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

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.