRIAlso: Structural magnetic resonance imagingA non-contrast brain MRI will be acquired for localizing EEG slow waves | Radiation | CLASS-D Cohort - Anti-phase, CLASS-D Cohort - In-phase, CLASS-D Cohort - Sham |
| Quantitative Sensory Testing (QST)Also: Quantitative Sensory TestingQuantitative sensory testing (QST) using increasing ramp thermal stimulation (32-52 ºC) will be delivered to compare arousal thresholds between conditions. | Diagnostic test | CLASS-D Cohort - Anti-phase, CLASS-D Cohort - In-phase, CLASS-D Cohort - Sham |
| Home sleep studyAlso: Unattended polysomnographyUnattended home sleep studies will be conducted on the night preceding sedation and on the night following sedation to assess changes in slow wave homeostasis. | Diagnostic test | CLASS-D Cohort - Anti-phase, CLASS-D Cohort - In-phase, CLASS-D Cohort - Sham |
| Acoustic stimulation (65 decibels or db) up-slope of EEG with QSTAlso: In-phase CLAS with sensory testingAcoustic stimulation (65 db) synchronized in-phase with the up-slope of EEG slow waves | Other | CLASS-D Cohort - In-phase |
| Acoustic stimulation (65db) down-slope of EEG with QSTAlso: Anti-phase CLAS with sensory testing65 dB acoustic stimulation synchronized with the down-slope of the EEG slow waves (anti-phase) | Other | CLASS-D Cohort - Anti-phase |
| 0 db with QSTAlso: Sham CLAS with sensory testingsham stimulation (0 dB volume) | Other | CLASS-D Cohort - Sham |
| DexmedetomidineAlso: Dexmedetomidine hydrochlorideAll participants will receive dexmedetomidine with sedation titrated step-wise to 2, 3 or 4 ng/ml | Drug | CLASS-D Cohort - Anti-phase, CLASS-D Cohort - In-phase, CLASS-D Cohort - Sham |
| Breathe-Squeeze TaskAlso: Internally directed behavioral taskAll participants will be asked to perform the breathe-squeeze task throughout the experiment. This will allow us to determine loss and return of responsiveness. | Other | CLASS-D Cohort - Anti-phase, CLASS-D Cohort - In-phase, CLASS-D Cohort - Sham |
Primary outcome
Difference in EEG Slow Wave Activity From Sham to In-phase Stimulation
Time frame: Sham stimulation and in-phase stimulation blocks during the intervention
EEG slow waves activity (power) relative to the timing of the stimulation. Values are log-transformed All participants serve in the same arm but experience both sham and in-phase blocks.
Difference in EEG Slow Wave Activity From Anti-phase to In-phase Stimulation
Time frame: Anti-phase and in-phase blocks during the intervention
EEG slow waves activity (power) relative to the timing of the stimulation. Values are log-transformed All participants serve in the same arm but experience both anti-phase and in-phase blocks.
Difference in EEG Slow Wave Density From Anti-phase to In-phase Stimulation
Time frame: anti-phase and in-phase blocks during the intervention
Difference in EEG slow wave density from anti-phase to in-phase stimulation by looking at EEG slow waves duration relative to the timing of the stimulation All participants serve in the same arm but experience both anti-phase and in-phase blocks.
Difference in EEG Slow Wave Density From Sham to In-phase Stimulation
Time frame: Sham stimulation and in-phase stimulation blocks during the intervention
Difference in EEG slow wave density from sham to in-phase stimulation by looking at EEG slow waves relative to the timing of the stimulation All participants serve in the same arm but experience both sham and in-phase blocks.
3 secondary outcomes
Difference of Reactivity to Thermal Stimulation From Anti-phase to In-phase Stimulation
Time frame: Anti-phase and in-phase blocks of the intervention
Difference of Reactivity to Thermal Stimulation From Sham to In-phase Stimulation
Time frame: Sham and in-phase blocks during intervention
Slow Wave Activity Calculated During N3 Sleep
Time frame: on the nights before and the night of the intervention
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 May 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 27927806Prerau MJ, Brown RE, Bianchi MT, Ellenbogen JM, Purdon PL. Sleep Neurophysiological Dynamics Through the Lens of Multitaper Spectral Analysis. Physiology (Bethesda). 2017 Jan;32(1):60-92. doi: 10.1152/physiol.00062.2015.
- Background: PubMed 29490885Leger D, Debellemaniere E, Rabat A, Bayon V, Benchenane K, Chennaoui M. Slow-wave sleep: From the cell to the clinic. Sleep Med Rev. 2018 Oct;41:113-132. doi: 10.1016/j.smrv.2018.01.008. Epub 2018 Feb 5.
- Background: PubMed 26834569Neske GT. The Slow Oscillation in Cortical and Thalamic Networks: Mechanisms and Functions. Front Neural Circuits. 2016 Jan 14;9:88. doi: 10.3389/fncir.2015.00088. eCollection 2015.
- Derived from this study: PubMed 38571816Smith SK, Kafashan M, Rios RL, Brown EN, Landsness EC, Guay CS, Palanca BJA. Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults. BJA Open. 2024 Mar 28;10:100276. doi: 10.1016/j.bjao.2024.100276. eCollection 2024 Jun.
- Derived from this study: PubMed 36967282Guay CS, Hight D, Gupta G, Kafashan M, Luong AH, Avidan MS, Brown EN, Palanca BJA. Breathe-squeeze: pharmacodynamics of a stimulus-free behavioural paradigm to track conscious states during sedation☆. Br J Anaesth. 2023 May;130(5):557-566. doi: 10.1016/j.bja.2023.01.021. Epub 2023 Mar 24.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ben J Palanca, MD PhD principal investigator
Washington University School of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing MRI, Quantitative Sensory Testing (QST) and Home sleep study in people with Sleep and Sedation Complication, run by Washington University School of Medicine 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 2 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: finished, as of the sponsor's last update on 1 May 2026. 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.
Are results available for this study?
Yes. Results are posted in the registry (first posted 1 May 2026). 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?
Difference in EEG Slow Wave Activity From Sham to In-phase Stimulation (time frame: Sham stimulation and in-phase stimulation blocks during the intervention). The study lists 4 primary outcomes in all. 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 NCT04206059, which also lists 5 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 May 2026.