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RecruitingNCT06642246Updated Aug 28, 2026

Sleep Promotion and Pediatric Hypertension

An interventional study of Intervention in Insufficient Sleep and Hypertension, sponsored by Children's Hospital of Philadelphia. Recruiting at 1 site in United States. Open to participants aged 13 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-08-28.

Sponsored by Children's Hospital of Philadelphia · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
10
Allocation
Not applicable
Ages
13 Years to 18 Years
Sex
All
01

Study summary

Determine the effectiveness and feasibility of a mobile health sleep extension approach in the pediatric nephrology setting, to increase sleep duration and reduce systolic and diastolic blood pressure.

Read the detailed description

Insufficient sleep is associated with hypertension in children. Despite this knowledge, sleep promotion is not considered as a behavioral target during the initial treatment of pediatric essential hypertension. Investigators are developing a mobile platform to promote sleep in children that may have utility for treating pediatric essential hypertension.

The overall objective of this study is to determine the effectiveness and feasibility of a mobile health sleep extension approach in the pediatric nephrology setting, to increase sleep duration and reduce systolic and diastolic blood pressure.

This is a home-based, single-site study, of 13-to-18-year-olds (N=10, 5 parent-child dyads). Participants will have a recent diagnosis of essential hypertension, based on clinical ambulatory blood pressure monitoring, with initial treatment targeting lifestyle modification without pharmacological therapy. Participants must have cellular or internet access and spend less than or equal to 7.5 hours in bed per night. Children will be excluded if they have a known clinical sleep disorder.

The sleep promotion intervention will be delivered using REDCap. All participants will be provided with a sleep tracker to monitor their sleep patterns throughout the study. A two-week run-in phase will be used to capture baseline sleep patterns, and a home sleep polysomnography test will be completed to provide clinical sleep data. During a 7-week intervention phase, all participants will receive the same intervention condition. Participants will be provided a sleep duration goal paired with a loss-framed financial incentive (virtual account) starting with deductions each time the sleep goal is not met, will be sent sleep guidance text messages, and will receive weekly performance feedback text messages. Further, at the end of the intervention phase, participants will undergo a second Ambulatory Blood Pressure Monitoring (ABPM). The primary outcome is acceptance and feasibility of completing this study captured via self-reported feedback and documenting compliance with the study protocol. The secondary outcomes are changes in sleep duration from baseline, and changes in daytime and nocturnal systolic and diastolic blood pressure from baseline.

02

Conditions studied

  • Insufficient Sleep
  • Hypertension

Keywords

  • Insufficient Sleep
  • Hypertension
03

Who can participate

Ages eligible
13 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • Speak, read and write in English.
  • Parental/guardian permission (informed consent) and child assent.
  • Have a computer or a tablet computer with access to the Internet or own a smartphone with a data and text plan.
  • Parent reported sleep duration on school nights less than or equal to 7.5 hours.
  • Recently diagnosed with essential hypertension by Ambulatory Blood Pressure Monitoring (ABPM).
  • If taking over the counter sleep aides, willing to stop them over the course of the study.

Exclusion Criteria:

  • Any clinically diagnosed sleep disorder (e.g. sleep apnea) in the electronic health record and or regular use of prescribed sleep aide.
  • Underlying chronic medical conditions, defined as a medical condition with a duration or expected duration longer than 3 months that involved taking regular medication, taking medications that could affect blood pressure (e.g., anti-hypertensive medications, glucocorticoids, or stimulants), and patients with underlying diagnoses known to be associated with elevated blood pressure (e.g., cardiac disease, kidney disease or diabetes).

Inclusion Criteria for Parents/Legal Guardians:

  • Be the parent/guardian of an eligible child enrolled in the main study.
  • Speak, read, and write in English.

Exclusion Criteria for Parents/Legal Guardians:

- Limited English proficiency

04

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
10 participants (estimated)

Study arms

  • Experimental
    Arm 1

    Sleep goal, Sleep guidance messaging, Loss-framed incentive, Supportive feedback.

    Behavioral: Intervention

Interventions

  • BehavioralIntervention

    During a 7-week intervention phase, parent-child dyads will be provided a sleep duration goal paired with a loss-framed financial incentive (virtual account) starting with deductions each time the sleep goal is not met, will be sent sleep guidance text messages, and will receive weekly performance feedback text messages.

05

What researchers measure

Primary outcomes

  1. Hypertension

    The number of participants who are still diagnosed with hypertension by ambulatory blood pressure monitoring (ABPM). This is defined as a mean systolic or diastolic blood pressure when either awake or asleep, greater than the 95th percentile.

    Time frame: From baseline to approximately week 11

  2. Change in sleep tracker estimated weeknight sleep duration

    Change in sleep tracker estimated weeknight sleep duration will be measured from baseline (operationalized as the average hours per weeknight per week). There will be one week of baseline data and seven weeks of intervention data as well as two weeks of follow-up data.

    Time frame: From baseline to approximately week 11

Secondary outcomes

  1. Change in sleep tracker estimated sleep duration

    Change in sleep tracker estimated sleep duration will be measured from baseline (operationalized as the average hours per night per week). There will be one week of baseline data and seven weeks of intervention data as well as two weeks of follow-up data.

    Time frame: From baseline to approximately week 11

  2. Changes in sleep disturbance score measured by the Patient-Reported Outcome Measurement System (PROMIS) tool

    Measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) item bank for pediatric sleep. This validated survey generates a composite sleep disturbance T-score based on items related to sleep onset, sleep continuity and sleep quality in the past week. Higher T-scores indicates poorer sleep quality.

    Time frame: From baseline to approximately week 11

  3. Change in daytime systolic/diastolic blood pressures as measured by Ambulatory Blood Pressure Monitoring (ABPM)

    Changes in daytime systolic and diastolic blood pressure from baseline. Measured variables include daytime systolic/diastolic mean BP, BP index (calculated by dividing the average BP of the participant by the sex and height specific 95th percentiles for systolic and diastolic BP\].

    Time frame: From baseline to approximately week 11

  4. Change in night time systolic/diastolic blood pressures as measured by ABPM

    Changes in nocturnal systolic and diastolic blood pressure from baseline. Measured variables include nighttime systolic/diastolic mean BP, percent nocturnal dipping, BP index (calculated by dividing the average BP of the participant by the sex and height specific 95th percentiles for systolic and diastolic BP\].

    Time frame: From baseline to approximately week 11

06

Study locations

1 of 1 sites recruiting
  • Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19146, United States
    Recruiting
07

References and documents

Publications

  • Sadeh A, Gruber R, Raviv A. The effects of sleep restriction and extension on school-age children: what a difference an hour makes. Child Dev. 2003 Mar-Apr;74(2):444-55. doi: 10.1111/1467-8624.7402008. PubMed 12705565 ↗
  • Mindell JA, Sedmak R, Boyle JT, Butler R, Williamson AA. Sleep Well!: A Pilot Study of an Education Campaign to Improve Sleep of Socioeconomically Disadvantaged Children. J Clin Sleep Med. 2016 Dec 15;12(12):1593-1599. doi: 10.5664/jcsm.6338. PubMed 27655459 ↗
  • Meltzer LJ, Williamson AA, Mindell JA. Pediatric sleep health: It matters, and so does how we define it. Sleep Med Rev. 2021 Jun;57:101425. doi: 10.1016/j.smrv.2021.101425. Epub 2021 Jan 19. PubMed 33601324 ↗
  • Allen SL, Howlett MD, Coulombe JA, Corkum PV. ABCs of SLEEPING: A review of the evidence behind pediatric sleep practice recommendations. Sleep Med Rev. 2016 Oct;29:1-14. doi: 10.1016/j.smrv.2015.08.006. Epub 2015 Sep 1. PubMed 26551999 ↗
  • Mitchell JA, Morales KH, Williamson AA, Jawahar A, Juste L, Vajravelu ME, Zemel BS, Dinges DF, Fiks AG. Promoting Sleep Duration in the Pediatric Setting Using a Mobile Health Platform: A Randomized Optimization Trial. medRxiv [Preprint]. 2023 Jan 5:2023.01.04.23284151. doi: 10.1101/2023.01.04.23284151. PubMed 36711634 ↗
  • Mitchell JA, Morales KH, Williamson AA, Huffnagle N, Eck C, Jawahar A, Juste L, Fiks AG, Zemel BS, Dinges DF. Engineering a mobile platform to promote sleep in the pediatric primary care setting. Sleep Adv. 2021 Apr 15;2(1):zpab006. doi: 10.1093/sleepadvances/zpab006. eCollection 2021. PubMed 33981997 ↗
  • Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science. 1981 Jan 30;211(4481):453-8. doi: 10.1126/science.7455683. PubMed 7455683 ↗
  • Chokshi NP, Adusumalli S, Small DS, Morris A, Feingold J, Ha YP, Lynch MD, Rareshide CAL, Hilbert V, Patel MS. Loss-Framed Financial Incentives and Personalized Goal-Setting to Increase Physical Activity Among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Randomized Trial. J Am Heart Assoc. 2018 Jun 13;7(12):e009173. doi: 10.1161/JAHA.118.009173. PubMed 29899015 ↗
  • Patel MS, Asch DA, Rosin R, Small DS, Bellamy SL, Heuer J, Sproat S, Hyson C, Haff N, Lee SM, Wesby L, Hoffer K, Shuttleworth D, Taylor DH, Hilbert V, Zhu J, Yang L, Wang X, Volpp KG. Framing Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults: A Randomized, Controlled Trial. Ann Intern Med. 2016 Mar 15;164(6):385-94. doi: 10.7326/M15-1635. Epub 2016 Feb 16. PubMed 26881417 ↗
  • Long JA, Jahnle EC, Richardson DM, Loewenstein G, Volpp KG. Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial. Ann Intern Med. 2012 Mar 20;156(6):416-24. doi: 10.7326/0003-4819-156-6-201203200-00004. PubMed 22431674 ↗
  • Sen AP, Sewell TB, Riley EB, Stearman B, Bellamy SL, Hu MF, Tao Y, Zhu J, Park JD, Loewenstein G, Asch DA, Volpp KG. Financial incentives for home-based health monitoring: a randomized controlled trial. J Gen Intern Med. 2014 May;29(5):770-7. doi: 10.1007/s11606-014-2778-0. Epub 2014 Feb 13. PubMed 24522623 ↗
  • Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G. Financial incentive-based approaches for weight loss: a randomized trial. JAMA. 2008 Dec 10;300(22):2631-7. doi: 10.1001/jama.2008.804. PubMed 19066383 ↗
  • Kuna ST, Shuttleworth D, Chi L, Schutte-Rodin S, Friedman E, Guo H, Dhand S, Yang L, Zhu J, Bellamy SL, Volpp KG, Asch DA. Web-Based Access to Positive Airway Pressure Usage with or without an Initial Financial Incentive Improves Treatment Use in Patients with Obstructive Sleep Apnea. Sleep. 2015 Aug 1;38(8):1229-36. doi: 10.5665/sleep.4898. PubMed 25581921 ↗
  • Wong CA, Miller VA, Murphy K, Small D, Ford CA, Willi SM, Feingold J, Morris A, Ha YP, Zhu J, Wang W, Patel MS. Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial. JAMA Pediatr. 2017 Dec 1;171(12):1176-1183. doi: 10.1001/jamapediatrics.2017.3233. PubMed 29059263 ↗
  • Asch DA, Troxel AB, Stewart WF, Sequist TD, Jones JB, Hirsch AG, Hoffer K, Zhu J, Wang W, Hodlofski A, Frasch AB, Weiner MG, Finnerty DD, Rosenthal MB, Gangemi K, Volpp KG. Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial. JAMA. 2015 Nov 10;314(18):1926-35. doi: 10.1001/jama.2015.14850. PubMed 26547464 ↗
  • Mullins EN, Miller AL, Cherian SS, Lumeng JC, Wright KP Jr, Kurth S, Lebourgeois MK. Acute sleep restriction increases dietary intake in preschool-age children. J Sleep Res. 2017 Feb;26(1):48-54. doi: 10.1111/jsr.12450. Epub 2016 Sep 19. PubMed 27641365 ↗
  • Simon SL, Field J, Miller LE, DiFrancesco M, Beebe DW. Sweet/dessert foods are more appealing to adolescents after sleep restriction. PLoS One. 2015 Feb 23;10(2):e0115434. doi: 10.1371/journal.pone.0115434. eCollection 2015. PubMed 25706861 ↗
  • Beebe DW, Fallone G, Godiwala N, Flanigan M, Martin D, Schaffner L, Amin R. Feasibility and behavioral effects of an at-home multi-night sleep restriction protocol for adolescents. J Child Psychol Psychiatry. 2008 Sep;49(9):915-23. doi: 10.1111/j.1469-7610.2008.01885.x. Epub 2008 Jun 28. PubMed 18564072 ↗
  • Van Dyk TR, Zhang N, Catlin PA, Cornist K, McAlister S, Whitacre C, Beebe DW. Feasibility and Emotional Impact of Experimentally Extending Sleep in Short-Sleeping Adolescents. Sleep. 2017 Sep 1;40(9). doi: 10.1093/sleep/zsx123. PubMed 28934531 ↗
  • Van Dyk TR, Krietsch KN, Saelens BE, Whitacre C, McAlister S, Beebe DW. Inducing more sleep on school nights reduces sedentary behavior without affecting physical activity in short-sleeping adolescents. Sleep Med. 2018 Jul;47:7-10. doi: 10.1016/j.sleep.2018.03.007. Epub 2018 Mar 29. PubMed 29880148 ↗
  • Hart CN, Carskadon MA, Considine RV, Fava JL, Lawton J, Raynor HA, Jelalian E, Owens J, Wing R. Changes in children's sleep duration on food intake, weight, and leptin. Pediatrics. 2013 Dec;132(6):e1473-80. doi: 10.1542/peds.2013-1274. Epub 2013 Nov 4. PubMed 24190680 ↗
  • Beebe DW, Simon S, Summer S, Hemmer S, Strotman D, Dolan LM. Dietary intake following experimentally restricted sleep in adolescents. Sleep. 2013 Jun 1;36(6):827-34. doi: 10.5665/sleep.2704. PubMed 23729925 ↗
  • Gruber R, Cassoff J, Frenette S, Wiebe S, Carrier J. Impact of sleep extension and restriction on children's emotional lability and impulsivity. Pediatrics. 2012 Nov;130(5):e1155-61. doi: 10.1542/peds.2012-0564. Epub 2012 Oct 15. PubMed 23071214 ↗
  • Fobian AD, Elliott L, Louie T. A Systematic Review of Sleep, Hypertension, and Cardiovascular Risk in Children and Adolescents. Curr Hypertens Rep. 2018 May 1;20(5):42. doi: 10.1007/s11906-018-0841-7. PubMed 29717377 ↗
  • Williams JA, Zimmerman FJ, Bell JF. Norms and trends of sleep time among US children and adolescents. JAMA Pediatr. 2013 Jan;167(1):55-60. doi: 10.1001/jamapediatrics.2013.423. PubMed 23403646 ↗
  • Matricciani LA, Olds TS, Blunden S, Rigney G, Williams MT. Never enough sleep: a brief history of sleep recommendations for children. Pediatrics. 2012 Mar;129(3):548-56. doi: 10.1542/peds.2011-2039. Epub 2012 Feb 13. PubMed 22331340 ↗
  • Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. J Clin Sleep Med. 2016 Nov 15;12(11):1549-1561. doi: 10.5664/jcsm.6288. PubMed 27707447 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT06642246
Lead sponsor
Children's Hospital of Philadelphia
Responsible party
Sponsor
First posted
Oct 15, 2024
Start date
Feb 16, 2026
Primary completion
Nov 2026 (estimated)
Completion
Nov 2026 (estimated)
Last update
Aug 28, 2026

Study contacts

Jonathan Mitchell
Contact
mitchellj2@chop.edu
267-426-1473
Abby Salem
Contact
salema1@chop.edu
215-590-2386
Jonathan Mitchell, PhD
principal investigator · Children's Hospital of Philadelphia

Oversight

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

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