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Trial registered on ANZCTR


Registration number
ACTRN12622000840785
Ethics application status
Approved
Date submitted
5/06/2022
Date registered
15/06/2022
Date last updated
25/05/2023
Date data sharing statement initially provided
15/06/2022
Type of registration
Prospectively registered

Titles & IDs
Public title
Examining the efficacy of a sleep-wake management tool for younger and older shift workers
Scientific title
Examining the efficacy of a personalised digital tool on sleep and cognition in older shift working nurses.
Secondary ID [1] 302351 0
N/A
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
shift work disorder 325978 0
sleep disorder 326561 0
insomnia 326562 0
depression 326563 0
poor cognitive performance 326564 0
Condition category
Condition code
Mental Health 323292 323292 0 0
Studies of normal psychology, cognitive function and behaviour

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Consenting nurses (i.e., individuals undertaking shift work) will receive access to a digital, app-based tool that delivers personalised recommendations for sleep and wake behaviours based on their shift schedules and other personal commitments. The primary strategy from the app includes a sleep-wake schedule (such as: sleep from 10 pm to 7 am, minimum sleep duration of 8 hours in 24 hour period). Other strategies include actionable insights, such as "consume caffeine in xx hours" or "avoid light at xx hours" based on shift timings and personal commitments of the user. Participants will be recommended to engage with the app for approximately five minutes during the day. The app has been designed co-designed with shift workers from healthcare and defence to provide sleep and lifestyle support based on their operational needs.

• Part 1: Baseline testing to identify sleep patterns – Two weeks
Prior to the start of the study, participants will be provided with the instructions on how to download and use the app for the first. Once the app is downloaded, it will provide participants with a walkthrough of its features and how participants can add or access shift work related information. At the start of the first two weeks of the study, participants will receive access to limited features of the app. We will request participants to use these features to record participants bedtime and waketime every day (~2 minutes daily).
During the baseline testing period, participants will also be requested to complete: a) an online questionnaire on sleep, chronotype (i.e., participants body clock) and mental health (once only, ~20 minutes), and b) cognitive testing (up to four times, ~8 minutes each time). The questionnaire can be completed using an online link. Participants can complete cognitive testing at the start and end of participants shifts using an iPad.
• Part 2: Using strategies delivered by the app – Up to six weeks
After the first two weeks of the study, participants will receive access to all features of the app. Participants are requested to engage with the app daily to receive strategies and attempt to follow them to the best of participants abilities. During this period, participants will continue to record participants bedtime and waketime every day (~2 minutes daily). Researchers may also request participants to provide a sleep report from participants smartwatch – this will be optional.
• Part 3: Mid and End of the study testing
During the halfway point of the study (week 4), participants will be requested to complete a short questionnaire on sleep and mood (~5 minutes). Participants will also be requested to complete cognitive testing at the same time during participants shifts as the baseline (up to four times, ~8 minutes each time). At the end of the study, participants will be requested to complete the same questionnaire and cognitive tests from the baseline, which will help us explore any potential changes in sleep and performance following the use of the app. We will also request any feedback on participants' experience using the app, which will help us improve the design and functionalities of the prototype. Participants' adherence to sleep recommendations will be monitored passively, through their responses about bedtime and waketime noted using the sleep diary feature of the app. Engagement with the app will be explored passively by measuring the average minutes of interaction with the app every day.
Intervention code [1] 323338 0
Lifestyle
Intervention code [2] 323728 0
Behaviour
Comparator / control treatment
No control group
Control group
Uncontrolled

Outcomes
Primary outcome [1] 331023 0
Changes in sleep from baseline, using the Insomnia Severity Index and PROMIS sleep-related impairment scale.
Timepoint [1] 331023 0
Midpoint (i.e. Week 2 of the intervention) and the end of the intervention (i.e.f beginning of Week 5).
Primary outcome [2] 331602 0
Acceptability, measured as perceived satisfaction with the app using rating scale.
Timepoint [2] 331602 0
In the week following the end of the intervention (i.e., week 5)
Primary outcome [3] 331689 0
Changes in cognitive performance from baseline, measured using Psychomotor vigilance task and N-back
Timepoint [3] 331689 0
Midpoint (i.e. Week 2) and end of the intervention (week 5)
Secondary outcome [1] 410633 0
Practicality, measured passively using engagement data from the app (such as minutes of app use during a week).
Timepoint [1] 410633 0
Duration of weekly app use (in minutes), reported for each week during intervention
Secondary outcome [2] 410634 0
Implementation, measured as intervention adherence (actual sleep window in relation to sleep recommendations)
Timepoint [2] 410634 0
Measured daily using a sleep diary on the app where participants note their bedtimes and waketimes. Daily overlap between sleep recommendations and actual sleep behaviours would be examined as a percentage and reported as an average for each week (e.g., 60% overlap between sleep recommendations and actual sleep behaviours in week 1).
Secondary outcome [3] 410636 0
Implementation, measured as participant retention rate
Timepoint [3] 410636 0
After the end of data collection period, by examining how many people started the study and how many people completed the final survey for the study (week 5).

Eligibility
Key inclusion criteria
1. Aged 21 years or above.
2. Employed in rotational or night shift work for a minimum of one year.
Minimum age
21 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
1. Prior diagnosis of an untreated sleep disorder other than insomnia or shift work sleep disorder (including restless leg syndrome, central or obstructive sleep apnoea, narcolepsy etc.).
2. Prior diagnosis of an untreated medical condition that may impact sleep (including diabetes, thyroid disease, hypertension, neurological conditions etc.).
3. Prior diagnosis of an untreated mental health (psychiatric) condition that may impact sleep other than depression or anxiety.
4. Current caffeine consumption >500mg per day
5. Alcohol consumption >20 standard drinks in a week.
6. Transmeridian travel in the past one month.
7. History of substance use in the past 12 months.
8. Investigational drug use in the past 60 days.

Study design
Purpose of the study
Prevention
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
N/A
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Single group
Other design features
Phase
Not Applicable
Type of endpoint/s
Efficacy
Statistical methods / analysis
Pre-post design to examine changes in sleep, mental health and performance pre and post the use of the app.

T-Tests to examine pre and post differences in sleep, mental health and performance based on age ( 21-44, 45 and above).

Recruitment
Recruitment status
Recruiting
Date of first participant enrolment
Anticipated
1/07/2022
Actual
1/07/2022
Date of last participant enrolment
Anticipated
1/05/2024
Actual
Date of last data collection
Anticipated
30/06/2024
Actual
Sample size
Target
120
Accrual to date
30
Final
Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC

Funding & Sponsors
Funding source category [1] 311191 0
Other
Name [1] 311191 0
CogSleep Centre for Research Excellence
Country [1] 311191 0
Australia
Primary sponsor type
University
Name
Monash University
Address
Wellington Rd, Clayton VIC 3800
Country
Australia
Secondary sponsor category [1] 312555 0
None
Name [1] 312555 0
Address [1] 312555 0
Country [1] 312555 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 306943 0
Monash University Human Research Ethics committee
Ethics committee address [1] 306943 0
26 Sports Walk, Clayton VIC 3168
Ethics committee country [1] 306943 0
Australia
Date submitted for ethics approval [1] 306943 0
07/04/2022
Approval date [1] 306943 0
12/04/2022
Ethics approval number [1] 306943 0
26335

Summary
Brief summary
Non-standard work hours in shift work lead to a misalignment between circadian timing and daily behaviours with well-documented adverse consequences for health and safety. Circadian misalignment is implicated in sleep disorders, impaired memory and executive functioning, and poor mental health.A combination of age-dependent cognitive decline, chronicity in circadian misalignment and a higher rate of impaired sleep amplify these risks in older shift workers. Older shift workers perform worse on cognitive tasks, have greater morbidity and experience up to 2.5 times higher risk of dementia in comparison to age-matched day workers.Older adults make a sizeable proportion of shift workers in Australia, including healthcare industry, providing them support can help with improving their health and wellbeing.

In this study, we seek to examine the efficacy of an app-based intervention that delivers sleep recommendations based on shift schedules and personal commitments. These recommendations are evidence-based and tested in lab and real-world settings for safety and efficacy. We also aim to examine whether the app is effective in improving sleep, mental health and performance in both younger and older nurses (i.e. 45 years or above).
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 105530 0
Dr Prerna Varma
Address 105530 0
Dr Prerna Varma/Dr Tracey Sletten
Turner Institute for Brain and Mental Health
Monash University
Address: Building 2
264 Ferntree Gully, Notting Hill VIC 3168
Country 105530 0
Australia
Phone 105530 0
+61 399050150
Fax 105530 0
Email 105530 0
prerna.varma@monash.edu
Contact person for public queries
Name 105531 0
Prerna Varma
Address 105531 0
Dr Prerna Varma/Dr Tracey Sletten
Turner Institute for Brain and Mental Health
Monash University
Address: Building 2
264 Ferntree Gully, Notting Hill VIC 3168
Country 105531 0
Australia
Phone 105531 0
+61 399050150
Fax 105531 0
Email 105531 0
prerna.varma@monash.edu
Contact person for scientific queries
Name 105532 0
Prerna Varma
Address 105532 0
Dr Prerna Varma/Dr Tracey Sletten
Turner Institute for Brain and Mental Health
Monash University
Address: Building 2
264 Ferntree Gully, Notting Hill VIC 3168
Country 105532 0
Australia
Phone 105532 0
+61 399050150
Fax 105532 0
Email 105532 0
prerna.varma@monash.edu

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment


What supporting documents are/will be available?

Doc. No.TypeCitationLinkEmailOther DetailsAttachment
16307Study protocol    Study protocol will be published in a peer-reviewe... [More Details]



Results publications and other study-related documents

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