National clinical trials, phase II/III, combined in two stages, randomized, double-blind, controlled, parallel, study of superiority, in which three hundred and seven (307) participants of both sexes, aged equal or more than 55 years will be randomly allocated to one of three treatment groups. In the first stage. The group 01 will use Melatonin 3mg plus CBT-I, the group 02 will use Melatonin 5mg plus CBT-I and the group 03 will use CBT-I plus placebo. Based on the results of an interim analysis will be making a decision on whether to proceed with the study and, if so, on which the doses will be selected for the second stage of the study, to be better studied. The final analysis of the treatments, melatonin in the selected dose plus CBT-I versus CBT-I alone and placebo, will include participants from both stages.
The treatment of insomnia disorder can be accomplished through pharmacological and nonpharmacological approaches. Behavioral techniques of Sleep Hygiene and Stimuli control are the most used. The Sleep hygiene is a psychoeducational intervention that teaches patients to prevent external or environmental factors generate adverse effects and harmful to sleep. The stimulus control technique is based on five instructions that encourages the patient to establish a proper sleep-wake rhythm and strengthens the links between the way for a quick sleep and well established. Melatonin is a hormone that participates in the regulation of the sleep-wake cycle, which is produced and secreted primarily by the pineal gland in the dark period and prepares the individual to sleep. Melatonin is involved in the induction of sleep and has proven therapeutic action in insomnia disorders, and may also play a role in the circadian timing system of mammals and serve as a marker for "biological clock".
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
307
Behavioral techniques of Sleep Hygiene and Stimulus Control standardized in clinical protocol plus placebo (01 tablet, orally, always at night one hour before bedtime) for 21(±2) days)
Behavioral techniques of Sleep Hygiene and Stimulus Control standardized in clinical protocol plus Melatonin 3 mg (01 tablet, orally, always at night one hour before bedtime) for 21(±2) days.
Behavioral techniques of Sleep Hygiene and Stimulus Control standardized in clinical protocol plus Melatonin 5 mg (01 tablet, orally, always at night one hour before bedtime) for 21(±2) days.
CEDOES - Centro de Diagnóstico e Pesquisa da Osteoporose do Espirito Santo.
Vitória, Espírito Santo, Brazil
RECRUITINGHospital de Clínicas de Porto Alegre
Porto Alegre, Rio Grande do Sul, Brazil
TERMINATEDAllergisa Pesquisa Dermato Cosmética Ltda.
Campinas, São Paulo, Brazil
RECRUITINGHospital das Clinicas da Faculdade de Medicina de Ribeirão Preto USP
Ribeirão Preto, São Paulo, Brazil
RECRUITINGCentro de Estudos Multidisciplinar CEPES da Faculdade de Medicina do ABC
Santo André, São Paulo, Brazil
TERMINATEDDr Consulta Clinica Medica Ltda
São Paulo, Brazil
RECRUITINGCentro Paulista de Investigação Clínica e Serviços Médicos Ltda.
São Paulo, Brazil
TERMINATEDCentro de Desenvolvimento em Estudo Clínicos Brasil - CDEC Brasil
São Paulo, Brazil
RECRUITINGChange of Sleep Latency after 21 (±2) days of the treatment.
Absolute change in sleep latency (in minutes) at the end of treatment compared to baseline. Sleep latency will be assessed by polysomnography.
Time frame: 21 (±2) days
Quality of Sleep - Pittsburgh Sleep Quality Index
Absolute change the overall score PSQI-BR, at the end of treatment from baseline
Time frame: 21 (±2) days
Wellness Day - Well-Being Index-5 (WHO-5)
Absolute change the overall score of the WHO-5 level, in the range of 0 to 100 points, at the end of treatment from baseline.
Time frame: 21 (±2) days
Severity of Insomnia - Insomnia Severity Index
Absolute change the overall score of the Insomnia Severity Index at the end of treatment from baseline
Time frame: 21 (±2) days
Total Sleep Time - Polysomnography
Evaluate the total sleep time by polysomnography at the end of treatment from baseline
Time frame: 21 (±2) days
Sleep Architecture - the length and proportion of N1(non-rapid eyes movement) stages, N2, N3 and REM
Proportion of participants with sleep architecture classified as normal or abnormal, assessed by polysomnography at the end of treatment from baseline.
Time frame: 21 (±2) days
Sleep Efficiency - Polysomnography
Sleep efficiency variation assessed by polysomnography at the end of treatment from baseline
Time frame: 21 (±2) days
The Latency of Persistent Sleep - Polysomnography
Latency of persistent sleep variation assessed by polysomnography at the end of treatment from baseline
Time frame: 21 (±2) days
Latency of REM (rapid eyes movement) Sleep - Polysomnography
Latency of REM sleep variation assessed by polysomnography at the end of treatment from baseline
Time frame: 21 (±2) days
Satisfaction of the participants with the treatment.
Proportion of participants in each level of satisfaction category Likert 5 point (1. totally dissatisfied, 2. dissatisfied, 3. neither satisfied nor dissatisfied, 4. satisfied, 5. completely satisfied) evaluated comparing the groups at the end of treatment
Time frame: 21 (±2) days
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