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InsomniaNCT07642479

A Theory-based Sleep Hygiene Education for Insomnia Disorder

A study testing Sleep Hygiene Education and CBT-I Apps in people with Insomnia and Adults, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Insomnia is a prevalent sleep disorder associated with numerous adverse health outcomes, including fatigue, irritability, and impaired daytime functioning. Despite the availability of effective pharmacological and psychological treatments, relatively few individuals with insomnia seek professional help, highlighting… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Insomnia, Adults
What is being tested?
Sleep Hygiene Education and CBT-I Apps
Could I receive a placebo?
No, everyone receives an active treatment
How many people
264 participants
Where
1 siteHong Kong
Study dates
10 Oct 2026to 30 Jun 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Hong Kong residents
  • Ethnic Chinese aged 18-65 years with the ability to communicate in Cantonese or Putonghua
  • Who fulfil the DSM-5 diagnostic criteria for insomnia disorder according to a validated diagnostic tool, the Brief Insomnia Questionnaire
  • Scored at least 10 points in the Insomnia Severity Index
  • Willing to give informed consent

Who cannot join

  • Any current diagnosis fulfilling the DSM-IV criteria of a major depressive disorder, generalized anxiety disorders, post-traumatic stress disorder, panic disorder, substance use disorders, or schizophrenia as screened using the Chinese version of the Structured Clinical Interview for DSM-IV
  • Other sleep disorders, including circadian rhythm disorder, narcolepsy, obstructive sleep apnoea (OSA), and restless leg syndrome (RLS)/periodic leg movement disorder (PLMD) as determined based on cut-off scores (≥ 7 on narcolepsy; ≥ 8 on circadian rhythm disorder; ≥ 15 on OSA; ≥ 7 on RLS/PLMD) using SLEEP-50. If in doubt, subjects will be referred to our team psychiatrist (KF Chung) for further assessment
  • Any current medical conditions or side-effects of medication that are contributing significantly to the subject's insomnia
  • Taking medications or currently participating in other psychotherapies for insomnia or other psychiatric disorders
  • Impaired cognitive functioning (<22 points in HK-MoCA) or with difficulty in giving consent or understanding instructions
  • Pregnant
  • Shift work

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Hong Kong1 site
  • School of Nursing, The Hong Kong Polytechnic University

    Hong Kong

Other trials in Hong Kong

About this study

Official title: A Theory-based Sleep Hygiene Education for Insomnia Disorder - A Non-inferiority Randomized Controlled Trial With Mixed-method Process Evaluation and Cost-effectiveness Analysis

Insomnia is a prevalent sleep disorder associated with numerous adverse health outcomes, including fatigue, irritability, and impaired daytime functioning. Despite the availability of effective pharmacological and psychological treatments, relatively few individuals with insomnia seek professional help, highlighting the need for accessible and acceptable non-pharmacological interventions. Sleep hygiene education (SHE) has the potential to address this gap due to its simplicity, low cost, and ease of self-administration. Building on our previously registered pilot-testing protocol, this study aims to examine the effectiveness of a theory-based SHE program integrated with behavior change techniques in a larger community population. Furthermore, it remains unclear whether theory-based SHE is inferior to gold-standard interventions such as cognitive behavioral therapy for insomnia (CBT-I) delivered via digital applications. Therefore, this study will also compare the effectiveness of theory-based SHE with a CBT-I app using a three-arm randomized controlled trial design.

Read the detailed description

Insomnia is a prevalent sleep disorder associated with substantial adverse health consequences, including fatigue, irritability, and impaired daytime functioning. Although effective pharmacological (e.g., hypnotics) and psychological treatments (e.g., cognitive behavioral therapy for insomnia, CBT-I) are available, both local and international surveys indicate that fewer than 50% of individuals with insomnia seek treatment. This treatment gap underscores the need for effective non-pharmacological interventions that are both accessible and acceptable.

Sleep hygiene education (SHE) represents a potentially suitable approach to address this unmet need. SHE is an educational intervention encompassing a range of lifestyle and environmental recommendations to optimize sleep quality and duration. These include maintaining a regular sleep-wake schedule, avoiding substances such as caffeine, nicotine, and alcohol, limiting daytime napping and stimulating activities before bedtime, optimizing the sleep environment, and adopting appropriate dietary and exercise habits etc. Given its simplicity, low cost, accessibility, and ease of delivery and adoption, SHE holds promise as a non-pharmacological strategy for insomnia management.

Despite these advantages, SHE is not typically recommended as a stand-alone treatment for individuals with sleep problems, as it is often perceived to be less effective than CBT-I or mindfulness-based interventions, with consistently small effect sizes reported. However, these findings should be interpreted with caution. In many previous studies, SHE has primarily been used as a passive control condition to account for nonspecific treatment effects, thereby underexploiting its active therapeutic potential. Moving SHE beyond a simple advice-giving modality to a structured, theory-informed approach may optimize its effectiveness by ensuring its content is informative and promising. Integrating SHE with established behavior change techniques may better equip individuals with the skills needed to initiate and sustain meaningful behavioral change.

Building on our previously registered pilot-testing protocol, this study aims to evaluate the effectiveness of a theory-based SHE program integrated with behavior change techniques in a larger community sample. In addition, it remains unclear whether theory-based SHE is inferior to gold-standard interventions such as digitally delivered CBT-I. This study will also examine whether a theory-based SHE program is a cost-effective approach for reducing insomnia severity in adults with insomnia disorder compared with a CBT-I app and a no-intervention control. To address these objectives, a three-arm randomized controlled trial will be conducted to compare the relative effectiveness of these interventions.

Conditions
Insomnia, Adults
Being tested
Sleep Hygiene Education, CBT-I Apps
Keywords
Insomnia, Sleep hygiene education, A non-inferiority randomized controlled trial, CBT-I apps, Adults
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.

  • Sleep Hygiene EducationBehavioural

    Participants in this group will receive a structured six-week SHE intervention. The intervention includes two weekly 2-hour group-based, face-to-face educational sessions (total 4 hours) conducted in a classroom at the School of Nursing, The Hong Kong Polytechnic University, followed by four weekly individualized telephone consultations lasting approximately 10 minutes each. During the educational sessions, participants will receive education on insomnia and evidence-based sleep hygiene practices, and will develop individualized behavior change plans to support sustained implementation of sleep hygiene practices. The subsequent telephone consultations will reinforce adherence to these plans by reviewing progress, discussing barriers, and providing tailored feedback.

  • CBT-I AppsBehavioural

    Participants in this group will receive a CBT-I program consisting of six weekly modules delivered in the Chinese language through a smartphone application proACT-S. The duration of each module is around 45 to 60 min with interactive features. The self-help CBT-I treatment content in proACT-S is based on the Chinese translated version of a well-established CBT-I treatment manual. The self-help CBT-I treatment content is designed to alter dysfunctional cognitive beliefs and maladaptive behaviors that perpetuate insomnia. The self-help CBT-I treatment content CBT-I aims at changing dysfunctional cognitive beliefs and maladaptive behaviors that contribute to the maintenance of insomnia.

Study groups in NCT07642479
Study groupRoleWhat they receive
Sleep Hygiene EducationExperimentalParticipants in this group will receive a structured six-week SHE intervention. The intervention includes two weekly 2-hour group-based, face-to-face educational sessions (total 4 hours) conducted in a classroom at the School of Nursing, The Hong Kong Polytechnic University, followed by four weekly individualized telephone consultations lasting approximately 10 minutes each. During the educational sessions, participants will receive education on insomnia and evidence-based sleep hygiene practices, and will develop individualized behavior change plans to support sustained implementation of sleep hygiene practices. The subsequent telephone consultations will reinforce adherence to these plans by reviewing progress, discussing barriers, and providing tailored feedback.
Receives: Behavioral: Sleep Hygiene Education
CBT-I AppActive comparatorParticipants in this group will receive a CBT-I program consisting of six weekly modules delivered in the Chinese language through a smartphone application proACT-S. The duration of each module is around 45 to 60 min with interactive features. The self-help CBT-I treatment content in proACT-S is based on the Chinese translated version of a well-established CBT-I treatment manual. The self-help CBT-I treatment content is designed to alter dysfunctional cognitive beliefs and maladaptive behaviors that perpetuate insomnia. The self-help CBT-I treatment content CBT-I aims at changing dysfunctional cognitive beliefs and maladaptive behaviors that contribute to the maintenance of insomnia.
Receives: Behavioral: CBT-I Apps
Waitlist ControlNo interventionParticipants in this group will receive no intervention from the study. They will be provided with the same SHE program and CBT-I apps after the follow-up period. Waitlist control is chosen as previous surveys have revealed that almost half of individuals with clinical insomnia refrain from seeking any treatment. Therefore, the waitlist control group reflects the typical help-seeking behavior of those coping with insomnia, thus providing a more realistic comparison for our study.

What is being measured

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

  1. The Insomnia Severity Index (ISI)

    The Insomnia Severity Index has 7 items that measured the severity of insomnia complaints and related daytime impairments. The total score ranges between 0 and 28, with the higher scores indicating more severe insomnia. Total score will be used.

    Measured: Baseline, week 6, week 12 and week 24

Secondary outcomes (10)
  1. Sleep Onset Latency Measured By Sleep Diary

    Participants will be asked to record their daily sleeping-waking schedule using a standard sleep diary. Sleep onset latency (SOL) is defined as the time (minutes) taken to fall asleep after going to bed. The average value over 7 consecutive nights will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  2. Wake After Sleep Onset Measured By Sleep Diary

    Participants will be asked to record their daily sleeping-waking schedule using a standard sleep diary. Wake after sleep onset (WASO) is defined as the total time (minutes) awake after initial sleep onset during the night. The average value over 7 consecutive nights will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  3. Sleep Efficiency Measured By Sleep Diary

    Participants will be asked to record their daily sleeping-waking schedule using a standard sleep diary. Sleep efficiency (SE) is defined as the percentage of time in bed spent asleep. The average percentage over 7 consecutive nights will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  4. Total Sleep Time Measured By Sleep Diary

    Participants will be asked to record their daily sleeping-waking schedule using a standard sleep diary. Total sleep time (TST) is defined as the total duration (minutes) of sleep per night. The average value over 7 consecutive nights will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  5. The Hospital Anxiety and Depression Scale (HADS)

    The Hospital Anxiety and Depression Scale is a self-report rating scale of 14 items on a 4-point Likert scale (range 0-3). It is designed to measure anxiety and depression (7 items for each subscale). The total score is the sum of the 14 items, and for each subscale the score is the sum of the respective seven items (ranging from 0-21).

    Measured: Baseline, week 6, week 12 and week 24

  6. The Short-Form Six Dimensions (SF-6D)

    The Short-Form Six Dimensions (SF-6D) will be used to assess the quality of life. The score ranges from 0 (worst quality of life) to 1 (perfect quality of life), with higher scores reflecting better overall health-related quality of life.

    Measured: Baseline, week 6, week 12 and week 24

  7. Sleep Onset Latency Measured By Actigraphy

    Sleep onset latency (SOL) will be objectively measured using a wrist-worn actigraphy device (GENEActiv, Activinsights, UK). Participants will wear the device on their non-dominant wrist for 7 consecutive nights prior to each assessment time point. SOL will be recorded in minutes, and the mean value over the 7-night period will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  8. Wake After Sleep Onset Measured By Actigraphy

    Wake after sleep onset (WASO) will be objectively measured using a wrist-worn actigraphy device (GENEActiv, Activinsights, UK). Participants will wear the device on their non-dominant wrist for 7 consecutive nights prior to each assessment time point. WASO will be recorded in minutes, and the mean value over the 7-night period will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  9. Sleep Efficiency Measured By Actigraphy

    Sleep efficiency (SE) will be objectively measured using a wrist-worn actigraphy device (GENEActiv, Activinsights, UK). Participants will wear the device on their non-dominant wrist for 7 consecutive nights prior to each assessment time point. SE will be expressed as a percentage, and the mean value over the 7-night period will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

  10. Total Sleep Time Measured By Actigraphy

    Total sleep time (TST) will be objectively measured using a wrist-worn actigraphy device (GENEActiv, Activinsights, UK). Participants will wear the device on their non-dominant wrist for 7 consecutive nights prior to each assessment time point. TST will be recorded in minutes, and the mean value over the 7-night period will be calculated.

    Measured: 7 consecutive nights before each assessment time point (i.e., baseline, week 6, week 12, and week 24)

Timeline

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

  1. First posted11 Jun 2026
  2. Study start10 Oct 2026 (estimated)
  3. Primary completion1 Jan 2028 (estimated)
  4. Study completion30 Jun 2028 (estimated)

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
264 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07642479
Sponsor's protocol ID
SHCI
Status last verified
Jun 2026
First submitted
23 May 2026
Last updated
24 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Sleep Hygiene Education and CBT-I Apps in people with Insomnia and Adults, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.

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 5 inclusion and 7 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: opening soon, as of the sponsor's last update on 24 Sep 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 Hong Kong. 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. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Wing Fai YEUNG (852-27664151, jerry-wf.yeung@polyu.edu.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Insomnia Severity Index (ISI) (time frame: Baseline, week 6, week 12 and week 24). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 24 Sep 2026.

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