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

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.

Conditions

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

Interventions

OTHER

Sleep 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

OTHER

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. 3. Neck Endurance and Strength Training (30-40 minutes)

OTHER

Control 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

Sponsors & Collaborators

• Al-Azhar University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

25 Years

Max Age

55 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-10-15

Primary Completion

2026-04-01

Completion

2026-05-02