Related Experiment Video
Updated: Sep 4, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
The Pain of Poor Sleep: A Clinician's Guide to Assessing and Addressing Sleep Dysfunction in People With
Abstract:
BACKGROUND: Poor sleep is highly prevalent among individuals with pain conditions and contributes to increased sensitivity, emotional dysregulation, and impaired recovery. Despite the strong evidence linking sleep disturbances with pain and disability, sleep is rarely addressed systematically. Physical therapists have the opportunity to screen for sleep dysfunction, provide behavioral education, and refer patients to sleep medicine specialists when necessary. CLINICAL QUESTION: How can physical therapists effectively integrate sleep health assessment and behavioral strategies into the management of individuals with musculoskeletal pain conditions? KEY RESULTS: This commentary provides a pragmatic framework for addressing sleep dysfunction in physical therapy. A stepped approach to sleep screening is recommended, focusing on key questions and validated tools to identify insomnia, obstructive sleep apnea, and restless legs syndrome. The role of cognitive behavioral therapy for insomnia (CBT-I) is highlighted, with an emphasis on 4 domains: reducing presleep arousal, increasing sleep drive, entraining circadian rhythm, and promoting sleep hygiene. Sleep hygiene alone has limited impact, but when integrated with other strategies, it supports broader behavioral change. CLINICAL APPLICATION: Physical therapists should routinely assess sleep as part of a comprehensive pain management strategy. Integrating sleep health promotion, screening tools, and appropriate referral pathways into practice supports person-centered pain care. Enhanced training in sleep health for physical therapists will support the delivery of evidence-informed sleep support. JOSPT Open 2026;4(1):12-22. Epub 11 November 2025. doi:10.2519/josptopen.2025.0198.
Related Concept Videos
Insufficient Sleep and Sleep Deprivation
Sleep deprivation is a more severe form of sleep loss...
Insomnia
Multiple factors contribute...
Primary Motives: Sleep, Sex, and Pain Avoidance
Sleep is a fundamental physiological drive that fosters a state of restfulness crucial for several bodily functions. It facilitates body restoration, the process by which the body repairs, rejuvenates, and maintains itself during sleep, including memory...
Understanding Sleep
The circadian rhythm, a nearly 24-hour cycle, is deeply influenced by environmental light cues. Light exposure directly affects the hypothalamus, which in turn regulates...
Management of Insomnia
Sleep-Wake Cycles
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge: