The goal of this clinical trial is to learn whether sleep hygiene education can improve sleep quality and reduce pain in adults with migraine and/or chronic lower back pain. Poor sleep is common in people with chronic pain and may worsen symptoms. Improving sleep may help break this cycle. The main questions this study aims to answer are: 1. Does a four-week sleep hygiene education program improve sleep quality? 2. Does improved sleep lead to reduced pain intensity and changes in pain sensitivity? This study does not include a comparison group. Each participant serves as their own comparison by completing the same tests before and after the sleep hygiene program. Participants will: * Attend two study visits lasting 30-60 minutes, one at the beginning and one after four weeks * Complete questionnaires about sleep, pain, mood, and quality of life at both visits * Undergo pain sensitivity testing using light pinprick stimulations on the forearm * Receive individual sleep hygiene education and written materials to use at home for four weeks * Complete a short weekly online check-in about sleep habits and pain * Complete a three-month follow-up questionnaire about sleep habits, sleep quality, and pain
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
100
The intervention consists of a structured and standardized sleep hygiene education program delivered in a single in-person session. Participants receive verbal instruction and written materials outlining evidence-based recommendations for improving sleep habits. The content focuses on establishing consistent bedtimes and wake times, creating a good sleep environment, reducing evening exposure to stimulants and electronic devices, developing calming nighttime routines, and adopting healthy daytime behaviors. Participants implement these strategies independently for four weeks.
Change in Sleep Quality (PSQI Global Score)
Sleep quality is measured using the Pittsburgh Sleep Quality Index (PSQI), a validated questionnaire summarized into a global sleep quality score (0-21). Higher scores indicate poorer sleep quality. The primary outcome is the change in PSQI global score after four weeks of sleep hygiene education.
Time frame: Baseline (Visit 1) to 4 weeks (Visit 2)
Change in Sleep Hygiene Behaviors (Sleep Hygiene Index, SHI)
Sleep hygiene behaviors are measured using the Sleep Hygiene Index (SHI), which assesses engagement in behaviors that negatively impact sleep. Higher scores reflect poorer sleep hygiene. Changes across time points will be assessed.
Time frame: Baseline (Visit 1) to 4 weeks (Visit 2); Week 1; Week 2; Week 3; 3-month follow-up
Change in Temporal Summation of Pain (Pinprick Sensitivity Test)
Temporal summation is assessed using a standardized pinprick protocol on the volar forearm. Participants provide pain ratings for a single stimulus and for the last of 10 consecutive stimuli. The outcome is the change in temporal summation response.
Time frame: Baseline (Visit 1) to 4 weeks (Visit 2)
Change in PainDetect
PainDetect assesses neuropathic and centrally mediated pain components. Higher scores indicate a higher likelihood of central sensitization.
Time frame: Baseline (Visit 1) to 4 weeks (Visit 2)
Change in Headache Impact (HIT-6) - for migraine participants only
The HIT-6 assesses the functional impact of headaches. Higher scores indicate greater impairment.
Time frame: Baseline (Visit 1) to 4 weeks (Visit 2)
Long-Term Maintenance of Sleep Hygiene Index, SHI
Assessed via an online questionnaire evaluating whether changes in SHI scores persist three months after the intervention period. Higher scores reflect poorer sleep hygiene adherence.
Time frame: 4 weeks (Visit 2) to 3-month post-intervention follow-up (remote)
Long-Term Maintenance of PSQI
Assessed via an online questionnaire evaluating whether changes in PSQI persist three months after the intervention period. Higher scores indicate poorer quality of sleep.
Time frame: 4 weeks (Visit 2) to 3-month post-intervention follow-up (remote)
Long-Term Pain Intensity Measure - PainDetect
Assessed via an online questionnaire evaluating whether changes in PainDetect scores persist three months after the intervention period. Higher scores indicate a higher likelihood of central sensitization.
Time frame: 4 weeks (Visit 2) to 3-month post-intervention follow-up (remote)
Long-Term Maintenance of Headache Impact (HIT-6) - for migraine participants only
Assessed via an online questionnaire evaluating whether changes in HIT-6 persist three months after the intervention period. Higher scores indicate greater impairment.
Time frame: 4 weeks (Visit 2) to 3-month post-intervention follow-up (remote)
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