Behavior Disorders, Hyperphagia, Sleep Disorder
Conditions
Brief summary
The main objective is to study the effect of deep propioceptive stimulation with a heavy blanket for 2 weeks compared with a placebo blanket on sleep quality and behavior in patients with PWS
Detailed description
Prader-Willi syndrome (PWS) is a genetic disease associated with sleep disorders whose etiology is partly central due to the inherent hypothalamic deficit. It is associated with low cognitive performance and worsening behavior with more impulsivity, tantrums, scratches and obsession for food. Deep propioceptive stimulation with a heavy blanket (HB) stimulates the parasympathetic system and improves the state of anxiety in persons with autism or other causes of intellectual disability and/or psychopathology. To date, there are no studies evaluating the effect of HB on sleep quality or brain activity in persons with PWS. The main objective is to study the effect of HB for 2 weeks compared to a placebo blanket on sleep quality and behavior in patients with SPW. Methodology: Actigraphy, questionnaires, crossover study in 60 patients with PWS, with HB/placebo blankets (15 days each). Effect of HB on brain connectivity with functional magnetic resonance imaging in 30 patients and 30 controls. Expected results: PWS group will show worse sleep quality and behavior that will improve after using HB. Brain connectivity will be different with/without HB. These favorable changes will help to justify the use of this ecological treatment and its inclusion in the NHS clinical practice guidelines for improving the quality of life of these patients and their caregivers.
Interventions
DEVICEDeep propioceptive stimulation
Participants will start using the blanket (of the arm name), 30 days wash-out and 15d with the other blanket
Sponsors
Instituto de Salud Carlos III
Corporacion Parc Tauli
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Heavy blanket and similar blanket (not heavy)
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients with PWS genetically confirmed at least 16y old willing to participate and being able to be still in the MRI.
Exclusion criteria
1. Age \< 16 years old 2. Presence of uncontrolled Obstructive Sleep Apnea (Residual AHI ≥ 30). 3. Narcolepsy or other sleep disorders with daily somnolence 4. Intolerance to the heavy blanket in spite of previous adaptation sessions 5. Active psychopathological disorder that may interfere with sleep 6. Use of hypnotic or sleep regulator drugs (change of dose in the last 3 months) 7. Contraindications for MRI 8. Impossibility to stay still during MRI adquisition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in number of awakenings | 14 nights | measured by actigraphy |
| Change in duration of awakenings | 14 nights | minutes measured by actigraphy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of tantrums | 15 days | caregivers report |
| number of skin injuries | 15 days | physical examination by the principal investigator or collaborators |
| Interest for food | 15 days | Hyperphagia questionnaire for clinical trials (9 items from 1-4, maximum score 36, more is worse) |
| Brain connectivity | 1 day | functional magnetic resonance imaging |
Countries
Spain
Outcome results
None listed