ClinicalTrials.gg
RecruitingNCT05780814COINUpdated Feb 23, 2026

The Effects of Treating Insomnia on Behavioral Weight Loss Outcomes in Survivors of Breast Cancer

An interventional study of Cognitive-Behavioral Therapy for Insomnia (CBT-I) and Sleep Education Control (EDU) in Breast Cancer, Insomnia and Weight Gain, sponsored by Johns Hopkins University. Recruiting at 4 sites in United States. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-02-23.

Sponsored by Johns Hopkins University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Feb 2024; still recruiting 2 years 9 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

The investigators propose a randomized controlled clinical trial in 250 women with a history of early stage breast cancer who are overweight or obese with insomnia to test whether a brief, cognitive-behavioral intervention for insomnia (CBT-I) prior to behavioral weight loss (CBT-I+BWL) is superior to a sleep education control (EDU) condition followed by behavioral weight loss (EDU+BWL). The investigators will measure outcomes at baseline, 8 weeks (after completing CBT-I or EDU and prior to BWL), and at 3, 6, and 12 months.

Read the detailed description

The entire study will span a 14-month period and involves one video screening visit (V1) and 4 in-person assessment visits (V2-V5) and 27 video sessions (6 for sleep intervention or sleep control and 19 for BWL). After passing an initial phone screen, participants will be scheduled for in-depth screening (V1). The investigators will complete urine samples for pregnancy and substances, administer study measures, obtain weight, height, anthropometrics and randomize at in-person visit (V2). The overall framework of the BWL intervention is social cognitive theory (increasing self-efficacy and social support) with motivational interviewing (MI) as an approach to helping participants engage in established behavior change strategies (e.g. self-monitoring, stimulus control, goal setting, feedback, etc.) aimed at reducing dietary intake and increasing physical activity (PA). Body composition will be assessed by Dual Energy X-Ray Absorptiometry (DEXA), which measures total and regional fat, lean tissue and bone mass. The investigators will conduct DEXA scans at two time points (V1 \& V5).The investigators' primary endpoint is % total weight loss (TWL) at 12 months. The investigators will measure weight in light clothes without shoes, using a digital scale and height to the nearest 0.1 cm using a calibrated stadiometer, according to standardized procedures.

02

Conditions studied

  • Breast Cancer
  • Insomnia
  • Weight Gain

Keywords

  • women
  • breast cancer
  • weight gain
  • weight loss
  • insomnia
  • sleep
03

In context

Breast Neoplasms

14,825 studies on the registry are indexed under Breast Neoplasms; 3,319 are open to participants now.

This study's planned enrollment of 250 is above the median of 72 across 10,896 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.

Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

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

  • Female
  • 18 years of age or older
  • -confirmed Ductal Carcinoma In Situ (DCIS) or stage I-III invasive carcinoma of the breast
  • (ECOG) performance status 0-2
  • Current ≥ 25 kg/m2 and weight ≤ 400 lbs
  • Willing to lose 10% of body weight
  • Diagnosed within 10 years with histologically-confirmed DCIS or stage I-III invasive carcinoma of the breast
  • Completed local therapy (i.e. surgery and radiation therapy) and any planned preoperative or chemotherapy/immunotherapy(/) human epidermal growth factor receptor 2 therapy/targeted therapy at least 3months prior to enrollment (concomitant endocrine therapy allowed)
  • Completed all planned/elective surgeries >4 weeks before enrollment
  • Meet (DSM-5) criteria for Insomnia disorder
  • Self-reported initial sleep onset time and/or wake after sleep onset (WASO) time > 30 minutes, > 3 nights/week
  • Reports sleep problems present for ≥ 3 months
  • Insomnia Severity Index Score ≥ 9

Exclusion criteria

Exclusion Criteria:

  • Serious/uncontrolled medical or psychiatric condition likely to hinder participation in BWL or CBT-l (bipolar disorder, psychotic disorder, seizure disorders, disease, etc.)
  • Current use of medications that cause sleep disturbances or weight gain/loss. (-) Current sedative hypnotic use
  • Sleep disorder other than insomnia (mild sleep apnea or moderate to severe sleep apnea successfully treated via positive airway pressure (PAP) therapy is permitted
  • Currently enrolled or planning to enroll in a sleep treatment or weight loss program (agree not to enroll for the duration of the study) (-) Home sleep test Apnea/hypopnea Index (AHI) > 15
  • Participants also agree not to enroll in such a program for the duration of study participation (regardless of randomization).
  • History of unstable psychiatric disorder
  • Self-reported suicidal ideation or severe depressive symptoms as determined by clinical assessment, triggered by score of ≥ 20 on the Center for Epidemiologic Studies Depression (CES-D)
  • Lactating, pregnant or plan to become pregnant in next 14 months
  • Positive urine toxicology for recreational drugs of abuse; alcohol or substance use disorder as determined by Alcohol Use Disorders Identification Test, Adapted for Use in the United States (USAUDIT294) and/or Structured Clinical Interview (SCID)
  • Daily smoker/nicotine user
  • Anything that, in the opinion of the investigator, would place the subject at increased risk or preclude the patient's full compliance with or completion of the study
Terms in these criteria, in plain language(7)

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.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Care provider, Investigator)
Enrollment
250 participants (estimated)

Study arms

  • Experimental
    Cognitive-Behavioral Therapy for Insomnia (CBT-I)

    The proposed intervention consists of 6 remotely-delivered sessions; Weeks 1, 2, 4, 6, 7, and 8, with weeks 3 and 5 being "rest weeks". Session 1 will be 60-90 mins, Session 2 will be \~60 mins, and remaining visits are \~45 mins. The investigators propose a methodological innovation for CBT-I, which involves conducting 15-minute sessions every other month during the BWL intervention. Prior to these maintenance sessions, participants in the CBT-I+BWL group will complete electronic sleep diaries for one week and interventionists will use this information in sessions to sustain and enhance long-term outcomes by using MI to reinforce application of CBT-I session content.

    Behavioral: Cognitive-Behavioral Therapy for Insomnia (CBT-I)

  • Placebo comparator
    Sleep Education Control (EDU)

    The EDU intervention will parallel the CBT-I intervention in number, format and length of all sessions, including maintenance sessions. It provides basic information about sleep and cancer, widely available to the public. EDU content does not include any individualized behavioral instructions, sleep diary monitoring during the intervention, or behavior change counseling. Content is presented didactically only.

    Behavioral: Sleep Education Control (EDU)

Interventions

  • BehavioralCognitive-Behavioral Therapy for Insomnia (CBT-I)

    The CBT-I intervention is a 6-session intervention spread out over 8 weeks that combines education and behavioral techniques to reduce insomnia.

  • BehavioralSleep Education Control (EDU)

    Subjects will be instructed to read and review select publications from the American Academy of Sleep Medicine

06

What researchers measure

Primary outcomes

  1. Change in Weight (pounds)

    Our primary endpoint is % total weight loss (TWL) at 12 months. We will measure weight in light clothes without shoes, using a digital scale (in pounds) and height to the nearest 0.1 cm using a calibrated stadiometer, according to standardized procedures.

    Time frame: Baseline (randomization); 8 weeks post-sleep intervention (prior to BWL); and at 3, 6, and 12 months post-BWL.

Secondary outcomes

  1. Diet quality as assessed by Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool

    Will be measured using the Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool, which follows an automated multiple-pass methodology.

    Time frame: Baseline (randomization); 8 weeks post-sleep intervention (prior to BWL); and at 3, 6, and 12 months post-BWL.

  2. Physical activity assessed by wearing and accelerometer to track movement.

    Accelerometers (ActiGraph, LLC, Fort Walton Beach, FL) will be used to assess both sedentary time and moderate to vigorous physical activity.

    Time frame: Baseline (randomization); 8 weeks post-sleep intervention (prior to BWL); and at 3, 6, and 12 months post-BWL.

  3. Body composition measured through DEXA scan

    Body composition will be assessed by dual energy x-ray absorptiometry (DEXA), which measures total and regional fat, lean tissue and bone mass

    Time frame: Baseline and week 61

07

Study locations

4 of 4 sites recruiting
  • Sibley Memorial Hospital
    Washington D.C., District of Columbia 20016, United States
    Recruiting
    • Katie Smith, BA · Contactksmit261@jhmi.edu · 410-550-8099
    • Janelle Wilder Coughlin, PHD · Principal investigator
    • Michael Smith, PHD · Principal investigator
  • Sidney Kimmel Comprehensive Cancer Center, the Avon Foundation Breast Center at Johns Hopkins
    Baltimore, Maryland 21218, United States
    Recruiting
    • Katie Smith, BA · Contactksmit261@jhmi.edu · 410-550-8099
    • Janelle Wilder Coughlin, PHD · Principal investigator
    • Michael Smith, PHD · Principal investigator
  • Johns Hopkins Bayview
    Baltimore, Maryland 21224, United States
    Recruiting
    • Katie Smith, BA · Contactksmit261@jhmi.edu · 410-550-8099
    • Janelle Wilder Coughlin, PHD · Principal investigator
    • Michael Smith, PHD · Principal investigator
  • Johns Hopkins Kimmel Cancer Center at Greenspring Station
    Lutherville, Maryland 21093, United States
    Recruiting
    • Katie Smith, BA · Contactksmit261@jhmi.edu · 410-550-8099
    • Janelle Wilder Coughlin, PHD · Principal investigator
    • Michael Smith, PHD · Principal investigator
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05780814
Responsible party
Sponsor
First posted
Mar 23, 2023
Start date
Feb 1, 2024
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Feb 23, 2026

Study contacts

Janelle Wilder Coughlin, PHD
Contact
jwilder3@jhmi.edu
(410) 550-7000
Katie Smith, BA
Contact
ksmit261@jhmi.edu
(410) 550-8099
Janelle Wilder Coughlin, PHD
principal investigator · Johns Hopkins University
Michael Smith, PHD
principal investigator · Johns Hopkins 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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