Phase 2
N=549
Efficacy of Ramelteon on Speeding Up Sleep in Subjects With Delayed Sleep Phase Syndrome
Sleep Disorders, Circadian Rhythm
Bottom Line
View on ClinicalTrials.gov: NCT00593736 ↗Enrolled (actual)
549
Serious AEs
0.0%
Results posted
Mar 2010
Primary outcome: Primary: Latency to Persistent Sleep Over a 2-night Average Measured by Polysomnography (Nights 6-7) — 59.30; 39.40; 55.94; 55.12 minutes — p=0.646
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Ramelteon (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Takeda
- Primary completion
- May 2008
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Latency to Persistent Sleep Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
59.30; 39.40; 55.94; 55.12 | 0.646 |
| SECONDARY Latency to Persistent Sleep Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
48.36; 38.61; 45.29; 46.64 | 0.854 |
| SECONDARY Total Sleep Time Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
376.41; 383.51; 378.62; 366.23 | 0.365 |
| SECONDARY Total Sleep Time Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
389.72; 378.04; 379.17; 388.51 | 0.920 |
| SECONDARY Sleep Efficiency Over a 2-night Average Measured by Polysomnography (0-3 Hours) (Nights 6-7) |
64.49; 71.83; 65.70; 64.64 | 0.973 |
| SECONDARY Sleep Efficiency Over a 2-night Average Measured by Polysomnography (0-3 Hours) (Nights 13-14) |
69.07; 75.13; 70.19; 70.99 | 0.661 |
| SECONDARY Sleep Efficiency Over a 2-night Average Measured by Polysomnography (0-8 Hours) (Nights 6-7) |
78.42; 79.90; 78.89; 76.30 | 0.365 |
| SECONDARY Sleep Efficiency Over a 2-night Average Measured by Polysomnography (0-8 Hours) (Nights 13-14) |
81.09; 79.33; 78.92; 80.80 | 0.900 |
| SECONDARY Wake Time After Sleep Onset Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
46.26; 62.86; 51.06; 62.11 | 0.051 |
| SECONDARY Wake Time After Sleep Onset Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
43.36; 63.47; 59.77; 48.88 | 0.511 |
| SECONDARY Number of Awakenings Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
9.22; 10.79; 10.79; 9.67 | 0.691 |
| SECONDARY Number of Awakenings Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
8.08; 9.33; 9.87; 9.51 | 0.197 |
| SECONDARY Total Wake Time Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
63.92; 50.67; 61.67; 63.63 | 0.972 |
| SECONDARY Total Wake Time Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
55.69; 44.68; 53.64; 52.19 | 0.659 |
| SECONDARY Sleep Time Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
22.40; 22.36; 22.35; 22.35 | 0.206 |
| SECONDARY Sleep Time Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
22.36; 22.36; 22.36; 22.33 | 0.194 |
| SECONDARY Wake Time Over a 2-night Average Measured by Polysomnography (Nights 6-7) |
06.35; 06.31; 06.30; 06.26 | 0.063 |
| SECONDARY Wake Time Over a 2-night Average Measured by Polysomnography (Nights 13-14) |
06.31; 06.21; 06.40; 06.26 | 0.675 |
| SECONDARY Total Sleep Time Measured by Actigraphy (Nights 6-7) |
374.37; 393.37; 370.83; 369.05 | 0.643 |
| SECONDARY Total Sleep Time Measured by Actigraphy (Nights 13-14) |
391.61; 390.76; 370.80; 378.91 | 0.286 |
| SECONDARY Sleep Efficiency Measured by Actigraphy (Nights 6-7) |
85.79; 83.46; 81.38; 82.72 | 0.040 sig |
| SECONDARY Sleep Efficiency Measured by Actigraphy (Nights 13-14) |
84.98; 82.91; 81.31; 83.24 | 0.352 |
| SECONDARY Wake Time During Sleep Interval Measured by Actigraphy (Nights 6-7) |
41.81; 51.98; 54.70; 53.14 | 0.053 |
| SECONDARY Wake Time During Sleep Interval Measured by Actigraphy (Nights 13-14) |
48.11; 54.72; 52.36; 51.32 | 0.566 |
| SECONDARY Wake Bouts Measured by Actigraphy (Nights 6-7) |
20.98; 22.91; 23.32; 22.82 | 0.356 |
| SECONDARY Wake Bouts Measured by Actigraphy (Nights 13-14) |
23.42; 24.21; 23.52; 22.78 | 0.698 |
| SECONDARY Sleep Latency Measured by Actigraphy (Nights 6-7) |
12.53; 18.05; 25.00; 12.42 | 0.979 |
| SECONDARY Sleep Latency Measured by Actigraphy (Nights 13-14) |
12.10; 16.40; 25.43; 12.36 | 0.975 |
| SECONDARY Sleep Time Measured by Actigraphy (Nights 6-7) |
23.28; 22.75; 23.11; 23.31 | 0.823 |
| SECONDARY Sleep Time Measured by Actigraphy (Nights 13-14) |
22.83; 22.71; 23.11; 23.18 | 0.092 |
| SECONDARY Wake Time Measured by Actigraphy (Nights 6-7) |
06.20; 06.18; 06.23; 06.36 | 0.298 |
| SECONDARY Wake Time Measured by Actigraphy (Nights 13-14) |
06.13; 06.08; 06.16; 06.30 | 0.349 |
| SECONDARY Subjective Sleep Latency Measured by a Post-sleep Questionnaire (Nights 6-7) |
103.55; 84.46; 92.79; 97.28 | 0.581 |
| SECONDARY Subjective Sleep Latency Measured by a Post-sleep Questionnaire (Nights 13-14) |
80.57; 69.40; 77.29; 74.75 | 0.561 |
| SECONDARY Subjective Total Sleep Time Measured by a Post-sleep Questionnaire (Nights 6-7) |
348.10; 370.14; 360.57; 341.76 | 0.655 |
| SECONDARY Subjective Total Sleep Time Measured by a Post-sleep Questionnaire (Nights 13-14) |
379.20; 375.73; 365.14; 368.99 | 0.475 |
| SECONDARY Subjective Wake Time After Sleep Onset Measured by a Post-sleep Questionnaire (Nights 6-7) |
35.15; 52.52; 34.41; 47.84 | 0.192 |
| SECONDARY Subjective Wake Time After Sleep Onset Measured by a Post-sleep Questionnaire (Nights 13-14) |
23.49; 45.54; 28.66; 30.52 | 0.379 |
| SECONDARY Subjective Number of Awakenings Measured by a Post-sleep Questionnaire (Nights 6-7) |
2.68; 3.72; 2.92; 3.23 | 0.284 |
| SECONDARY Subjective Number of Awakenings Measured by a Post-sleep Questionnaire (Nights 13-14) |
2.94; 3.72; 3.33; 3.04 | 0.867 |
| SECONDARY Subjective Sleep Quality Measured by a Post-sleep Questionnaire (Nights 6-7) |
4.45; 4.61; 4.33; 4.74 | 0.206 |
| SECONDARY Subjective Sleep Quality Measured by a Post-sleep Questionnaire (Nights 13-14) |
4.27; 4.35; 4.03; 4.20 | 0.796 |
| SECONDARY Subjective Sleep Time Measured by a Post-sleep Questionnaire (Nights 6-7) |
10.36; 10.41; 10.40; 10.40 | 0.766 |
| SECONDARY Subjective Sleep Time Measured by a Post-sleep Questionnaire (Nights 13-14) |
10.36; 10.30; 10.36; 10.40 | 0.722 |
| SECONDARY Subjective Getting up in the Morning Measured by a Post-sleep Questionnaire (Nights 6-7) |
4.68; 4.76; 4.67; 4.88 | 0.498 |
| SECONDARY Subjective Getting up in the Morning Measured by a Post-sleep Questionnaire (Nights 13-14) |
4.46; 4.66; 4.30; 4.28 | 0.519 |
| SECONDARY Subjective Ability to Concentrate in the Morning Measured by a Post-sleep Questionnaire (Nights 6-7) |
4.31; 4.30; 4.40; 4.48 | 0.425 |
| SECONDARY Subjective Ability to Concentrate in the Morning Measured by a Post-sleep Questionnaire (Nights 13-14) |
3.77; 4.17; 4.01; 4.01 | 0.294 |
| SECONDARY Subjective Level of Alertness Measured by a Post-sleep Questionnaire (Nights 6-7) |
4.43; 4.32; 4.33; 4.53 | 0.655 |
| SECONDARY Subjective Level of Alertness Measured by a Post-sleep Questionnaire (Nights 13-14) |
4.02; 4.32; 3.99; 4.12 | 0.684 |
| SECONDARY Next Morning Residual Effects Assessments of Psychomotor and Cognitive Function Via Digit Symbol Substitution Test |
44.1; 42.4; 39.9; 40.6 | 0.157 |
| SECONDARY Next Morning Residual Effects Assessments of Psychomotor and Cognitive Function Via Memory Recall Test--Immediate |
8.1; 7.7; 8.6; 8.6 | 0.413 |
| SECONDARY Next Morning Residual Effects Assessments of Psychomotor and Cognitive Function Via Memory Recall Test--Delayed |
6.5; 5.9; 6.7; 7.1 | 0.441 |
| SECONDARY Visual Analogue Scale for Mood |
34.2; 33.4; 34.3; 33.4 | 0.860 |
| SECONDARY Visual Analogue Scale for Feelings |
37.3; 34.8; 36.8; 36.9 | 0.837 |
| SECONDARY The Time of Dim Light Melatonin Secretion Onset |
21.40; 21.30; 20.93; 21.21 | 0.513 |
| SECONDARY The Time of Dim Light Melatonin Secretion Offset |
11.21; 10.73; 10.96; 10.85 | 0.307 |
| SECONDARY The Total Duration of Secretion of Melatonin |
1021.8; 1003.1; 980.2; 1027.9 | 0.902 |
| SECONDARY The Area Under the Concentration-time Curve of Melatonin From 0 to 24 Hours |
608.5; 563.3; 528.3; 631.5 | 0.685 |
| SECONDARY Average Cmax (Maximum Observed Plasma Concentration) Calculated as the Average of Three Highest Cmax Observations Within the Sampling Period. |
75.3; 69.3; 65.2; 79.2 | 0.589 |
Summary
The purpose of this study is to evaluate the ability of ramelteon, once daily (QD), to advance the timing of sleep in individuals with delayed sleep phase syndrome.
Eligibility Criteria
Inclusion Criteria
- Females of childbearing potential who is sexually active must agree to use adequate contraception from screening throughout the duration of the study.
- Must have a diagnosis of Delayed Sleep Phase Syndrome according to International Classification of Sleep Disorders criteria for at least 3 months.
- Based on sleep history, subject's habitual sleep time is more than 3 hours later than the desired sleep time.
- Must have had self reported insomnia which is defined per the sleep history as his or her sleep latency of at least 45 minutes when attempting to sleep at desired sleep time required by his or her work or school schedule.
- The subjective sleep latency via Post sleep questionnaire during outpatient screening period must be greater than or equal to 45 minutes during every working night or school night provided the subject went to bed at their desired sleep time.
- During single blind placebo run-in Polysomnography screening nights, subject is instructed to go to bed at their desired bed time and must demonstrate difficulty in falling asleep based on the following criteria:
- During Polysomnography screening nights when the subject goes to bed at their desired sleep time or
- The average of total wake time
- Is in good health as determined by a medical and psychiatric history, physical examination, Electrocardiogram, and serum chemistry and hematology.
- Is able to complete self-rating scales via interactive voice response system, and has a touch tone phone.
- Is willing to comply with study procedures and restrictions with fixed sleep time and wake time during the study and to attend regularly scheduled clinic visits as specified in this protocol.
- Has a body mass index is between 18 and 34 kg/m2, inclusive.
- Has a negative urine test result for selected substances of abuse (including alcohol).
- Has a negative test result for hepatitis B surface antigen and hepatitis C virus antibody or history of human immunodeficiency virus.
- Has not used pharmacological sleep assistance for more than 4 times/week during the 3 months prior to Initial Screening.
- Must have discontinued use of all pharmacological sleep aids beginning 1 week prior to Visit 2 and for the duration of the trial.
Exclusion Criteria
- Has a known hypersensitivity to ramelteon or related compounds, including melatonin and melatonin-related compounds or 5-hydroxytryptophan.
- Has participated in any other investigational study and/or taken any investigational drug within 30 days or 5 half-lives prior to the first dose of study medication, whichever is longer.
- Has flown across greater than 3 time zones within the past 3 months prior to administration of study medication.
- Has sleep schedule changes required by employment (eg, shift worker) within 3 months prior to the administration of study medication.
- Has participated in a weight loss program or has substantially altered their exercise routine within 30 days prior to the administration of study medication.
- Has a history of alcohol abuse within the past 12 months, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, or regularly consumes more than 14 alcoholic drinks per week or consumes any alcoholic drinks within 24 hours of Screening Visit.
- Has a history of drug abuse within the past 12 months.
- Has a current, clinically significant neurological (including cognitive), hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, hematological, or metabolic disease, as determined by the investigator.
- Has a probable current diagnosis of another circadian rhythm disorder or a sleep disorder other than Delayed Sleep Phase Syndrome that is the primary cause of insomnia.
- Had an apnea hypopnea index greater than 10 on the first night of Polysomnography Screening.
- Has periodic limb movements during sleep with arousal index greater than 10 as seen on the first night of Polysomnography screening only.
- Has a pos
Data sourced from ClinicalTrials.gov (NCT00593736). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.