RecruitingNot ApplicableNCT05424406

Role of Sleep Reactivity in Shift Work Disorder

Sleep Reactivity as a Novel Mechanism in Shift Work Disorder

Sponsor

Henry Ford Health System

Enrollment

150 participants

Start Date

Jan 1, 2023

Study Type

INTERVENTIONAL

Conditions

Shift-work Disorder

Summary

The purpose of this project is to test sleep reactivity as an independent cause of Shift Work Disorder (SWD). The primary hypothesis is that those with high sleep reactivity will show persistent SWD symptoms after experimental reduction of circadian misalignment, which will then be mitigated with CBT.

Eligibility

Min Age: 18 Years

Inclusion Criteria4

Participants must be working a fixed nightshift schedule, operationalized as: a) working at least three night shifts a week, b) shifts must begin between 18:00 and 02:00, and last between 8 to 12 hours, and c) must also plan to maintain the nightshift schedule for the duration of the study
Participants must have Shift Work Disorder, which will be diagnosed based on ICSD-3 criteria
Participants must show circadian misalignment, operationalized as a baseline melatonin onset between 18:00 and 01:00.
Participants must be at least 18 years old

Exclusion Criteria8

Insomnia disorder or excessive sleepiness predating the onset of shift work
Termination of nightshift schedule
Presence of other sleep disorders (e.g. obstructive sleep apnea, narcolepsy) determined by standard clinical polysomnography
Diagnosis of bipolar disorder
History of neurological disorders determined by self-report and medical history
Pregnancy
Alcohol use disorder
Illicit drug use via self-report and urine drug screen if reasonable suspicion to test

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Interventions

BEHAVIORALActive phototherapy

Timed bright light exposure delivered in a controlled laboratory setting (10,000 photopic lux) designed to delay the DLMO to 4 am or later.

BEHAVIORALControl phototherapy

Timed less intense light exposure delivered in a controlled laboratory setting (100 photopic lux) that still has a perceptible alerting effect but is not designed to shift circadian phase.

BEHAVIORALCognitive Behavioral Therapy (CBT)

Cognitive strategies will identify stressors (e.g., dysfunctional beliefs about sleep) and intervene on worry and rumination with cognitive reappraisal and active coping. Sessions will be conducted by a trained behavioral sleep medicine provider via telemedicine to increase accessibility.

BEHAVIORALSleep education control

Sleep duration recommendations will be equivalent to the CBT group (8 hours of sleep opportunity) to ensure that outcomes are not confounded by time in bed. Materials in the sleep education control condition will be separated into weekly electronic materials monitored for engagement and completion.