Behavioral and Cognitive Therapy for Insomnia in the Treatment of Pathological Gambling (SOMJEU)
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ClinicalTrials.gov Identifier: NCT06026722 |
Recruitment Status :
Not yet recruiting
First Posted : September 7, 2023
Last Update Posted : September 7, 2023
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Gambling is a public health risk. The wide panel of games available (poker, sport bets, scratch card games, slot machines, stock speculation …) and the advent of the Internet means that this behaviour is increasingly monitored on an epidemiological level, to the point where its pathological practice is now recognized in the DSM-5. Indeed, the scientific literature suggests a bidirectional link between use disorders and sleep disorders.
Sleep deprivation is known to lead to impaired judgment (risk-taking), increased sensitivity to reward, attentional difficulties and poor emotional management. The reverse has also been demonstrated: for example, playing at night has an impact on sleep quality, particularly in terms of difficulty falling asleep, ruminations about the game and a delay in the sleep-wake phase. Sleep disorders also affect patients undergoing withdrawal and/or cessation of a substance or behavior. This established link between addictions and circadian rhythms is important, since it is suggested that patients who are more impaired in both respects are more likely to relapse and respond less well to treatment.
In addictology, Behavioral and Cognitive Therapy for Insomnia (CBT-I) has proved effective in alcohol-dependent subjects in four studies. All reported a better quality of life (less depressive cognitions, better lifestyle) after CBT-I, although only one study reported a numerical reduction in consumption.The treatment of substance use disorders (AUD) remains limited : no pharmacological treatment has proved its worth, and the reference treatment remains mainly CBT. Despite the indisputable effectiveness of CBT, between 14% and 50% of patients are reported to have broken off from follow-up and care, and almost 90% of patients end up relapsing.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Gambling Disorder Treatment | Behavioral: cognitive behavioral therapy for insomnia | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 60 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Single (Participant) |
Primary Purpose: | Treatment |
Official Title: | "Behavioral and Cognitive Therapy for Insomnia in the Treatment of Pathological Gambling: Randomised and Control Pilot Study |
Estimated Study Start Date : | September 1, 2023 |
Estimated Primary Completion Date : | February 1, 2025 |
Estimated Study Completion Date : | October 1, 2025 |
Arm | Intervention/treatment |
---|---|
Experimental: interventional group
patient will follow cognitive behavioral therapy for insomnia 1 per week during 1 month. this therapy will start a month after inclusion.
|
Behavioral: cognitive behavioral therapy for insomnia
CBT-I is a 4-session program built around 3 main axes: psychoeducation on sleep hygiene, cognitive therapy and behavioral stimulus control, sleep restriction and relaxation. Each of the 3 axes will be worked on over 3 sessions, the last one being a summary and consolidation session of the first 3. For ethical reasons, it has been decided that patients in the control arm will also follow CBT-I (on a waiting list). The control group will have the same follow-up as the experimental group, but will start the intervention 6 months after the experimental group. This will enable all patients to access CBT-I. |
control group (waiting list)
patient will follow cognitive behavioral therapy for insomnia 1 per week during 1 month. this therapy will start 7 month after inclusion.
|
Behavioral: cognitive behavioral therapy for insomnia
CBT-I is a 4-session program built around 3 main axes: psychoeducation on sleep hygiene, cognitive therapy and behavioral stimulus control, sleep restriction and relaxation. Each of the 3 axes will be worked on over 3 sessions, the last one being a summary and consolidation session of the first 3. For ethical reasons, it has been decided that patients in the control arm will also follow CBT-I (on a waiting list). The control group will have the same follow-up as the experimental group, but will start the intervention 6 months after the experimental group. This will enable all patients to access CBT-I. |
- variation of the severity of gambling disorder betwen day 0 and month 4 of inclusion [ Time Frame: day 0, month 4 of inclusion ]difference of G-SAS (gambling symptom assessment scale) score between day 0 and month 4
- variation of the severity of gambling disorder betwen day 0 and month 7 of inclusion [ Time Frame: day 0, month 7 of inclusion ]difference of G-SAS score between day 0 and month 7
- variation of the severity of gambling disorder during patient follow up [ Time Frame: day0, month4, month 7 of inclusion ]difference of G-SAS score between day 0, month and month 7
- variation of relative amplitude of rhythms betwen day 0 and month 7 of inclusion [ Time Frame: day 0, month 7 of inclusion ]
- variation of relative amplitude of rhythms betwen day 0 and month 4 of inclusion [ Time Frame: day 0, month 4 of inclusion ]
- variation of total sleep time betwen Day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- variation of total sleep time betwen Day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- variation wake after sleep onset (WASO) Day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- variation wake after sleep onset (WASO) betwen Day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change of sleep fragmentation index betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- change in sleep fragmentation index betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change in sleep efficiency index betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- change in sleep efficiency index betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change of Insomnia Severity Index (ISI) score betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- change of Insomnia Severity Index (ISI) score betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change of Pittsburg Sleep Quality Index (PSQI) score betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change of Pittsburg Sleep Quality Index (PSQI) score betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- change of Munich Chronotype Type Questionnaire (MCTQ) score betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change of Munich Chronotype Type Questionnaire (MCTQ) score betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- change of Epworth Sleepiness Scale (ESS) score betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- change of Epworth Sleepiness Scale (ESS) score betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- sleep fragmentation index betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- sleep fragmentation index betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- presume sleep time betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- presume sleep time betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
- time spend in bed betwen day 0 and month 4 of inclusion [ Time Frame: day 0 and month 4 of inclusion ]
- time spend in bed betwen day 0 and month 7 of inclusion [ Time Frame: day 0 and month 7 of inclusion ]
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Ages Eligible for Study: | 18 Years to 65 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient with criteria of chronic gambling disorder according to DSM-5 defined as score greater than or equal to 5 for th South Oaks Gamling Screen (SOGS) and insomnia according to DSM-5 with score at ISI greater than 10.
- Outpatient or day hospitalization for gambling disorder in one of the psychiatric departments of the study centers for a period of care of at least 6 months.
- write, read and speak French
- Affiliated to a social security scheme (excluding State Medical Aid)
- volonteer, able to give their consent, informed
Exclusion Criteria:
- Specially protected adult, under guardianship or curatorship, or under therapeutic injunction
- pregnant woman
- Presence of any psychiatric pathology or clinically significant or unstable psychiatric appearance (decompensated bipolar disorder, decompensated schizophrenia, neurodegenerative disease)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT06026722
Contact: Guillaume DAVIDO | 01 40 25 82 63 ext +33 | guillaume.davido@aphp.fr |
France | |
Bichat - Claude-Bernard hospital | |
Paris, France, 75018 |
Responsible Party: | Assistance Publique - Hôpitaux de Paris |
ClinicalTrials.gov Identifier: | NCT06026722 |
Other Study ID Numbers: |
APHP221164 2023-A00397-38 ( Other Identifier: IDRCB ) |
First Posted: | September 7, 2023 Key Record Dates |
Last Update Posted: | September 7, 2023 |
Last Verified: | June 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Gambling disorder,sleep disorder, insomnia, CBT-I, addiction |
Sleep Initiation and Maintenance Disorders Gambling Sleep Disorders, Intrinsic Dyssomnias |
Sleep Wake Disorders Nervous System Diseases Mental Disorders Disruptive, Impulse Control, and Conduct Disorders |