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Abstract

Objective: Brief behavioral interventions targeting pain (Physical Self-Regulation, PSR) or sleep (Brief Behavioral Intervention for Insomnia, BBTI) show promise for interdisciplinary management of chronic pain, though their feasibility with chronic musculoskeletal orofacial pain (MSK-OFP) populations remains underexplored. This pilot study assessed the feasibility of a randomized clinical trial (RCT) of these interventions in a university-affiliated tertiary OFP clinic and explored clinical changes in pain, sleep, and other secondary outcomes.

Methods: Treatment-seeking participants (N=19) with chronic MSK-OFP and insomnia were randomized to three-session PSR or BBTI. At pre- and post-intervention, participants completed questionnaires (assessing pain intensity, insomnia symptomatology, sleep quality, headache disability, fatigue, jaw-movement limitations, and quality of life), 8 consecutive days of actigraphy and morning/evening diaries. Feasibility outcomes were recruitment, retention, and adherence rates. Clinical outcomes included clinically-meaningful reductions in insomnia symptoms (Insomnia Severity Index [ISI]< 15) and pain intensity (>2.5 point on 0–10 Numerical Rating Scale).

Results: Over a 17-month period, of 19 consenting participants (88.9% females, 38.4±12.2y/o, recruitment rate: 1.1/month),12 (92% females, 38.5±11.5y/o) completed the study (retention rate: 63.2%) with high completion rate (questionnaires: 95.8%, daily diaries: 95%, actigraphy: 100%). Despite no significant changes in pain, ISI scores decreased by 6.0 and 4.8-points among BBTI and PSR groups. Improvements in sleep quality, headache disability, fatigue, jaw-movement limitations, and quality of life wereobserved.

Conclusion: RCTs of brief behavioral interventions are feasible in tertiary-OFP clinics.

Document Type

Article

Publication Date

2026

Notes/Citation Information

© 2025 Taylor & Francis Group, LLC

Digital Object Identifier (DOI)

https://doi.org/10.1080/08869634.2025.2476606

Funding Information

This research was funded by a Fellowship from the Graduate School of the University of Kentucky, Research Grant from the American Academy of Orofacial Pain (AAOP). Research reported in this publication was also supported by the National Institute of Dental & Craniofacial Research of the National Institutes of Health under Award Number [K23DE031807]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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