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Phase 2 N=549 Randomized Double-blind Treatment

Efficacy of Ramelteon on Speeding Up Sleep in Subjects With Delayed Sleep Phase Syndrome

Sleep Disorders, Circadian Rhythm

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

OutcomeResultp-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
View full record on ClinicalTrials.gov →

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.

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