Evidence map›Paper›PMID 34895308›Full record

ArticleTrials2021

TIMELAPSE study-efficacy of low-dose amitriptyline versus cognitive behavioral therapy for chronic insomnia in patients with medical comorbidity: study protocol of a randomized controlled multicenter non-inferiority trial.

Nynke L Rauwerda, Hans Knoop, Irene Pot, Annemieke van Straten, Marian E Rikkert, Anouk Zondervan, Thom P J Timmerhuis, Annemarie M J Braamse, H Myrthe Boss

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Nynke L RauwerdaDepartment of Medical Psychology, Hospital Gelderse Vallei, Ede, The Netherlands. rauwerdan@zgv.nl.ORCID http://orcid.org/0000-0003-4246-4543
Hans KnoopDepartment of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Irene PotDepartment of Medical Psychology, Hospital Gelderse Vallei, Ede, The Netherlands.
Annemieke van StratenDepartment of Clinical Psychology & Amsterdam Public Health Research Institute, VU University, Amsterdam, The Netherlands.
Marian E RikkertDepartment of Medical Psychology, Hospital Rivierenland, Tiel, The Netherlands.
Anouk ZondervanDepartment of Medical Psychology, Zaans Medical Center, Zaandam, The Netherlands.
Thom P J TimmerhuisDepartment of Neurology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, the Netherlands.
Annemarie M J BraamseDepartment of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
H Myrthe BossDepartment of Neurology, Hospital Gelderse Vallei, Ede, The Netherlands.
Ziekenhuis Gelderse Vallei · NLAmsterdam University Medical Centers · NLJeroen Bosch Ziekenhuis · NLZaans Medisch Centrum · NLZiekenhuis Rivierenland · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsomnia is common in people with long-term medical conditions and is related to increased mortality and morbidity. Cognitive behavioral therapy for insomnia (CBT-I) is first choice treatment and effective for people with insomnia and comorbid long-term medical conditions. However, CBT-I has some limitations as it might not always be available or appeal to patients with medical conditions. Furthermore, a small proportion of patients do not respond to CBT-I. Preliminary evidence and clinical experience suggest that low-dose amitriptyline (AM) might be an effective alternative to treat insomnia in patients with medical comorbidity. In this randomized controlled trial, we will determine whether AM is non-inferior to the first choice treatment for insomnia, CBT-I. METHODS/

designThis study will test if treatment with low-dose amitriptyline for insomnia in patients with medical comorbidity is non-inferior to CBT-I in a multicenter randomized controlled non-inferiority trial. Participants will be 190 adults with a long-term medical condition and insomnia. Participants will be randomly allocated to one of two intervention arms: 12 weeks AM (starting with 10 mg per day, and if ineffective at 3 weeks, doubling this dose) or 12 weeks of CBT-I consisting of 6 weekly sessions and a follow-up session 6 weeks later. The primary outcome is subjective insomnia severity, measured with the Insomnia Severity Index (ISI). The primary endpoint is at 12 weeks. Secondary outcomes include sleep quality (e.g., sleep efficiency), questionnaires on daytime functioning (physical functioning and impairment of functioning), and symptoms (e.g., fatigue, pain, anxiety) at 12 weeks and 12 months post treatment and relapse of insomnia until 12 months after treatment. DISCUSSION: Irrespective of the outcome, this study will be a much-needed contribution to evidence based clinical guidelines on the treatment of insomnia in patients with medical comorbidity.

trial registrationDutch Trial Register NTR NL7971 . Registered on 18 August 2019.

Indexed as

Cognitive Behavioral TherapySleep Initiation and Maintenance DisordersAdultAmitriptylineComorbidityEquivalence Trials as TopicHumansMulticenter Studies as TopicNeoplasm Recurrence, LocalRandomized Controlled Trials as TopicSleep QualityAmitriptylineAmitriptylineCBT-ICognitive behavioral therapyFatigueInsomniaMedical comorbidityNon-inferiorityPainTreatment preference

Identifiers

PMID34895308
PMCPMC8665718
OpenAlexW4200517196

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.