Examining the efficacy of attentional bias re-training in reducing pre-sleep cognitive arousal and insomnia symptoms

ISRCTN ISRCTN11643569
DOI https://doi.org/10.1186/ISRCTN11643569
Secondary identifying numbers ER5451619
Submission date
14/05/2018
Registration date
05/06/2018
Last edited
29/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
People with insomnia display a tendency to show increased attention towards cues which are related to sleep (i.e. sleep-related cues). These can be internal in nature (e.g. bodily sensations whilst trying to sleep) or external (checking the clock/time whilst trying to fall asleep). This behaviour in turn leads people with insomnia to feel more anxious about sleep and can actually make the sleep disturbance worse. This study aims to use a computer-based task delivered online (i.e. attentional bias modification) to train such attention away from sleep-related cues.

Who can participate?
Adults with insomnia

What does the study involve?
Participants are randomly allocated to either online attentional bias modification training, or to a standard online attentional bias task (non-treatment). All participants allocated to the non-treatment are offered the attentional bias modification training once the study is complete. The total duration of treatment is 9 days, with follow-up on the 9th and the 16th day (one week after treatment is complete).

What are the possible benefits and risks of participating?
This study has the potential benefit of reducing symptoms of insomnia and the amount of time it takes to fall asleep. No major risks are anticipated with participation in this study. Whilst the experimental computer based task is relatively short, some may find this uncomfortable (e.g. experience of eye strain) due to its repetitive nature.

Where is the study run from?
Sheffield Hallam University (UK)

When is the study starting and how long is it expected to run for?
May 2018 to February 2019

Who is funding the study?
Sheffield Hallam University (UK)

Who is the main contact?
Dr Umair Akram
u.akram@shu.ac.uk

Contact information

Dr Umair Akram
Scientific

HC.2.06, Heart of the Campus, Department of Psychology, Sociology and Politics
Sheffield Hallam University, Collegiate Crescent
Sheffield
S10 2BQ
United Kingdom

Phone +44 (0)114 225 3621
Email u.akram@shu.ac.uk

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Internet/virtual
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleA randomised controlled trial to examine the therapeutic potential of attentional bias modification training for insomnia
Study acronymN/A
Study objectivesThis study will examine the efficacy of using attentional bias modification to reduce symptom severity, pre-sleep arousal and sleep onset latency in insomnia. As research in this area is limited, with the evidence based mixed, the trialists offer no a priori hypothesis. Despite the lack of hypothesis, this exploratory study could show therapeutic potential of attentional bias modification for insomnia.
Ethics approval(s)Sheffield Hallam University Research Ethics Committee, 19/04/2018, ref: ER5451619
Health condition(s) or problem(s) studiedInsomnia disorder
InterventionThis study will use a simple randomisation with an allocation ratio of 1:1 which will be carried out by the automated online system. Participants will be randomised to an online attentional bias modification training condition, or to a standard attentional bias task (non-treatment) control condition. Both conditions will be delivered online by a web platform. All participants allocated to the non-treatment control group will be offered ABM training once the study is complete.

Total duration of treatment: 9 days, with follow-up 1 being on the 9th day, follow-up 2 on the 16th (one week after experimental protocol is complete).
Intervention typeOther
Primary outcome measurePrimary outcome measure as of 25/09/2018:
1. Sleep-related attentional bias (i.e. vigilance, disengagement) assessed using a dot-probe task consisting of sleep-negative and neutral words at baseline (day1) and then again on day 9
2. Insomnia severity measured by the Insomnia Severity Index at baseline (day 1), on completion of experimental protocol (day 9), and on day 16
3. Sleep onset latency measured by a sleep diary at baseline (day 1) and on completion of experimental protocol (day 9)
4. Pre-sleep cognitive arousal measured by the Pre-Sleep Cognitive Arousal Scale prior to sleep on days where the experiment will be administered (days 3-7)

Previous primary outcome measure:
1. Sleep-related attentional bias (i.e. vigilance, disengagement) assessed using a dot-probe task consisting of sleep-negative and neutral words at baseline (day1) and then again on day 9
2. Insomnia severity measured by the Insomnia Severity Index at baseline (day 1), on completion of experimental protocol (day 9), and on day 16
3. Sleep onset latency measured by a sleep diary at baseline (day 1) and on completion of experimental protocol (day 9)
4. Pre-sleep cognitive arousal measured by the Pre-Sleep Cognitive Arousal Scale prior to sleep on days where the experiment will be administered (day 3, 5 and 7)
Secondary outcome measuresSafety and monitoring behavior, assessed using the SAMI at baseline (day 1), 9 and 16
Overall study start date10/05/2018
Completion date31/01/2020

Eligibility

Participant type(s)Other
Age groupAdult
SexBoth
Target number of participants90
Key inclusion criteria1. Adult members from the general population who meet the DSM-5 criteria for Insomnia Disorder
2. Dissatisfaction with sleep characterized by either a difficulty initiating or maintaining sleep or early morning awakenings
3. Insomnia should be present for three or more nights per week, for at least three months, and cause significant daytime impairment
4. These conditions must be met despite an adequate opportunity to sleep
Key exclusion criteria1. Symptoms of a sleep/wake disorder other than insomnia
2. Existing psychiatric illness
3. Central nervous system disorder
4. Use of medication that may affect sleep
5. Prior head injury
6. Current shift-work
Date of first enrolment10/05/2018
Date of final enrolment05/02/2019

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Sheffield Hallam University
Sheffield
s10 2bp
United Kingdom

Sponsor information

Sheffield Hallam University
University/education

Department of Psychology, Sociology and Politics
Sheffield Hallam University, Collegiate Crescent
Sheffield
S11 8AH
England
United Kingdom

ROR logo "ROR" https://ror.org/019wt1929

Funders

Funder type

University/education

Sheffield Hallam University
Private sector organisation / Universities (academic only)
Location
United Kingdom

Results and Publications

Intention to publish date02/08/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planProtocol to be submitted with all additional information to the Journal Trials following registration. Planned publication of the study results in a high-impact peer reviewed journal approximately six months following completion of data collection.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Dr Umair Akram (u.akram@shu.ac.uk, u.akram@outlook.com). Data will become available after publication of the final outcomes. This will be in the form of raw data scores for each participant. Participant demographics will be available, however no identifying information will be provided.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 19/10/2018 Yes No

Editorial Notes

29/04/2019: The overall trial end date was updated from 01/05/2019 to 31/01/2020.
22/10/2018: Publication reference added.
25/09/2018: The following changes were made to the trial record:
1. The primary outcome measures were updated.
2. The overall trial end date was updated from 02/02/2019 to 01/05/2019.
3. The recruitment end date was updated from 20/08/2018 to 05/02/2019.