Investigators propose a double-blind, placebo-controlled trial evaluating the use of the use of Suvorexant in breast cancer survivors on selective estrogen receptor modulators or aromatase inhibitors with sleep disturbance to assess the impact on insomnia symptoms and quality of life. Breast cancer survivors have an increased risk of insomnia for which Suvorexant has the has the potential ability to impact to improve sleep related outcomes and cancer survivorship outcomes. Breast cancer survivors with sleep disturbance based on an Insomnia Severity Index Score (ISI) \>15 will be randomized to either Suvorexant or placebo, with both arms receiving education on sleep hygiene.
Cancer survivors have an incidence of sleep disturbance and insomnia higher than the general population, with significant potential implications on health outcomes including in survivorship domains and mortality outcomes. Available pharmacologic options for management of sleep disturbance are limited in efficacy and in their side effects. Investigators propose a double-blind placebo-controlled trial evaluating the use of the use of Suvorexant in breast cancer survivors on selective estrogen receptor modulators or aromatase inhibitors with sleep disturbance to assess the impact on insomnia symptoms and quality of life. Evaluation of breast cancer survivors on endocrine therapy uses a study population with high 5-year survival rate while retaining the capacity for recruitment and creating an opportunity to explore potential effects on vasomotor symptoms. Suvorexant has the potential to have a significant impact in cancer survivors not only on sleep related outcomes but also on cancer survivorship outcomes. The purpose of the research study is to evaluate the ability of Suvorexant, a medication approved by the Food and Drug Administration (FDA) for insomnia, to treat sleep disturbance in breast cancer survivors on endocrine therapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
QUADRUPLE
Enrollment
44
Suvorexant initially with 10-20 mg for 28 days
Matched Placebo Control for 28 days
MUSC Department of Family Medicine
Charleston, South Carolina, United States
RECRUITINGParticipant reported insomnia symptoms evaluated using the Insomnia Severity Index (ISI)
The within-person change in Insomnia Severity Index (ISI) will be evaluated from baseline to 4 weeks. The ISI is a scored on a scale of 0-28 based on responses to 7 questions. Higher values indicate more severe symptoms of sleep disturbance.
Time frame: Assessed at baseline, 2 weeks, 4 weeks
Vasomotor Symptoms assessed using the Hot Flash Related Daily Interference Scale
Evaluation of Vasomotor Symptoms by the hot flash related daily interference scale. The hot flash related daily interference scale ranges from 0-100 with higher scores indicated a greater level of interference.
Time frame: Assessed at baseline, 2 weeks, 4 weeks
Quality of Life evaluated using the SF-36
Evaluation using the SF-36. The SF-36 evaluates 8 multi-item scales (Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, Mental Health). Scores for each of these scales is 0-100 with higher scores indicated a higher health care related quality of life.
Time frame: Assessed at baseline, 4 weeks
Quality of Life evaluated using the Cancer Problems in Living Scale (CPIL)
Evaluation using the Cancer Problems of Living (CPIL) Scale. The CPIL includes multi-item list of problems for which the participant classifies each problem based on severity.
Time frame: Assessed at baseline, 4 weeks
Pain Evaluation evaluated using the Brief Pain Inventory (BPI)
Evaluation conducted using the Brief Pain Inventory (BPI). Participants are asked to rate their current symptoms, their average experiences of pain, and the minimum and maximum intensities of their symptoms on scales that range from 0 to 10. A total pain severity score can be found by averaging these items. Higher scores indicated increased symptoms.
Time frame: Assessed at baseline, 2 weeks, 4 weeks
Medication Adherence
Evaluated using the simplified medication adherence questionnaire (SMAQ). The Simplified Medication Adherence Questionnaire (SMAQ) is a short questionnaire posed directly to the participant regarding medication-taking habits composed of 6 multiple choice questions. Positive responses or more than 2 reported missed doses over the past week indicates medication non-adherence.
Time frame: Assessed at baseline, 4 weeks
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