ClinicalTrials.gg
CompletedNCT03356938PNPUpdated Feb 21, 2021

The Role of the Circadian System in Neurological Sleep-wake Disorders

An interventional study of Sleep restriction and Sleep deprivation in Narcolepsy 1 and Idiopathic Hypersomnia, sponsored by Esther Werth. Completed at 1 site in Switzerland. Open to participants aged 18 Years to 35 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-02-21.

Sponsored by Esther Werth · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
36
Allocation
Non-randomized
Ages
18 Years to 35 Years
Sex
All
01

Study summary

The aim of this study is to investigate the role of the circadian system in patients with neurologic sleep-wake disorders. Therefore, overnight sleep will be distributed over 30 hours into repetitive sleep-wake cycles (poly-nap protocol), so that sleep episodes occur at different circadian phases. Vigilance, attention, risk behavior as well as sleep onset latency will be observed.

Ambulatory accelerometer recordings gain more and more attention in the diagnostic work-up of sleep disorders, as they allow to also include the everyday rest-activity rhythm before examinations in the sleep laboratory. Advances of novel devices should improve the detection of rest and activity and therefore the estimation of sleep and wake, especially in patients with neurologic sleep-wake disorders exhibiting fragmented sleep. Two types of actimeters will be applied throughout our study protocol to explore better classification of sleep and wake phases and patterns of the rest-activity rhythm.

This study is designed as an observational case-controlled study targeting the disorders of narcolepsy type 1 and idiopathic hypersomnia, and including interventional procedures in the healthy control group (sleep deprivation, sleep restriction) in a counter-balanced design.

02

Conditions studied

  • Narcolepsy 1
  • Idiopathic Hypersomnia

Browse trials for

03

In context

Idiopathic Hypersomnia

52 studies on the registry are indexed under Idiopathic Hypersomnia; 23 are open to participants now.

This study's enrollment of 36 is below the median of 82 across 40 interventional studies indexed under Idiopathic Hypersomnia.

Browse Idiopathic Hypersomnia studies →

Lead sponsor

This is the only study on the registry with Esther Werth as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 35 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male and Female participants 18 years to 35 years of age
  • Written by the participant after information about the research project
  • Healthy controls: 7-8 hours of sleep per night
  • Healthy controls: sleep satiation before start of the study
  • Narcolepsy type 1: diagnosis of narcolepsy with cataplexy, drug free during study, proven excessive daytime sleepiness with increased REM (MSLT), clear-cut cataplexy present, undetectable or low cerebrospinal fluid hypocretin levels (if data is available)
  • Idiopathic hypersomnia: diagnosis of idiopathic hypersomnia, drug free during study, proven excessive daytime sleepiness without increased REM (MSLT), increased sleep need (>10h/day) on work-free days shown by 2-week actigraphy

Exclusion criteria

Exclusion Criteria:

  • signs of neurological, psychiatric, or other sleep-wake disorders
  • signs of sleep deprivation
  • shift work and time zone change of more than one hour within one month prior the study start
  • extreme morning and evening types
  • underweight
  • obstructive gastro-intestinal disease or history of gastrointestinal surgery
  • an implanted medical device or a scheduled MRI scan during the experimental period
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
36 participants (actual)

Study arms

  • No intervention
    Baseline recording
  • Experimental
    Sleep restriction

    Behavioral: Sleep restriction

  • Experimental
    Sleep deprivation

    Behavioral: Sleep deprivation

Interventions

  • BehavioralSleep restriction

    Restricted sleep to 5 hours / night for 5 days prior to sleep laboratory examination

  • BehavioralSleep deprivation

    Sleep deprivation during first night of sleep laboratory examination

06

What researchers measure

Primary outcomes

  1. Endogenous melatonin

    Dim light melatonin onset (DLMO) will show whether there is a phase difference between patient groups and between patients and controls. The amplitude of the melatonin profile will show whether there is a dampening of the circadian rhythm or not.

    Time frame: Half an hour before and half an hour after a nap during PNP protocol, up to 2 minutes.

  2. EEG slow-wave activity (SWA)

    SWA is a marker of homeostatic sleep pressure and will show whether patients with narcolepsy or idiopathic hypersomnia live under different sleep pressure than controls.

    Time frame: Over nap times, up to 80 minutes.

Secondary outcomes

  1. Performance in neurobehavioral tests

    Outcome for vigilance and cognition of the subjects.

    Time frame: One hour before each nap, up to 45mins.

  2. EEG event related potentials (ERPs)

    Time frame: One hour before each nap, up to 45minutes.

07

Study locations

1 site
  • University Hospital Zurich
    Zürich, 8091, Switzerland
08

References and documents

Publications

  • Borbely AA. A two process model of sleep regulation. Hum Neurobiol. 1982;1(3):195-204. No abstract available. PubMed 7185792 ↗
  • Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. 2007 Feb 10;369(9560):499-511. doi: 10.1016/S0140-6736(07)60237-2. PubMed 17292770 ↗
  • Frenette E, Kushida CA. Primary hypersomnias of central origin. Semin Neurol. 2009 Sep;29(4):354-67. doi: 10.1055/s-0029-1237114. Epub 2009 Sep 9. PubMed 19742411 ↗
  • Munch M, Knoblauch V, Blatter K, Schroder C, Schnitzler C, Krauchi K, Wirz-Justice A, Cajochen C. Age-related attenuation of the evening circadian arousal signal in humans. Neurobiol Aging. 2005 Oct;26(9):1307-19. doi: 10.1016/j.neurobiolaging.2005.03.004. Epub 2005 Apr 18. PubMed 16182904 ↗
  • Saper CB, Scammell TE, Lu J. Hypothalamic regulation of sleep and circadian rhythms. Nature. 2005 Oct 27;437(7063):1257-63. doi: 10.1038/nature04284. PubMed 16251950 ↗
  • Wulff K, Gatti S, Wettstein JG, Foster RG. Sleep and circadian rhythm disruption in psychiatric and neurodegenerative disease. Nat Rev Neurosci. 2010 Aug;11(8):589-99. doi: 10.1038/nrn2868. Epub 2010 Jul 14. PubMed 20631712 ↗
  • Morgenthaler T, Alessi C, Friedman L, Owens J, Kapur V, Boehlecke B, Brown T, Chesson A Jr, Coleman J, Lee-Chiong T, Pancer J, Swick TJ; Standards of Practice Committee; American Academy of Sleep Medicine. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep. 2007 Apr;30(4):519-29. doi: 10.1093/sleep/30.4.519. PubMed 17520797 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Nov 2017 to primary completion in May 2019, 18 months.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 15, 2017
First posted
Nov 29, 2017
StartActual
Nov 28, 2017
Primary completionActual
May 31, 2019
CompletionActual
May 31, 2020
Last update
Feb 21, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 21, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03356938
Lead sponsor
Esther Werth
Responsible party
Esther Werth (Head of Sleep Laboratory, University of Zurich) — Sponsor-investigator
First posted
Nov 29, 2017
Start date
Nov 28, 2017
Primary completion
May 31, 2019
Completion
May 31, 2020
Last update
Feb 21, 2021

Study contacts

Esther Werth, PhD
principal investigator · University of Zurich

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion