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CompletedNCT04316663Updated Apr 27, 2023

Well-being Promotion and Sleep Hygiene Education to Improve Sleep Quality

An interventional study of Well-Being Intervention and Sleep Hygiene in Poor Quality Sleep, sponsored by Columbia University. Completed at 1 site in United States. Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-04-27.

Sponsored by Columbia University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
76
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The overall goal of this project is to evaluate the effect of enhanced psychological well-being on sleep quality. This study will demonstrate whether combining an intervention designed to promote psychological well-being with sleep hygiene education improves sleep quality in a non-clinical population of distressed adults reporting poor sleep in the absence of a diagnosed sleep disorder. The investigators expect an intervention combining elements of psychological well-being and sleep hygiene education to result in significant improvements in sleep quality measures from baseline to post-intervention, and greater improvements in sleep quality measures at post-intervention as compared with sleep hygiene education alone.

Read the detailed description

Psychological distress is often associated with poor sleep quality. The role of psychological well-being has often been neglected and most interventions for sleep improvement have focused primarily on sleep disorders. This approach is limited to those individuals who have specific conditions and little resources have been directed to the promotion of sleep quality in the general population.

This study will be a pilot parallel-arm, randomized controlled trial to assess the baseline associations between psychological well-being and different measures of sleep outcomes, determine the effect of elements of a psychological well-being promoting intervention on sleep quality, and examine effect size estimates of key sleep-related outcomes (duration, efficiency, quality) to provide essential data to inform a main efficacy trial.

02

Conditions studied

  • Poor Quality Sleep

Keywords

  • Sleep Quality
  • Psychological Distress
  • Psychological Well-Being
  • Well-Being Therapy
  • Sleep Hygiene
03

In context

Lead sponsor

Columbia University is the lead sponsor of 1,103 studies on the registry; 193 are open to participants now.

Of its 172 completed or terminated interventional studies of FDA-regulated products, 142 (83%) have results posted.

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

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Age 18-65 years
  • Distress according to the Perceived Stress Scale
  • Poor sleep quality according to the Pittsburgh Sleep Quality Index
  • No diagnosis of sleep disorders
  • English fluency
  • Access to a computer with an Internet connection

Exclusion criteria

Exclusion Criteria:

  • Inability to provide informed consent for any reason
  • Cognitive impairment according to the Montreal Cognitive Assessment
  • Suspected presence of sleep apnea according to the Berlin Questionnaire
  • Diagnosis of a chronic medical or psychiatric condition
  • Severe depression or suicidal thoughts or wishes according to the Beck Depression Inventory
  • Body Mass Index (BMI) ≥ 35 kg/m2
  • Chronic use of medications for sleep or chronic medical and psychiatric conditions
  • Any current psychological or behavioral intervention administered by a health care provider or as part of a research project
  • Shift workers
  • Pregnant women
  • Parents or caregivers of newborns (\<1 year)
  • Heavy drinkers (≥ 8 drinks/week for women and ≥ 15 drinks/week for men)
  • Binge drinkers (≥ 4 drinks on a single occasion within about 2 hours for women and ≥ 5 drinks on a single occasion within about 2 hours for men
  • Use of recreational or street drugs
  • Heavy smokers (≥ 20 cigarettes daily)
  • Heavy caffeine users (> 400 mg a day, corresponding to about 4 or 5 cups of coffee)
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
76 participants (actual)

Study arms

  • Experimental
    Well-Being and Sleep Hygiene

    Participants in the experimental group will receive an intervention focused on both principles of psychological well-being and sleep hygiene education.

    Behavioral: Well-Being Intervention · Behavioral: Sleep Hygiene

  • Active comparator
    Sleep Hygiene (Control)

    Participants in the control group will receive sleep hygiene education alone.

    Behavioral: Sleep Hygiene

Interventions

  • BehavioralWell-Being Intervention

    The main aim of the well-being intervention is to reduce levels of distress through the promotion of psychological well-being. Key components of the intervention are self-monitoring of instances of well-being and what leads to their interruption (i.e., thoughts and behaviors), cognitive restructuring of interfering thoughts, and homework assignments to address dysfunctional behaviors and increase exposure to optimal experiences. Participants will become aware of their functioning based on six different dimensions of psychological well-being (i.e., self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth), and will be guided in finding a balance within each dimension.

  • BehavioralSleep Hygiene

    The main aim of sleep hygiene education is to provide participants with a set of behavioral and environmental recommendations intended to promote healthy sleep. During the intervention, participants will become aware of their own sleep patterns, will learn about healthy sleep habits, and will be encouraged to follow a set of recommendations to improve their sleep. Key components of the intervention are sleep hygiene and education.

06

What researchers measure

Primary outcomes

  1. Change in sleep quality: Pittsburgh Sleep Quality Index (PSQI)

    Measured by the Pittsburgh Sleep Quality Index (PSQI), a 19-item self-rating scale for the assessment of sleep quality over a 1-month time interval. The PSQI yields 7 component scores and one global score. The component scores consist of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Each item is given a score from 0-3. The global score is calculated by summing the seven component scores, providing an overall score ranging from 0-21, where lower scores indicate a higher sleep quality.

    Time frame: Baseline to immediate post-intervention

  2. Change in insomnia severity: Insomnia Severity Index (ISI)

    Measured by the Insomnia Severity Index (ISI), a 7-item self-rated questionnaire to measure insomnia severity in the past 2 weeks. The total score ranges from 0-28, with higher scores indicating greater severity of insomnia. Scores of 8-14, 15-21, and 22-28 are indicative of subthreshold, moderate, and severe clinical insomnia, respectively.

    Time frame: Baseline to immediate post-intervention

  3. Changes in total sleep time

    Measured by self-reported sleep diary

    Time frame: Baseline to immediate post-intervention

  4. Changes in sleep onset latency

    Measured by self-reported sleep diary

    Time frame: Baseline to immediate post-intervention

  5. Changes in wake after sleep onset

    Measured by self-reported sleep diary

    Time frame: Baseline to immediate post-intervention

Secondary outcomes

  1. Change in psychological distress

    Measured by the Symptom Questionnaire (SQ), a 92-item self-rating scale for the assessment of psychological distress over a 1-week time interval. The SQ yields 4 main scales: anxiety, depression, somatization, and hostility. Each scale can be further divided into 2 sub-scales: one concerned with symptoms (17 items) and the other with well-being (6 items). Answers on each item are dichotomous (i.e., yes/no or true false). Scales and subscales can be scored separately, and the sum of the 4 main scale scores yields a total distress score. A response of yes/true for a symptom item gives 1 point, and a response of no/false for a well-being question gives 1 point for a score ranging from 0-23 for each main scale and 0-17 for each subscale, where a higher score indicates greater distress. If the well-being score is calculated separately the raw score can be subtracted from 6 for a score ranging from 0-6, where a higher score indicates greater well-being.

    Time frame: Baseline to immediate post-intervention

  2. Change in psychological well-being

    Measured by the Psychological Well-being scale, a 42-item self-rating scale for the assessment of 6 dimensions of psychological well-being: self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth. Each of the 42 six-point response items are given a score from 1-6, with questions phrased in the negative reversed (e.g., 1 to 6, 6 to 1). The total score in each dimension ranges from 7-42, and all the dimensions scores are summed to give a final total ranging from 42-252, with higher scores indicating greater psychological well-being.

    Time frame: Baseline to immediate post-intervention

07

Study locations

1 site
  • Columbia University Irving Medical Center
    New York, New York 10032, United States
08

References and documents

Publications

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  • Bermudez-Millan A, Perez-Escamilla R, Segura-Perez S, Damio G, Chhabra J, Osborn CY, Wagner J. Psychological Distress Mediates the Association between Food Insecurity and Suboptimal Sleep Quality in Latinos with Type 2 Diabetes Mellitus. J Nutr. 2016 Oct;146(10):2051-2057. doi: 10.3945/jn.116.231365. Epub 2016 Aug 3. PubMed 27489004 ↗
  • Benasi G, Guidi J, Rafanelli C, Fava GA. New applications of Well-Being Therapy. Rivista Sperimentale di Freniatria, 1:87-106, 2019
  • Buysse DJ. Sleep health: can we define it? Does it matter? Sleep. 2014 Jan 1;37(1):9-17. doi: 10.5665/sleep.3298. PubMed 24470692 ↗
  • Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosom Med. 2008 Sep;70(7):741-56. doi: 10.1097/PSY.0b013e31818105ba. Epub 2008 Aug 25. PubMed 18725425 ↗
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  • Fava GA. Well-Being Therapy: Current Indications and Emerging Perspectives. Psychother Psychosom. 2016;85(3):136-45. doi: 10.1159/000444114. Epub 2016 Apr 5. No abstract available. PubMed 27043240 ↗
  • Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci. 2008;10(4):473-81. doi: 10.31887/DCNS.2008.10.4/plfranzen. PubMed 19170404 ↗
  • Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Med Rev. 2015 Aug;22:23-36. doi: 10.1016/j.smrv.2014.10.001. Epub 2014 Oct 16. PubMed 25454674 ↗
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  • Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health. 2010 Feb;46(2):124-32. doi: 10.1016/j.jadohealth.2009.06.016. Epub 2009 Aug 3. PubMed 20113918 ↗
  • Murawski B, Wade L, Plotnikoff RC, Lubans DR, Duncan MJ. A systematic review and meta-analysis of cognitive and behavioral interventions to improve sleep health in adults without sleep disorders. Sleep Med Rev. 2018 Aug;40:160-169. doi: 10.1016/j.smrv.2017.12.003. Epub 2017 Dec 29. PubMed 29397329 ↗
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  • Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2012 Aug;16(4):283-95. doi: 10.1016/j.smrv.2011.05.002. Epub 2011 Jul 26. PubMed 21795081 ↗
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  • Seixas AA, Nunes JV, Airhihenbuwa CO, Williams NJ, Pandi-Perumal SR, James CC, Jean-Louis G. Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey. Neuropsychiatr Dis Treat. 2015 Sep 25;11:2425-30. doi: 10.2147/NDT.S77909. eCollection 2015. PubMed 26442563 ↗
  • Scott D, Paterson JL, Happell B. Poor sleep quality in Australian adults with comorbid psychological distress and physical illness. Behav Sleep Med. 2014;12(4):331-41. doi: 10.1080/15402002.2013.819469. Epub 2013 Nov 1. PubMed 24180418 ↗
  • Tinetti ME, Bogardus ST Jr, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med. 2004 Dec 30;351(27):2870-4. doi: 10.1056/NEJMsb042458. No abstract available. PubMed 15625341 ↗
  • Vaghela P, Sutin AR. Discrimination and sleep quality among older US adults: the mediating role of psychological distress. Sleep Health. 2016 Jun;2(2):100-108. doi: 10.1016/j.sleh.2016.02.003. Epub 2016 Apr 4. PubMed 28923251 ↗
  • Beck AT, Steer RA, Brown GK. Beck Depression Inventory: second edition manual. San Antonio (TX): The Psychological Corporation, 1996.
  • Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4. PubMed 2748771 ↗
  • Fava GA, Guidi J. The pursuit of euthymia. World Psychiatry. 2020 Feb;19(1):40-50. doi: 10.1002/wps.20698. PubMed 31922678 ↗
  • Kellner R. A symptom questionnaire. J Clin Psychiatry. 1987 Jul;48(7):268-74. PubMed 3597327 ↗
  • Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x. Erratum In: J Am Geriatr Soc. 2019 Sep;67(9):1991. doi: 10.1111/jgs.15925. PubMed 15817019 ↗
  • Ryff CD. Happiness is everything or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology 57(6):1069-81, 1989.
  • Spoormaker VI, Verbeek I, van den Bout J, Klip EC. Initial validation of the SLEEP-50 questionnaire. Behav Sleep Med. 2005;3(4):227-46. doi: 10.1207/s15402010bsm0304_4. PubMed 16190812 ↗

Individual participant data

Plan to share: Yes — Investigators can request de-identified data after the primary outcomes of this research project are published. Requests should be made in writing to the PI.

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 27, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04316663
Lead sponsor
Columbia University
Responsible party
Marie-Pierre St-Onge (Associate Professor of Nutritional Medicine, Columbia University) — Principal investigator
First posted
Mar 20, 2020
Start date
Apr 28, 2020
Primary completion
Jan 17, 2021
Completion
Apr 20, 2022
Last update
Apr 27, 2023

Study contacts

Marie-Pierre St-Onge, PhD
principal investigator · Columbia University

Oversight

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

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