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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.

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

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

Other trials in United States

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.

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 groups in NCT04206059
Study groupRoleWhat they receive
CLASS-D Cohort - In-phaseExperimentalWithin-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-phaseActive comparatorWithin-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 - ShamSham comparatorWithin-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.

  1. 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

  2. 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

  3. 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

  4. 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)
  1. 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

  2. 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

  3. 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.

  1. First posted20 Dec 2019
  2. Study start20 Jan 2021
  3. Primary completion1 Jun 2022
  4. Study completion1 Jul 2023

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
Diagnosis
Allocation
Non-randomised
Intervention model
Crossover
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
18 participants (actual)
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
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 27927806
  • Leger 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 29490885
  • Neske 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 26834569
  • Smith 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 38571816
  • Guay 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

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.

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