ClinicalTrials.gg
Not yet recruitingNCT07911826TASSLEUpdated Nov 3, 2026

Targeting Sleep and Slow-Wave Activity to Enhance Cognition in MCI

An interventional study of active intervention and Control Intervention in Amnestic Mild Cognitive Impairment - aMCI and Insomnia, sponsored by New York State Psychiatric Institute. Not yet recruiting. Open to participants aged 60 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-11-03.

Sponsored by New York State Psychiatric Institute · Not applicable, Interventional, and Prevention

Updated Nov 3, 2026Newly registeredGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
60 Years to 85 Years
Sex
All
01

Study summary

Study Description As most clinical trials in Alzheimer's disease (AD) have been unsuccessful to date, it has become increasingly crucial to focus on treating earlier stages of the disease. Compelling evidence indicates that sleep disruption is associated with accumulation of Alzheimer's biomarkers, including amyloid-beta (Aβ) and tau pathology. Slow-wave activity (SWA) during sleep is particularly important for the clearance of Aβ and sleep-dependent memory consolidation, and sleep disturbance could reduce the amount of time spent in slow-wave sleep. Together, these findings suggest that treating sleep disruption in older adults may help reduce the level of adverse brain aging.

The goal of this study is to better understand the effect of sleep interventions on improving sleep and building cognitive resilience in older adults with amnestic mild cognitive impairment (aMCI), and to assess the feasibility of relevant study protocols. Fifty older adults (ages 60-85) with aMCI and sleep disturbance (Insomnia Severity Index score of 8 or greater) will be randomized 1:1 to one of two treatment arms: Cognitive Behavioral Therapy for Insomnia only (CBT-I + Sham), or CBT-I combined with acoustic slow-wave activity enhancement (CBT-I + SWAE). CBT-I is a psychotherapy intervention designed to address maladaptive cognitive and behavioral patterns associated with sleep and bedtime. SWAE is administered through non-invasive earbuds (Smartbuds, NextSense Inc.) that detect and amplify endogenous slow-wave activity using acoustic pulses during sleep.

Each participant will complete 3 visits over approximately 6 months: a baseline visit, a post-treatment visit (approximately 12 weeks after baseline), and a 6-month follow-up visit. Group differences will be compared on changes in cognitive performance and plasma biomarkers of AD (phosphorylated tau [pTau-217]) across these time points. The study will also explore potential mechanisms behind the relationship between sleep and cognition/biomarkers by investigating a range of objectively measured sleep metrics (e.g., sleep architecture, sleep duration, arousals) along with depressive symptoms.

Hypotheses:

CBT-I will be associated with more favorable outcomes (i.e., less decline or greater improvement) in frontal network functioning (sustained attention/target detection, executive functions), while SWAE will be associated with better outcomes in measures of episodic memory (word-list learning and story recall). Improvements in total sleep time and insomnia symptoms at 8 weeks are hypothesized to mediate the relationship between CBT-I and performance on attention and executive functions over 6 months, while improvements in slow-wave non-rapid eye movement (NREM) sleep at 12 weeks are hypothesized to mediate the relationship between SWAE and episodic memory measures. Additionally, CBT-I is hypothesized to be associated with increased scores on the Visuospatial Abilities, Planning, Organization, and Divided Attention subscales of the Everyday Cognition (ECog) questionnaire after 6 months, while SWAE is hypothesized to be associated with a significant increase in the Everyday Memory subscale.

Objectives:

Aim 1: To determine if CBT-I and SWAE have different neuropsychological outcomes in aMCI.

Aim 2: To examine the impact of sleep treatments on cognitively mediated everyday functioning.

Exploratory Aim: To assess whether CBT-I and/or SWAE are associated with changes in plasma pTau and whether pTau moderates the association between sleep and cognition.

Results from this study will determine whether sleep interventions can build brain and cognitive resilience in the context of aging, and will inform the design of a future, larger-scale R01 study rigorously examining the association between targeted sleep modifications and markers of AD pathophysiology as a potentially modifiable risk factor for dementia.

02

Conditions studied

  • Amnestic Mild Cognitive Impairment - aMCI
  • Insomnia

Keywords

  • CBT-I
  • Cognitive Behavioral Therapy for Insomnia
  • Slow-Wave Activity Enhancement
  • Sleep
  • Alzheimer's Disease prevention
  • Amnestic Mild Cognitive Impairment
03

In context

Sleep Initiation and Maintenance Disorders

2,722 studies on the registry are indexed under Sleep Initiation and Maintenance Disorders; 726 are open to participants now.

This study's planned enrollment of 50 is below the median of 68 across 2,350 interventional studies indexed under Sleep Initiation and Maintenance Disorders.

Browse Sleep Initiation and Maintenance Disorders studies →

Lead sponsor

New York State Psychiatric Institute is the lead sponsor of 435 studies on the registry; 27 are open to participants now.

Of its 51 completed or terminated interventional studies of FDA-regulated products, 45 (88%) have results posted.

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

04

Who can participate

Ages eligible
60 Years to 85 Years
Sexes eligible
All
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

  • English speaking, ages 60-85 years Telephone (T-MMSE) score of 22 or greater at screening Diagnosis of amnestic MCI, per Logical Memory (LM) delayed recall and QDRS criteria (education-adjusted LM cutoffs; QDRS total ≥1.5 with memory subscore ≥0.5) Presence of sleep disturbance, defined as Insomnia Severity Index (ISI) score ≥8 at baseline Capacity to provide Access to a stable internet connection Availability of a family member or other informant in regular contact with the participant, willing to serve as an informant (telephone informant acceptable)

Exclusion criteria

Exclusion Criteria:

  • Diagnosis of stroke or excessive cardiovascular disease risk Neurologic disease, including movement disorders, multiple sclerosis, epilepsy, or traumatic brain injury with loss of consciousness >15 minutes Untreated diabetes Active cancer treatment Telephone score below 22, or Logical Memory score above education-adjusted cutoffs (indicating no cognitive impairment) Sleep disorders other than insomnia (moderate-to-severe sleep apnea, REM behavior disorder, restless legs syndrome, circadian rhythm disorder); mild sleep apnea is not exclusionary Current diagnosis of schizophrenia, schizoaffective disorder, substance/alcohol use disorder, or bipolar disorder Use of sleep aids (prescription or OTC) within the past 14 days Use of antidepressants with significant anticholinergic properties (e.g., amitriptyline, doxepin, mirtazapine - full list in protocol) Use of benzodiazepines (e.g., diazepam, lorazepam, alprazolam - full list in protocol) Moderate-to-severe depression (Geriatric Depression Scale >8) Inability to provide an informant
Terms in these criteria, in plain language(3)

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.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

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.

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.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
50 participants (estimated)

Study arms

  • Sham comparator
    Sham Condition

    This sham condition includes the device being worn without any active pink noise engagement

    Device: Control Intervention

  • Active comparator
    Slow Wave Enhancement

    Slow wave enhancement via NextSense SmartBuds

    Device: active intervention

Interventions

  • Deviceactive intervention

    slow wave sleep enhancement vi NextSense Smart buds

  • DeviceControl Intervention

    Sham condition (device worn without active enhancement)

06

What researchers measure

Primary outcomes

  1. Change in Attention/Executive Function Composite Score

    Composite of performance on the No Practice Effect (NPE) test battery measures of frontal network functioning, including N-back (target detection/working memory), Letter-Number Span (executive function), Symbol Coding (processing speed), and Verbal Fluency. Change reflects Hypothesis 1a (CBT-I predicted to show greater improvement on this domain).

    Time frame: 8 weeks and 6 months

Secondary outcomes

  1. Change in Everyday Cognition (ECog) Subscale Scores

    Informant-rated change on ECog subscales, including Everyday Memory, Visuospatial Abilities, Planning, Organization, and Divided Attention, assessing cognitively mediated everyday functioning (Aim 2/Hypothesis 2).

    Time frame: Baseline and 6 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Kim H, Zhu X, Zhao Y, Bell SA, Gehrman PR, Cohen D, Devanand DP, Goldberg TE, Lee S; Alzheimer's Disease Neuroimaging Initiative. Resting-state functional connectivity changes in older adults with sleep disturbance and the role of amyloid burden. Mol Psychiatry. 2023 Oct;28(10):4399-4406. doi: 10.1038/s41380-023-02214-9. Epub 2023 Aug 18. PubMed 37596355 ↗
  • Papalambros NA, Santostasi G, Malkani RG, Braun R, Weintraub S, Paller KA, Zee PC. Acoustic Enhancement of Sleep Slow Oscillations and Concomitant Memory Improvement in Older Adults. Front Hum Neurosci. 2017 Mar 8;11:109. doi: 10.3389/fnhum.2017.00109. eCollection 2017. PubMed 28337134 ↗
  • Cassidy-Eagle E, Siebern A, Unti L, Glassman J, O'Hara R. Neuropsychological Functioning in Older Adults with Mild Cognitive Impairment and Insomnia Randomized to CBT-I or Control Group. Clin Gerontol. 2018 Mar-Apr;41(2):136-144. doi: 10.1080/07317115.2017.1384777. Epub 2017 Dec 8. PubMed 29220627 ↗

Individual participant data

Plan to share: Yes

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jan 2027; primary completion for Jun 2029, 29 months later.

Of 1,207 non-industry interventional studies with no phase under Sleep Initiation and Maintenance Disorders, half reached primary completion within 15 months of starting (the median), counting those still running; a quarter within 6 and three quarters within 35. This study's planned 29 months is above that.

Counting every sponsor, half of 1,285 studies reached it within 15 months; a quarter within 6 and three quarters within 34.

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

Registered
Oct 27, 2026
First posted
Nov 3, 2026
StartEst.
Jan 2027
Primary completionEst.
Jun 2029
CompletionEst.
Jan 2030
Last update
Nov 3, 2026
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.
Registered
First appeared on the registry. No changes since
Nov 3, 2026
Show all 1 update
  1. Nov 3, 2026
    First appeared on the registry

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
NCT07911826
Collaborators
Alzheimer's Association
Responsible party
Hyun "Monica" Kim (Assistant Professor of Clinical Neurobiology, New York State Psychiatric Institute) — Principal investigator
First posted
Nov 3, 2026
Start date
Jan 2027 (estimated)
Primary completion
Jun 2029 (estimated)
Completion
Jan 2030 (estimated)
Last update
Nov 3, 2026

Oversight

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

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