ClinicalTrials.gg
CompletedNCT04897581BBTI_PSR_21Updated Jun 17, 2026

BBTI vs PSR in Musculoskeletal Orofacial Pain Adults

An interventional study of Brief Behavioral Therapy for Insomnia, BBTI and Physical Self-Regulation, PSR in Myofascial Pain and Myalgia, sponsored by Ian Boggero, PhD. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-17.

Sponsored by Ian Boggero, PhD · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
19
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This clinical study aims to compare the efficacy of two brief psychological interventions: Brief Behavioral Therapy for Insomnia (BBIT) and Physical Self-Regulation or (PSR) delivered over telehealth for the management of chronic musculoskeletal orofacial pain conditions (local myalgia, myofascial pain, centrally mediated myalgia) in a tertiary orofacial pain clinic. It is hypothesized that both interventions will produce beneficial changes and exploratory analysis will aim to establish which intervention -if any- is better for each specific outcome.

Read the detailed description

New patients who come into the orofacial pain clinic are evaluated by a dental resident and given an orofacial pain diagnosis. If this primary diagnosis involves masticatory myofascial pain, local myalgia, or centrally-mediated myalgia, and if patients self-report poor sleep, they will be introduced to the study. An initial evaluation for PSR and BBTI will be scheduled over telehealth. If willing and eligible to participate, at the end of this first evaluation, they will be provided with an informed consent form and be randomly assigned to three sessions of PSR or three sessions of BBTI. After providing an e-consent, they will be sent a questionnaire battery on REDCap to assess their outcomes at pre-intervention. A REDCap daily questionnaire will be sent every day (morning and evening) starting one week before session 1 of the intervention, until two weeks after the last session. Moreover, to a small group of patients randomly selected, an actigraphy watch will be mailed. Two weeks after the last session of the intervention, a REDCap questionnaire will be sent to assess their outcomes at post-intervention. As per the current clinical protocol, all participants will be offered both interventions; only data from the first intervention will be utilized for the current study. All PSR and BBTI sessions will be conducted via telehealth using a HIPAA-compliant zoom account.

02

Conditions studied

  • Myofascial Pain
  • Myalgia

Keywords

  • local myalgia
  • centrally-mediated myalgia
  • masticatory pain
  • sleep
  • insomnia
  • behavioral therapy
  • self-regulation
  • depression
  • anxiety
  • fatigue
03

In context

Myalgia

256 studies on the registry are indexed under Myalgia; 46 are open to participants now.

This study's enrollment of 19 is below the median of 44 across 216 interventional studies indexed under Myalgia.

Browse Myalgia studies →

Lead sponsor

Ian Boggero, PhD is the lead sponsor of 2 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • present with a score on Insomnia Severity Index > 15
  • have a primary diagnosis of chronic (onset more than 3 months before) MSK pain (myofascial pain and/or local myalgia and/or centrally mediated myalgia) from a board-certified orofacial pain specialist at UK Orofacial Pain Clinic
  • maintain a stable medication regime in previous month and during the intervention
  • older than 18 years old
  • able to understand English
  • willing to participate to telehealth intervention
  • have internet access and an email address
  • present with total STOP BANG score \< 5

Exclusion criteria

Exclusion Criteria:

  • less than 18 years old
  • unable to provide
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
19 participants (actual)

Study arms

  • Experimental
    Brief Behavioral Therapy for Insomnia, BBTI

    Participants in this group will receive 3 sessions of BBTI over telehealth.

    Behavioral: Brief Behavioral Therapy for Insomnia, BBTI

  • Experimental
    Physical Self-Regulation, PSR

    Participants in this group will receive 3 sessions of PSR over telehealth.

    Behavioral: Physical Self-Regulation, PSR

Interventions

  • BehavioralBrief Behavioral Therapy for Insomnia, BBTI

    BBTI includes sleep hygiene, stimulus control, and sleep restriction, and is administered in three 50-minute sessions over telehealth by psychologic team.

  • BehavioralPhysical Self-Regulation, PSR

    PSR is conducted over telehealth and consists of three 50-minute sessions focused on jaw relaxation exercises, proprioceptive awareness training, and diaphragmatic breathing entrainment.

06

What researchers measure

Primary outcomes

  1. Change in Self-report Insomnia Symptoms

    Insomnia symptomatology will be assessed via the Insomnia Severity Index (ISI). The ISI includes seven items (sleep-onset, sleep maintenance, early morning awakening, satisfaction with current sleep pattern, interference with daily functioning, impairment attributed to sleep problems, distress caused by sleep problems), related to the prior 2 weeks on a five-point Likers scale (0= no problem, 4 = severe problem). The total score ranges from 0 to 28, with 28 indicating severe insomnia. The cut-off for the present study is 15. The ISI has good internal consistency and is demonstrated to be sensitive to changes in sleep of older adults following behavioral treatment for insomnia. Clinical improvement is defined as a reduction of ISI below the cut-off of 15.

    Time frame: At pre-intervention (1 week before starting with the intervention) and post-intervention (2 weeks after the last session of the intervention)

  2. Change in Self-report Average Pain Intensity

    The average pain intensity will be assessed using a Numeric Rating Scale (NRS) on a 10-point scale, where 0 coincides with "no pain" and 10 coincides with "worse pain ever felt".

    Time frame: At pre-intervention (1 week before starting with the intervention), post-intervention (2 weeks after the last session of the intervention)

  3. Change in Self-report Quality of Life

    The overall quality of life will be assessed with 12-Item Short Form Health Survey (SF-12), a 12-item questionnaire designed to measure general health by addressing eight domains: limitations in social, physical, usual role activities because of physical health and emotional problems; bodily pain; general mental health; vitality; general health perceptions. SF-12 has been shown to reflect change over time like the long form SF-36 and to demonstrate good reliability and validity . Studies have addressed the impact of orofacial pain and sleep problems on health-related quality of life. The average score of the US population is set at 50. A score below this cut-off identifies a poor self-report quality of life.

    Time frame: At pre-intervention (1 week before starting with the intervention), post-intervention (2 weeks after the last session of the intervention)

Secondary outcomes

  1. Change in Self-report Sleep Quality

    The sleep quality will be assessed via the RU-SATED, constituted by 6 items. RU-SATED appears to be a valid instrument for the assessment of sleep health among adults that is related to, but distinct from, other established sleep constructs. It provides a score from 0 to 12, with response to 6 questions. The lower the score, the worse the self-report sleep quality of the patient.

    Time frame: At pre-intervention (1 week before starting with the intervention), post-intervention (2 weeks after the last session of the intervention)

  2. Sleep architecture

    Sleep architecture will be assessed subjectively via daily morning and evening sleep diaries, sent to the participants via a REDCap survey. It will be assessed objectively via an actigraphy watch. The measured variables are sleep efficiency (SE), total sleep time (TST), sleep onset latency (SOL), number of awakening per night (NOA). For such variable, the change in outcomes will be collected; therefore, there is not a scale for measuring the change.

    Time frame: Each morning and each evening from the first session to 2 weeks after the last session of the intervention

  3. Change in Self-report Depression Symptoms

    Depression symptoms will be assessed at pre- and post-intervention via Pain-Health Questionnaire-4 (PHQ4). The Pain-Health Questionnaire (PHQ, 4 items) allows for a brief and accurate measurement of signs/symptoms of anxiety and depression, by providing an overall measure of symptom burden, as well as functional impairment and disability with a 4-point scale . PHQ-4 has demonstrated strong psychometric properties and have been validated for use in the general population. The first two questions of PHQ4 (PHQ-2) consists of core criteria for depression. The score goes from 0 to 4 for each question (for a total of 8, being 8 the most severe depression symptoms), and a score of 3 or above on the Depression subscale represent a reasonable cut off point for identifying potential cases of depression and a psychologist or counselor referral will be offered. Depression symptoms will be also monitored daily via morning and evening daily diaries, sent to the participant via a REDCap survey. �

    Time frame: At pre-intervention (one week before the first session of the intervention), at post-intervention (two weeks after the last session of the intervention) and every day during the intervention period

  4. Change in Self-report Anxiety Symptoms

    Anxiety symptoms will be assessed at pre- and post-intervention via Pain-Health Questionnaire-4 (PHQ4). The Pain-Health Questionnaire (PHQ, 4 items) allows for a brief and accurate measurement of signs/symptoms of anxiety and depression, by providing an overall measure of symptom burden, as well as functional impairment and disability with a 4-point scale. PHQ-4 has demonstrated strong psychometric properties and have been validated for use in the general population. The last two questions (GAD-2) consists of core criteria for anxiety, with score going from 0 (no symptoms) to 4 (most severe anxiety symptoms) for each question. A score of 3 or above on the Anxiety subscale represents a reasonable cut off point for identifying potential cases of depression and a psychologist or counselor referral will be offered. Anxiety and depression symptoms will be also monitored daily via morning and evening daily diaries, sent to the participant via a REDCap survey. �

    Time frame: At pre-intervention (one week before the first session of the intervention), at post-intervention (two weeks after the last session of the intervention) and every day during the intervention period

  5. Change in Self-report Headache Intensity

    Headache measures will investigate the severity of headache on a 10-point scale (Numeric Rating Scale, NRS), with 0 identifying "no pain", and 10 identifying "the worst pain experienced".

    Time frame: At pre-intervention (one week before the first session of the intervention), at post-intervention (two weeks after the last session of the intervention)

  6. Change in Self-report Headache Frequency

    This questionnaire investigate headache disability (in terms of lack of productivity, missing working days or school days), frequency and intensity will be also assessed using the Migraine Disability Assessment Test (MIDAS, 6-item). Each item identifies the total number of days per month of headache frequency (being 0 "no days of headache" and being 30 "each day with headache"). The minimum score is 0, the maximum is 150, with the upper limit identifying the highest frequency of headaches.

    Time frame: At pre-intervention (one week before the first session of the intervention), at post-intervention (two weeks after the last session of the intervention)

07

Study locations

1 site
  • University of Kentucky
    Lexington, Kentucky 40536, United States
08

References and documents

Publications

  • Ballou S, Katon J, Rangan V, Cheng V, Nee J, Iturrino J, Lembo A. Brief Behavioral Therapy for Insomnia in Patients with Irritable Bowel Syndrome: A Pilot Study. Dig Dis Sci. 2020 Nov;65(11):3260-3270. doi: 10.1007/s10620-020-06182-w. Epub 2020 Mar 9. PubMed 32152868 ↗

Individual participant data

Plan to share: No — The data will be de-identified from the sensible data information. The data will be retained for 5 years after the end of the study. There is no intension to share the IPD with other researchers. However, the data collected from this study will be utilised by the investigators for possible future studies.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Oct 2021 to primary completion in May 2023, 19 months.

Of 101 non-industry interventional studies with no phase under Myalgia, half reached primary completion within 8 months of starting (the median), counting those still running; a quarter within 3 and three quarters within 16. This study's 19 months is above that.

Counting every sponsor, half of 111 studies reached it within 8 months; a quarter within 3 and three quarters within 16.

How these figures are worked out, and which studies are left out of them.

Registered
May 14, 2021
First posted
May 21, 2021
StartActual
Oct 21, 2021
Primary completionActual
May 23, 2023
CompletionActual
May 23, 2023
Last update
Jun 17, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 17, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04897581
Lead sponsor
Ian Boggero, PhD
Responsible party
Ian Boggero, PhD (Assistant Professor, University of Kentucky) — Sponsor-investigator
First posted
May 21, 2021
Start date
Oct 21, 2021
Primary completion
May 23, 2023
Completion
May 23, 2023
Last update
Jun 17, 2026

Study contacts

Ian Boggero, PhD
principal investigator · University of Kentucky

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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