Linda Sangalli: Establishing the Effectiveness of BBTI vs. PSR on Sleep and Pain Parameters in Adults with Musculoskeletal Orofacial Pain

Abstract Chronic musculoskeletal pain in orofacial regions (MSK-OR) affects approximately 5-12% of the population and has an estimated cost of $4.3 billion dollars in US (1). In addition to pain, patients with MSK-OR commonly report disrupted sleep (2). Poor sleep has been shown to exacerbate pain intensity in MSK-OR (3), and increased pain often contributes to sleep disruption (4), leading to vicious cycle of poor sleep and high pain. Multidisciplinary management of chronic MSK-OR has historically relied on brief psychological interventions targeting sleep or pain (5). Such interventions, consisting of 3-5 sessions, have shown moderate efficacy when delivered in person (6). However, due to the COVID-19 pandemic, brief psychological interventions targeting pain (i.e., Physical Self-Regulation [PSR]) or sleep (Brief Behavioral Therapy for Insomnia [BBTI]) have been delivered via telehealth in the tertiary orofacial pain clinic at University of Kentucky to maintain continuity of care. To date, no studies have demonstrated the efficacy of brief psychological interventions in a chronic orofacial pain population via telehealth. The aim of this study is to establish the efficacy of PSR and BBTI delivered via telehealth on self-report pain intensity, sleep quality, and overall quality of life in patients with chronic MSK-OR. It is hypothesized that both interventions delivered via telehealth will produce beneficial changes on these outcomes (Aim 1). Further, no study to date has compared whether targeting sleep or targeting pain is a better clinical approach for the psychological management of MSK-OR patients. An exploratory secondary aim is to establish which intervention (BBTI vs. PSR) is more effective for each of the three outcomes (Aim 2).