ClinicalTrials.gg
CompletedNCT07178496Updated Sep 22, 2026

Sleep Hygiene Plus Physiotherapy for Sleep and Disability in Chronic Neck Pain

An interventional study of Sleep Hygiene Techniques and conventional physiotherapy program in Neck Pain, Neck Pain Musculoskeletal and Sleep Disturbances, sponsored by Al-Azhar University. Completed at 1 site in Palestinian Territories. Open to participants aged 25 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-22.

Sponsored by Al-Azhar University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
99
Allocation
Randomized
Ages
25 Years to 55 Years
Sex
All
01

Study summary

This study investigates the effectiveness of a combined intervention that integrates sleep hygiene education with physiotherapy exercises in patients suffering from chronic neck pain. Chronic neck pain is often associated with both musculoskeletal dysfunction and secondary sleep disturbances, which in turn may exacerbate pain perception, fatigue, and disability. Traditional physiotherapy exercise programs focus primarily on improving cervical mobility, muscle strength, and postural control, but they do not typically address sleep-related problems that can hinder recovery.

The intervention in this study consists of two main components:

Physiotherapy Exercise Program - A structured regimen targeting cervical spine mobility, deep cervical flexor strengthening, scapular stabilization, and postural correction. These exercises aim to reduce pain, restore function, and improve overall physical performance.

Sleep Hygiene Education - A structured educational module covering principles of healthy sleep habits, including maintaining consistent sleep-wake schedules, creating an optimal sleep environment, limiting stimulants before bedtime, and adopting relaxation strategies to promote better sleep initiation and maintenance.

By combining these approaches, the intervention addresses not only the physical impairments associated with chronic neck pain but also the psychosocial and behavioral factors contributing to poor sleep quality.

Outcome Measures:

Primary Outcomes: Sleep quality, assessed using validated tools such as the Pittsburgh Sleep Quality Index (PSQI).

Secondary Outcomes: Disability and functional limitations, measured by the Neck Disability Index (NDI), along with pain intensity assessed using a Visual Analog Scale (VAS).

Fatigue will be assessed by fatigue inventory index

Study Hypothesis: The combined intervention of sleep hygiene education and physiotherapy exercise will lead to greater improvements in sleep quality and reductions in disability and fatigue compared to physiotherapy exercise alone.

Clinical Significance: If effective, this integrative approach may provide a cost-effective, non-pharmacological management strategy for patients with chronic neck pain, targeting both physical and behavioral contributors to their condition.

02

Conditions studied

  • Neck Pain
  • Neck Pain Musculoskeletal
  • Sleep Disturbances
  • Fatigue, Mental

Keywords

  • sleep quaity
  • sleep hygiene
  • neck pain
03

In context

Neck Pain

1,360 studies on the registry are indexed under Neck Pain; 299 are open to participants now.

This study's enrollment of 99 is above the median of 50 across 1,116 interventional studies indexed under Neck Pain.

Browse Neck Pain studies →

Lead sponsor

Al-Azhar University is the lead sponsor of 531 studies on the registry; 172 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

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

04

Who can participate

Ages eligible
25 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

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

Participants will be eligible for the study if they meet the following conditions:

  1. Adults aged 25-55 years.
  2. Clinical diagnosis of chronic neck pain, defined as symptoms persisting for more than 3 months.
  3. Poor sleep quality, indicated by a Pittsburgh Sleep Quality Index (PSQI) score >5.
  4. Willingness to participate and comply with both the physiotherapy and sleep hygiene intervention program.
  5. Ability to provide .

Exclusion criteria

Exclusion Criteria

Participants will be excluded if any of the following conditions are present:

  1. History of cervical spine trauma, surgery, or fracture within the past 6 months.
  2. Severe depression or anxiety, defined by scores above the severe threshold on the Hospital Anxiety and Depression Scale (HADS).
  3. Neurological disorders affecting neck function (e.g., cervical radiculopathy, myelopathy).
  4. Other musculoskeletal disorders causing significant neck or shoulder pain.
  5. Sleep disorders unrelated to neck pain (e.g., obstructive sleep apnea, restless legs syndrome, narcolepsy), whether diagnosed or suspected.
  6. Ongoing pharmacological treatments that may significantly affect sleep (e.g., sedatives, hypnotics), unless the patient has been on a stable dose for >3 months.

6 Uncontrolled systemic illnesses such as diabetes, cardiovascular disease, or cancer.

7 Pregnancy.

8 Participation in any recent physiotherapy program targeting neck pain within the last 3 months.

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
None (open label)
Enrollment
99 participants (actual)

Study arms

  • Experimental
    Group receive conventional Physiotherapy program

    Conventional Physiotherapy Program 1. Treatment Frequency and Duration Frequency: 3 sessions per week Duration: 8 weeks Session length: 45-60 minutes 2. Hot Pack Application (10-15 minutes) Purpose: Reduce pain, improve soft-tissue extensibility, and prepare muscles for exercise. Procedure: Moist hot pack applied to the cervical region. Temperature: 40-45°C (comfortable warmth, checked to avoid burns). Duration: 10-15 minutes with adequate towel layers. Neck Endurance and Strength Training (30-40 minutes)

    Other: conventional physiotherapy program

  • Experimental
    Group receive conventional Physiotherapy program plus sleep hygiene technique

    Exercise and 1. Delivery Method Initial Education Session: A 45-minute one-on-one session with a physiotherapist or trained researcher. Delivered face-to-face using visual aids (slides, posters, printed guide). Explains what sleep hygiene is, why it matters in chronic neck pain, and how to apply each strategy. Follow-up Sessions: Weekly 15-20-minute reinforcement sessions (in-person or by phone/video call). Used to review progress, clarify doubts, troubleshoot barriers, and adjust advice if necessary. Written Materials: A patient booklet summarizing all recommendations in simple language, including diagrams of neck-friendly sleeping postures. A daily sleep diary to track bedtime, wake time, naps, and perceived sleep quality. 2. Program Content A. Regular Sleep-Wake Timing Go to bed at the same time every night and wake at the same time every morning, even on weekends. Use alarms only for waking, not for forcing sleep onset. Limit naps to \<30 minutes, no later than 4

    Other: Sleep Hygiene Techniques

  • Other
    control

    advices and home program

    Other: Control arm

Interventions

  • OtherSleep Hygiene Techniques

    Sleep Hygiene Techniques The sleep hygiene program includes education and behavioral strategies to promote healthier sleep patterns, delivered alongside physiotherapy exercises. Key components are: Regular Sleep-Wake Schedule Encourage patients to maintain consistent bedtime and wake-up times, even on weekends. Avoid excessive time in bed when not sleeping. Optimizing the Sleep Environment Ensure a quiet, dark, and cool bedroom (18-22°C). Use supportive pillows to maintain neutral cervical alignment and reduce neck strain. Remove distractions such as TVs, mobile phones, and bright lights. Pre-Sleep Routine Establish a relaxing wind-down routine (e.g., gentle stretching, breathing exercises, reading). Avoid mentally stimulating activities or heavy problem-solving before bedtime. Limiting Stimulants and Alcohol Avoid caffeine, nicotine, and alcohol at least 4-6 hours before bedtime. Avoid heavy meals close to bedtime; a light snack is acceptable if hungry. Daytime Habits t

  • Otherconventional physiotherapy program

    Conventional Physiotherapy Program 1. Treatment Frequency and Duration Frequency: 3 sessions per week Duration: 8 weeks Session length: 45-60 minutes 2. Hot Pack Application (10-15 minutes) Purpose: Reduce pain, improve soft-tissue extensibility, and prepare muscles for exercise. Procedure: Moist hot pack applied to the cervical region. Temperature: 40-45°C (comfortable warmth, checked to avoid burns). Duration: 10-15 minutes with adequate towel layers. 3. Neck Endurance and Strength Training (30-40 minutes)

  • OtherControl arm

    only advices and home advices Physiotherapy Advice for Patients with Neck Pain Adhere to Your Exercise Program Perform the prescribed neck strengthening and endurance exercises daily. Focus on quality over quantity-slow, controlled movements are more effective. Maintain Correct Posture During All Activities Keep your neck in a neutral position whether sitting, standing, or walking. Incorporate Frequent Micro-Breaks Every 30-45 minutes, pause to gently move and stretch your neck and shoulders. Small posture corrections throughout the day prevent stiffness. Use Heat Before Exercise if Stiff or Painful Apply a hot pack for 10-15 minutes before exercises to relax muscles. Avoid prolonged or excessive heat application. Stay Active - Avoid Prolonged Rest Light physical activity (walking, cycling, gentle mobility work) helps recovery. Bed rest should be avoided unless pain is severe. Practice Relaxation and Breathing C

06

What researchers measure

Primary outcomes

  1. PSQI to assess sleep quality

    Pittsburgh Sleep Quality Index (PSQI): The PSQI is a widely used and validated self-reported questionnaire designed to assess sleep quality and disturbances over a 1-month period. It consists of 19 individual items that generate seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each component is scored on a 0-3 scale, and the sum of these components yields a global score ranging from 0 to 21, with higher scores indicating poorer sleep quality. A global score greater than 5 is typically used to distinguish poor sleepers from good sleepers. The PSQI provides a comprehensive overview of both qualitative and quantitative aspects of sleep, making it a suitable primary outcome measure in this study.

    Time frame: pre and 8 weeks post interventions as well as 8 weeks follow up

  2. NDI to assess Disability related to neck pain

    Neck Disability Index (NDI): The NDI is a standardized, condition-specific outcome measure used to determine the level of disability in individuals with neck pain. It contains 10 items addressing pain intensity and the impact of neck pain on daily activities such as personal care, lifting, reading, concentration, work, driving, sleeping, and recreation. Each item is scored on a 0-5 scale, with the total score ranging from 0 to 50, which can then be expressed as a percentage. Higher scores reflect greater disability. The NDI is recognized as a reliable and valid tool for evaluating functional limitations and tracking treatment progress in patients with chronic neck pain.

    Time frame: Pre, 8 weeks post PT intervention's and 8 weeks follow up

Secondary outcomes

  1. VAS to assess Pain

    Visual Analog Scale (VAS) for Pain: The VAS is a simple, validated tool used to measure pain intensity. It typically consists of a 10-centimeter horizontal line, with the left end representing "no pain" and the right end representing "worst imaginable pain." Patients are asked to mark a point along the line that best represents their perceived pain intensity at the time of assessment. The score is determined by measuring the distance in centimeters from the left end of the line to the patient's mark, yielding a score between 0 and 10. The VAS is highly sensitive to changes in pain over time and is widely used in clinical and research settings to evaluate treatment effectiveness.

    Time frame: Pre, 8 weeks post PT and 8 weeks follow up

  2. FSS to assess Fatigue

    Fatigue Severity Scale (FSS): The Fatigue Severity Scale is a self-reported questionnaire designed to assess the severity and impact of fatigue on daily functioning. It consists of nine statements that evaluate how fatigue interferes with motivation, exercise, physical functioning, and social life. Each statement is rated on a 7-point Likert scale, ranging from 1 (strongly disagree) to 7 (strongly agree). The mean of all item scores is calculated, with higher scores indicating greater fatigue severity. The FSS is a reliable and valid measure, particularly relevant in chronic pain populations, as fatigue is a common and often overlooked symptom that contributes significantly to reduced quality of life.

    Time frame: Pre, 8 weeks post PT interventions, and 8 weeks follow up

07

Study locations

1 site
  • Naser medical complex
    Gaza, Palestinian Territories
08

References and documents

Publications

  • Gupta CC, Sprajcer M, Johnston-Devin C, Ferguson SA. Sleep hygiene strategies for individuals with chronic pain: a scoping review. BMJ Open. 2023 Feb 2;13(2):e060401. doi: 10.1136/bmjopen-2021-060401. PubMed 36731933 ↗

Individual participant data

Plan to share: Undecided

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 2025 to primary completion in Aug 2026, 9 months.

Of 763 non-industry interventional studies with no phase under Neck Pain, half reached primary completion within 7 months of starting (the median), counting those still running; a quarter within 3 and three quarters within 15. This study's 9 months is above that.

Counting every sponsor, half of 772 studies reached it within 7 months; a quarter within 3 and three quarters within 15.

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

Registered
Aug 27, 2025
First posted
Sep 17, 2025
StartActual
Oct 15, 2025
Primary completionActual
Aug 1, 2026
CompletionActual
Aug 2, 2026
Last update
Sep 22, 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 Sep 22, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07178496
Responsible party
Mosab ALdabbas (Assistant Professor, Al Zhar University, Gaza, Palestine _ Field physiotherapy Officer, International committee of the red cross, Gaza, Al-Azhar University) — Principal investigator
First posted
Sep 17, 2025
Start date
Oct 15, 2025
Primary completion
Aug 1, 2026
Completion
Aug 2, 2026
Last update
Sep 22, 2026

Oversight

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

Not currently enrolling

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

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion