ClinicalTrials.gg
Not yet recruitingNCT07566481Updated Nov 10, 2026

Stress, Coping, and Sleep Health Study

An observational study in Sleep, sponsored by National Institute of Environmental Health Sciences (NIEHS). Not yet recruiting at 1 site in United States. Open to participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2026-11-10.

Sponsored by National Institute of Environmental Health Sciences (NIEHS) · Observational

Updated Nov 10, 2026Start date movedGo to Updates ↓
Study type
Observational
Model
Ecologic or community
Time perspective
Cross-sectional
Enrollment
70
Ages
18 Years to 120 Years
Sex
All
01

Study summary

Background:

Poor sleep is common among refugee groups worldwide. It can lead to an increased risk of heart disease, diabetes, cancer, and premature death. It can also worsen mental health disorders. Researchers have studied the mental health issues among refugees from Bhutan in the United States. Now they want to understand more about how difficulty sleeping may relate to their other health outcomes.

Objective:

To learn how the social and environmental conditions Bhutanese refugees affect their sleep health and health outcomes.

Eligibility:

Refugees aged 18 years and older of Bhutanese-Nepali or Bhutanese American descent. The participants must live in central Ohio. Also needed are people aged 18 years and older who interact with Bhutanese refugees in this region.

Design:

Participants will participate in a focus group discussion. The group will have 8 to 10 participants. It will last 60 to 90 minutes.

They will talk about their experiences as a refugee and their sleep health. Topics may include adjusting to a new culture; access to housing and health care; and experiences with differential treatment by members inside and outside of their group. The study team will audio record the discussion. They will not share the recording with anyone.

Participants will complete a short questionnaire. They will answer questions about their age, sex, language preferences, and how long they have lived in the United States.

Participants who are not refugees will take part in a virtual interview led by a member of the study team. Participants will share their experiences with adapting to a new culture, differential treatment, and other factors have affected refugees sleep. The interview will take about 1 hour.

Read the detailed description

Study Description:

This qualitative study seeks to examine the role of discrimination, acculturative stressors, and coping mechanisms in shaping the sleep health of Bhutanese refugees living in Central Ohio. Using focus group discussions (n=approximately 6) with Bhutanese refugees and key informant interviews (n=approximately 10) with community leaders, the study will examine associations between refugee-related stressors-such as trauma, discrimination, and acculturation challenges-and sleep health. It will also explore coping strategies employed in response to sleep difficulties, experiences of discrimination, and other stressors, and identify recommendations for enhanced community resources and support.

Objectives:

The primary objectives of this study include:

  1. Investigate associations between stressors related to being a refugee (e.g., trauma, financial strain, discrimination, acculturation, political) and various sleep health dimensions.
  2. Identify coping strategies used in response to difficulties with sleep, discriminatory experiences, and other stressors.
  3. Determine recommendations regarding the types of support and resources needed by the Bhutanese refugee community to manage stressors and support sleep health.

Endpoints:

We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data contain sufficient depth, diversity of perspectives, and contextual detail to fully address our central research questions. This assessment will involve triangulation, using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence.

02

Conditions studied

  • Sleep

Keywords

  • Refugee
  • Sleep
  • Discrimination
03

In context

Lead sponsor

National Institute of Environmental Health Sciences (NIEHS) is the lead sponsor of 183 studies on the registry; 18 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This study will enroll between 48-60 adults (18+ years) living in Ohio, US for Focus Group Discussions and 10 adults (18+ years) who work with or support Bhutanese Refugees living in Ohio.

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

In order to be eligible to participate in a FGD for this study, an individual must meet all of the following criteria:

  1. Adult (aged 18 years or older) living in Ohio, US
  2. Self-identify as Bhutanese-Nepali or Bhutanese American
  3. Identify as a refugee
  4. Speak and understand English and/or Nepali.
  5. Ability to understand and the willingness to provide and participate in the FGD

In order to be eligible to participate in a KII for this study, an individual must meet all of the following criteria:

  1. Adult (aged 18 years or older)
  2. Ability to speak and understand English; Familiarity with the lives and experiences of Bhutanese refugees living in Ohio, US
  3. Ability to understand and the willingness to provide informed consent and participate in the virtual KII.

Exclusion criteria

EXCLUSION CRITERIA:

Individuals who are unable to communicate in either English or Nepali will be excluded from FGD. Since Nepali is the primary language spoken by most Bhutanese refugees before relocation, and English is the dominant language in the United States, participants are expected to have sufficient proficiency in at least one of these languages.

Individuals who are unable to communicate in English will be excluded from KII. Given their leadership roles and interactions with the healthcare system, educational institutions, local government service providers, and nonprofit organizations in Ohio-where English is the primary language-participants are expected to have sufficient English proficiency. We will not exclude any participants that meet the inclusion criteria from participating in the study overall or in any of the study procedures.

Children (individuals under 18) are excluded from this study because the knowledge sought is not relevant to this population. This study investigates the relationship between sleep quality and experiences of discrimination among Bhutanese-Nepali refugees in Ohio, as well as the coping mechanisms adults use to manage discrimination-related stress, particularly as it pertains to sleep.

The constructs under investigation, including perceived discrimination, its psychosocial impact, and adaptive coping strategies, are anchored in the adult experience of resettlement and the stressors associated with adult social and occupational life. Children's experiences of discrimination, sleep patterns, and coping mechanisms differ substantially from those of adults in both nature and context, and findings from an adult sample would not be generalizable to a pediatric population. For these reasons, the inclusion of children would not yield scientifically meaningful data relevant to the study aims.

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

Observational model
Ecologic or community
Time perspective
Cross-sectional
Enrollment
70 participants (estimated)

Groups and cohorts

  • US Bhutanese

    Those self-identifying as Bhutanese living in central Ohio.

06

What researchers measure

Primary outcomes

  1. Investigate associations between stressors related to being a refugee (e.g., trauma, financial strain, discrimination, acculturation, political) and various sleep health dimensions.

    We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data is sufficiently rich and detailed to fully address our central research questions. This assessment will involve triangulation using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence

    Time frame: Will use qualitative best practices to determine when study objectives have been sufficiently achieved.

  2. Identify coping strategies used in response to difficulties with sleep, discriminatory experiences, and other stressors.

    We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data is sufficiently rich and detailed to fully address our central research questions. This assessment will involve triangulation using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence

    Time frame: Will use qualitative best practices to determine when study objectives have been sufficiently achieved.

  3. Determine recommendations regarding the types of support and resources needed by the Bhutanese refugee community to manage stressors and support sleep health.

    We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data is sufficiently rich and detailed to fully address our central research questions. This assessment will involve triangulation using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence

    Time frame: Will use qualitative best practices to determine when study objectives have been sufficiently achieved.

07

Study locations

1 site
08

References and documents

Publications

  • Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med. 2022 Jan;292:114523. doi: 10.1016/j.socscimed.2021.114523. Epub 2021 Nov 2. PubMed 34785096 ↗
  • Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res. 1999 Dec;34(5 Pt 2):1189-208. PubMed 10591279 ↗
  • Misra SM, Nepal VP, Banerjee D, Giardino AP. Chronic Health Conditions, Physical Activity and Dietary Behaviors of Bhutanese Refugees: A Houston-Based Needs Assessment. J Immigr Minor Health. 2016 Dec;18(6):1423-1431. doi: 10.1007/s10903-015-0282-1. PubMed 26458956 ↗
  • Liu RT, Steele SJ, Hamilton JL, Do QBP, Furbish K, Burke TA, Martinez AP, Gerlus N. Sleep and suicide: A systematic review and meta-analysis of longitudinal studies. Clin Psychol Rev. 2020 Nov;81:101895. doi: 10.1016/j.cpr.2020.101895. Epub 2020 Aug 8. PubMed 32801085 ↗
  • Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Med Rev. 2021 Dec;60:101556. doi: 10.1016/j.smrv.2021.101556. Epub 2021 Sep 23. PubMed 34607184 ↗
  • Jou YC, Pace-Schott EF. Call to action: Addressing sleep disturbances, a hallmark symptom of PTSD, for refugees, asylum seekers, and internally displaced persons. Sleep Health. 2022 Dec;8(6):593-600. doi: 10.1016/j.sleh.2022.09.003. Epub 2022 Oct 27. PubMed 36511279 ↗
  • Lies J, Mellor A, Jobson L, Drummond SPA. Prevalence of sleep disturbance and its relationships with mental health and psychosocial issues in refugees and asylum seekers attending psychological services in Australia. Sleep Health. 2019 Aug;5(4):335-343. doi: 10.1016/j.sleh.2019.06.002. Epub 2019 Jul 16. PubMed 31320291 ↗
  • Lies J, Drummond SPA, Jobson L. Longitudinal investigation of the relationships between trauma exposure, post-migration stress, sleep disturbance, and mental health in Syrian refugees. Eur J Psychotraumatol. 2020 Nov 19;11(1):1825166. doi: 10.1080/20008198.2020.1825166. PubMed 33425241 ↗
  • Subedi P, Li C, Gurung A, Bizune D, Dogbey MC, Johnson CC, Yun K. Mental health first aid training for the Bhutanese refugee community in the United States. Int J Ment Health Syst. 2015 May 9;9:20. doi: 10.1186/s13033-015-0012-z. eCollection 2015. PubMed 25987894 ↗
  • Aernout E, Benradia I, Hazo JB, Sy A, Askevis-Leherpeux F, Sebbane D, Roelandt JL. International study of the prevalence and factors associated with insomnia in the general population. Sleep Med. 2021 Jun;82:186-192. doi: 10.1016/j.sleep.2021.03.028. Epub 2021 Apr 2. PubMed 33957414 ↗
  • Baskaran A, Marogi E, Bitar R, Attarian H, Saadi A. Improving Sleep Health Among Refugees: A Systematic Review. Neurol Clin Pract. 2023 Apr;13(2):e200139. doi: 10.1212/CPJ.0000000000200139. Epub 2023 Mar 14. PubMed 36936393 ↗
  • Hagaman AK, Sivilli TI, Ao T, Blanton C, Ellis H, Lopes Cardozo B, Shetty S. An Investigation into Suicides Among Bhutanese Refugees Resettled in the United States Between 2008 and 2011. J Immigr Minor Health. 2016 Aug;18(4):819-827. doi: 10.1007/s10903-015-0326-6. PubMed 26758579 ↗
  • Ao T, Shetty S, Sivilli T, Blanton C, Ellis H, Geltman PL, Cochran J, Taylor E, Lankau EW, Lopes Cardozo B. Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States. J Immigr Minor Health. 2016 Aug;18(4):828-835. doi: 10.1007/s10903-015-0325-7. PubMed 26711245 ↗
  • Polcher K, Calloway S. Addressing the Need for Mental Health Screening of Newly Resettled Refugees: A Pilot Project. J Prim Care Community Health. 2016 Jul;7(3):199-203. doi: 10.1177/2150131916636630. Epub 2016 Mar 4. PubMed 26944513 ↗
  • Torres L, Driscoll MW, Voell M. Discrimination, acculturation, acculturative stress, and Latino psychological distress: a moderated mediational model. Cultur Divers Ethnic Minor Psychol. 2012 Jan;18(1):17-25. doi: 10.1037/a0026710. PubMed 22250895 ↗
  • Zhang M, Gurung A, Anglewicz P, Baniya K, Yun K. Discrimination and Stress Among Asian Refugee Populations During the COVID-19 Pandemic: Evidence from Bhutanese and Burmese Refugees in the USA. J Racial Ethn Health Disparities. 2022 Apr;9(2):589-597. doi: 10.1007/s40615-021-00992-y. Epub 2021 Mar 2. PubMed 33651371 ↗
  • Salinas M, Salinas JL. "We Are from Nowhere": A Qualitative Assessment of the Impact of Collective Trauma from the Perspective of Resettled Bhutanese Refugees. Health Equity. 2021 Oct 28;5(1):762-769. doi: 10.1089/heq.2020.0116. eCollection 2021. PubMed 34909546 ↗
  • Maleku A, Soukenik E, Haran H, Kirsch J, Pyakurel S. Conceptualizing Mental Health Through Bhutanese Refugee Lens: Findings from a Mixed Methods Study. Community Ment Health J. 2022 Feb;58(2):376-393. doi: 10.1007/s10597-021-00835-4. Epub 2021 May 15. PubMed 33993363 ↗
  • Richter K, Baumgartner L, Niklewski G, Peter L, Kock M, Kellner S, Hillemacher T, Buttner-Teleaga A. Sleep disorders in migrants and refugees: a systematic review with implications for personalized medical approach. EPMA J. 2020 May 13;11(2):251-260. doi: 10.1007/s13167-020-00205-2. eCollection 2020 Jun. PubMed 32549917 ↗
  • Chattu VK, Chattu SK, Spence DW, Manzar MD, Burman D, Pandi-Perumal SR. Do Disparities in Sleep Duration Among Racial and Ethnic Minorities Contribute to Differences in Disease Prevalence? J Racial Ethn Health Disparities. 2019 Dec;6(6):1053-1061. doi: 10.1007/s40615-019-00607-7. Epub 2019 Jul 1. PubMed 31264064 ↗
  • Zhang J, He M, Wang X, Jiang H, Huang J, Liang S. Association of sleep duration and risk of mental disorder: a systematic review and meta-analysis. Sleep Breath. 2024 Mar;28(1):261-280. doi: 10.1007/s11325-023-02905-1. Epub 2023 Aug 29. PubMed 37642884 ↗

Individual participant data

Plan to share: No

09

Updates

32 registry updates since Sep 25, 2026
Start date
Sep 29, 2026→Nov 15, 2026
moved 32 times, Sep 25, 2026 – Nov 10, 2026
Show all 32 updates
  1. Nov 10, 2026
    Start date Nov 12, 2026→Nov 15, 2026
  2. Nov 9, 2026
    Start date Nov 11, 2026→Nov 12, 2026
  3. Nov 6, 2026
    Start date Nov 10, 2026→Nov 11, 2026
  4. Nov 5, 2026
    Start date Nov 9, 2026→Nov 10, 2026
  5. Nov 4, 2026
    Start date Nov 8, 2026→Nov 9, 2026
  6. Nov 3, 2026
    Start date Nov 5, 2026→Nov 8, 2026
  7. Nov 2, 2026
    Start date Nov 4, 2026→Nov 5, 2026
  8. Oct 30, 2026
    Start date Nov 3, 2026→Nov 4, 2026
  9. Oct 29, 2026
    Start date Nov 2, 2026→Nov 3, 2026
  10. Oct 28, 2026
    Start date Nov 1, 2026→Nov 2, 2026
  11. Oct 27, 2026
    Start date Oct 29, 2026→Nov 1, 2026
  12. Oct 26, 2026
    Start date Oct 28, 2026→Oct 29, 2026
  13. Oct 23, 2026
    Start date Oct 27, 2026→Oct 28, 2026
  14. Oct 22, 2026
    Start date Oct 26, 2026→Oct 27, 2026
  15. Oct 21, 2026
    Start date Oct 25, 2026→Oct 26, 2026
  16. Oct 20, 2026
    Start date Oct 22, 2026→Oct 25, 2026
  17. Oct 19, 2026
    Start date Oct 21, 2026→Oct 22, 2026
  18. Oct 16, 2026
    Start date Oct 20, 2026→Oct 21, 2026
  19. Oct 15, 2026
    Start date Oct 19, 2026→Oct 20, 2026
  20. Oct 14, 2026
    Start date Oct 18, 2026→Oct 19, 2026
  21. Oct 13, 2026
    Start date Oct 14, 2026→Oct 18, 2026
  22. Oct 9, 2026
    Start date Oct 13, 2026→Oct 14, 2026
  23. Oct 8, 2026
    Start date Oct 12, 2026→Oct 13, 2026
  24. Oct 7, 2026
    Start date Oct 11, 2026→Oct 12, 2026
  25. Oct 6, 2026
    Start date Oct 8, 2026→Oct 11, 2026
  26. Oct 5, 2026
    Start date Oct 7, 2026→Oct 8, 2026
  27. Oct 2, 2026
    Start date Oct 6, 2026→Oct 7, 2026
  28. Oct 1, 2026
    Start date Oct 5, 2026→Oct 6, 2026
  29. Sep 30, 2026
    Start date Oct 4, 2026→Oct 5, 2026
  30. Sep 29, 2026
    Start date Oct 1, 2026→Oct 4, 2026
  31. Sep 28, 2026
    Start date Sep 30, 2026→Oct 1, 2026
  32. Sep 25, 2026
    Start date Sep 29, 2026→Sep 30, 2026

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07566481
Responsible party
Sponsor
First posted
May 5, 2026
Start date
Nov 15, 2026 (estimated)
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Nov 10, 2026

Study contacts

Chandra L Jackson, Ph.D.
Contact
chandra.jackson@nih.gov
(984) 297-3701
Chandra L Jackson, Ph.D.
principal investigator · National Institute of Environmental Health Sciences (NIEHS)

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. 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