Daytime vs Evening Rehabilitation in Lumbar Disc Herniation Patients at High Risk for Obstructive Sleep Apnea
Starting soon · Not applicable
Conditions studied: Lumbar Disc Herniation, Obstructive Sleep Apnea Risk Management
In brief
Lumbar disc herniation is a common musculoskeletal condition that negatively affects quality of life, physical function, and daily activities. Previous studies have shown that individuals with lumbar disc herniation often experience poor sleep quality, which is closely related to pain severity and functional limitations. In addition, a bidirectional relationship exists between chronic pain and sleep disturbances, where poor sleep can increase pain perception, and pain can further impair sleep. Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with reduced sleep quality, daytime dysfunction, and adverse health outcomes. The STOP-Bang questionnaire (Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) is a widely used and practical screening tool to identify individuals at high risk for OSA in clinical settings. Physiotherapy and rehabilitation programs are commonly used in the conservative management of lumbar disc herniation and have been shown to improve pain and functional outcomes. However, the effect of the timing of rehabilitation (daytime versus evening) on sleep-related outcomes has not been sufficiently investigated. Considering that circadian rhythms influence pain perception, physiological processes, and sleep regulation, the timing of rehabilitation interventions may play an important role in clinical outcomes. Therefore, this randomized controlled trial aims to investigate the effects of daytime versus evening rehabilitation programs on sleep quality and daytime sleepiness in patients with lumbar disc herniation who are at high risk for obstructive sleep apnea.
Key facts
- Study ID
- NCT07522021
- Run by
- Mardin Artuklu University
- People needed
- 60
- Starts
- 2026-04-10
- Expected to finish
- 2026-11-12
- Last updated by the study team
- 2026-04-13
Who can join
Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Individuals aged 18-65 years
- High risk for obstructive sleep apnea, defined as a score >4 on the STOP-Bang questionnaire (Snoring, Tiredness, Observed apnea, high blood pressure, Body mass index, Age, Neck circumference, and Gender)
- Presence of lumbar disc herniation (bulging, protrusion, or extrusion) at L1-S1 levels confirmed by magnetic resonance imaging (MRI)
- Chronic low back pain lasting at least 3 months with clinical symptoms consistent with imaging findings
- Mild to moderate radicular symptoms For participants over 55 years of age: single-level or dominant-level protrusion or extrusion-type disc herniation to minimize confounding effects of multilevel degeneration
- Pain intensity ≥4 on the Visual Analog Scale (VAS) within the last week
- Ability to participate regularly in the physiotherapy and rehabilitation program
- Willingness to provide written informed consent Exclusion Criteria:
- Presence of sequestrated disc herniation or cauda equina compression confirmed by magnetic resonance imaging (MRI)
- Progressive motor deficit or significant muscle weakness
- Indication for urgent surgical intervention
- History of previous lumbar spine surgery
- Low back pain due to specific causes (e.g., spinal tumor, infection such as spondylodiscitis, inflammatory rheumatic diseases, or traumatic fracture)
- Previous use of continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy
- Shift work or irregular sleep patterns
- Major changes in sleep medication within the last 4 weeks
- Contraindications to electrotherapy (e.g., pacemaker or implanted electronic devices, suspected malignancy, sensory loss in the treatment area, open wounds, or infection)
- Cardiopulmonary conditions that contraindicate exercise
- Uncontrolled hypertension or advanced heart failure
- Pregnancy
- Severe psychiatric disorders or cognitive impairment
- Neurological disorders (e.g., multiple sclerosis, stroke sequelae)
- Epidural or facet joint injection within the last 3 months
- Diagnosed severe obesity hypoventilation syndrome or severe chronic obstructive pulmonary disease (COPD)
- Refusal to provide informed consent
Full record on ClinicalTrials.gov
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