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RecruitingInsomniaInsomnia DisorderChronic Insomnia

A SMART Approach to Evaluating the Benefits of Common Prescription and OTC Medications for Insomnia

Eligible age

18–80 yrs

Accepts

All genders

Locations

1 state

Healthy volunteers

No

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About this study

The purpose of this study is to assess the relative effectiveness, safety, and durability of the most commonly used prescription (zolpidem, trazodone) and over-the-counter (OTC) (melatonin, diphenhydramine) medications for insomnia, as well as a less commonly used prescription that may have a better risk/benefit profile (doxepin).

Sponsor: University of Pennsylvania

You may qualify if…

  • Adults aged 18-80 years.
  • Meet DSM-5 criteria for Insomnia Disorder.
  • Score ≥15 on the Insomnia Severity Index (ISI).
  • Sleep initiation and/or maintenance complaints: ≥30 minutes in duration, occurring ≥3 nights/week, with a duration of ≥3 months.
  • Willingness to discontinue use of all sleep-related medications prior to enrollment.
  • Completion of a 2-week washout period before starting any study medication.
  • Willingness to provide clinician assent for participation.

You may not qualify if…

  • Patients will be ineligible if they meet any of the following criteria: self-reported daytime napping (≥1 hour per day on ≥3 days per week); a history of suicidal attempts or current ideation, acute or chronic psychiatric or medical condition not controlled by therapy (according to their primary care physician), or current alcohol or drug misuse; or the diagnoses of (or high risk for) other sleep disorders, including circadian rhythm disorders (phase advance or phase delay syndromes), shift work related sleep disorder ("day sleepers" who work \~11pm to 7am) and those with rotating shiftwork schedules. To determine eligibility, all subjects will be screened using a multitier process including: an online screener; an intake interview; a review of the subjects EMR; and, finally, the receipt of the patient's PCP's assent. The following provides additional listing and details (AD) for the Exclusion Criteria:
  • General Considerations
  • Age \< 18 or \> 80 years old
  • Inadequate English language comprehension
  • Minimal facility with smartphones, computers, i-Pads, or the internet.
  • Women's Health Given the potential for teratogenic effects with at least trazodone (FDA Class C), women intending to become pregnant, or who are pregnant, or who are breastfeeding will not be eligible for the study. Women will be asked to confirm the use of birth control using self-report and, if applicable, by providing evidence of contraceptive medication (e.g., prescription or pill pack). We will perform a urine pregnancy test at baseline for female participants who are of reproductive age to confirm eligibility. At study enrollment, participants will be told to alert the study team and stop taking study medications if they become pregnant. Participants will be asked to test for pregnancy in the event of a missed cycle.
  • Medical and Psychiatric Considerations
  • Acute or unstable psychiatric conditions

Where it's recruiting

Pennsylvania

Philadelphia

Source: ClinicalTrials.gov · NCT07542756 · last updated 2026-06-05