Effects of Connective Tissue Massage in Patients With Chronic Insomnia
Chronic Insomnia
What this study involves
The registry does not currently label this study as recruiting. Ask about its status before planning a screening visit.
- Study type
- Interventional
- Phase
- Not applicable
- Age range
- 18 years - 65 years
- Sex eligible
- All sexes
- Healthy volunteers
- Not accepted
- Participants
- 74 Estimated
These are starting points, not an eligibility decision. The research team must review the full requirements.
About the research
This randomized controlled trial will investigate the effects of connective tissue massage on insomnia severity, objective and subjective sleep outcomes, and stress- and autonomic-related biomarkers in adults with chronic insomnia. Chronic insomnia is a common sleep disorder characterized by persistent difficulties in initiating or maintaining sleep and is associated with impaired daytime functioning, reduced cognitive performance, and diminished quality of life. Non-pharmacological interventions may provide a safe alternative or complementary approach for individuals with chronic insomnia.
A total of 74 adults diagnosed with chronic insomnia by a neurologist and who have not used sleep medication during the previous four weeks will be enrolled. Participants will be randomly allocated to either a connective tissue massage group or a control group. The intervention group will receive 12 sessions of connective tissue massage over a four-week period, with three sessions per week, in addition to sleep hygiene education. The control group will receive sleep hygiene education alone.
Assessments will be performed at baseline and immediately after the four-week intervention period. The primary outcome will be the change in insomnia severity, assessed using the Insomnia Severity Index. Secondary outcomes will include objective sleep parameters recorded by actigraphy over five consecutive days, including total sleep time, sleep efficiency, sleep onset latency, and wake after sleep onset. Blood biomarkers associated with hypothalamic-pituitary-adrenal axis activity and autonomic regulation, including cortisol, DHEA-S, alpha-amylase, and oxytocin, will also be assessed. Subjective sleep quality and sleep hygiene will be evaluated using the Pittsburgh Sleep Quality Index and Sleep Hygiene Index, respectively. Adherence to sleep hygiene recommendations will additionally be assessed using sleep diaries.
The study aims to determine whether connective tissue massage combined with sleep hygiene education is more effective than sleep hygiene education alone in reducing insomnia severity and improving objective and subjective sleep outcomes and selected physiological biomarkers in adults with chronic insomnia.
Who may be able to participate?
The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.
Inclusion Criteria:
- Inclusion Criteria:
- Adults aged 18 to 65 years, of either sex.
- Diagnosis of chronic insomnia disorder according to the International -Classification of Sleep Disorders, Third Edition, Turkish version (ICSD-3-TR), established by a neurologist.
- Difficulty initiating or maintaining sleep occurring at least three nights per week for at least three months, consistent with ICSD-3-TR diagnostic criteria.
- No use of pharmacological agents for insomnia during the previous four weeks, including benzodiazepines, non-benzodiazepine hypnotics, melatonin and melatonin receptor agonists, sedating antidepressants, and anxiolytics.
- Insomnia Severity Index score of ≥15, indicating moderate to severe insomnia. Ability to read and write.
- Standardized Mini-Mental State Examination score of ≥24, indicating adequate cognitive status.
- Willingness to participate in the study and provision of written informed consent.
- Exclusion Criteria:
- History of shift work during the previous month or lifestyle changes that may disrupt circadian rhythm.
- Presence of obstructive sleep apnea syndrome, circadian rhythm sleep-wake disorders, or other primary sleep disorders.
- History of any neurological diagnosis, such as epilepsy or Parkinson's disease, or psychiatric diagnosis, such as depression or bipolar disorder.
- Presence of an open wound, infection, dermatitis, or other dermatological condition impairing skin integrity in the area where connective tissue massage will be applied.
- Regular use of medications that may affect sleep, including antidepressants, beta-blockers, or corticosteroids.
- Initiation of any pharmacological treatment for insomnia, including sleep medications or sedatives, during the four-week study period.
Treatment, groups and participation
The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.
- Assignment
- Random assignment
- Masking
- No masking
Connective Tissue Massage + Sleep Hygiene Education
Participants will receive standardized sleep hygiene education provided verbally by a neurologist and as a written brochure, in addition to 12 sessions of connective tissue massage delivered by a physiotherapist over four weeks, three sessions per week.
Procedure: Connective Tissue Massage · Behavioral: Sleep Hygiene Education
Sleep Hygiene Education
Participants will receive standardized sleep hygiene education provided verbally by a neurologist and as a written brochure. No connective tissue massage will be provided during the four-week study period.
Behavioral: Sleep Hygiene Education
Connective Tissue Massage PROCEDURE
Connective tissue massage will be administered by a physiotherapist three times per week for four consecutive weeks, for a total of 12 sessions.
Sleep Hygiene Education BEHAVIORAL
Standardized sleep hygiene education based on clinical guidelines will be provided verbally by a neurologist following the baseline assessment, and the same content will be provided to participants in written brochure format.
What researchers are measuring
Outcome measures describe what is being studied. They are not proof that a treatment works.
Primary measures
Change in Insomnia Severity Index Score
Time frame: From baseline to 4 weeks
Change in insomnia severity will be assessed using the Insomnia Severity Index (ISI), a 7-item self-report questionnaire with total scores ranging from 0 to 28. Higher scores indicate greater insomnia severity, whereas lower scores indicate fewer insomnia symptoms. Scores are interpreted as follows: 0-7, no clinically significant insomnia; 8-14, subthreshold insomnia; 15-21, moderate clinical insomnia; and 22-28, severe clinical insomnia. The change in total score from baseline to the end of the intervention will be evaluated.
Secondary measures
Change in Cortisol Level
Time frame: From baseline to immediately after the 4-week intervention period
Cortisol level will be assessed as a blood biomarker reflecting hypothalamic-pituitary-adrenal axis activity. The change from baseline to immediately after the 4-week intervention period will be evaluated.
Change in DHEA-S Level
Time frame: From baseline to immediately after the 4-week intervention period
DHEA-S level will be assessed as a blood biomarker related to hypothalamic-pituitary-adrenal axis activity. The change from baseline to immediately after the 4-week intervention period will be evaluated.
Change in Alpha-Amylase Level
Time frame: From baseline to immediately after the 4-week intervention period
Alpha-amylase level will be assessed as a blood biomarker related to autonomic regulation. The change from baseline to immediately after the 4-week intervention period will be evaluated.
Change in Oxytocin Level
Time frame: From baseline to immediately after the 4-week intervention period
Oxytocin level will be assessed as a blood biomarker related to neuroendocrine and autonomic regulation. The change from baseline to immediately after the 4-week intervention period will be evaluated.
Change in Total Sleep Time
Time frame: From baseline to immediately after the 4-week intervention period; actigraphy will be recorded for 5 consecutive days at each assessment point.
Total sleep time will be assessed objectively using actigraphy over 5 consecutive days at baseline and after the 4-week intervention period. The change in total sleep time will be evaluated.
Change in Sleep Efficiency
Time frame: From baseline to immediately after the 4-week intervention period; actigraphy will be recorded for 5 consecutive days at each assessment point.
Sleep efficiency will be assessed objectively using actigraphy over 5 consecutive days at baseline and after the 4-week intervention period. The change in sleep efficiency will be evaluated.
Change in Sleep Onset Latency
Time frame: Sleep onset latency will be assessed objectively using actigraphy over 5 consecutive days at baseline and after the 4-week intervention period. The change in sleep onset latency will be evaluated.
From baseline to immediately after the 4-week intervention period; actigraphy will be recorded for 5 consecutive days at each assessment point.
Change in Wake After Sleep Onset (WASO)
Time frame: From baseline to immediately after the 4-week intervention period; actigraphy will be recorded for 5 consecutive days at each assessment point.
Wake after sleep onset (WASO) will be assessed objectively using actigraphy over 5 consecutive days at baseline and after the 4-week intervention period. The change in WASO will be evaluated.
Change in Number of Nighttime Awakenings
Time frame: From baseline to immediately after the 4-week intervention period; actigraphy will be recorded for 5 consecutive days at each assessment point.
The number of nighttime awakenings will be assessed objectively using actigraphy over 5 consecutive days at baseline and after the 4-week intervention period. The change in the number of awakenings will be evaluated.
Change in Sleep Fragmentation Index
Time frame: From baseline to immediately after the 4-week intervention period; actigraphy will be recorded for 5 consecutive days at each assessment point.
Sleep fragmentation index will be assessed objectively using actigraphy over 5 consecutive days at baseline and after the 4-week intervention period. The change in sleep fragmentation index will be evaluated.
Change in Pittsburgh Sleep Quality Index Score
Time frame: From baseline to immediately after the 4-week intervention period
Subjective sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). The change in PSQI score from baseline to immediately after the 4-week intervention period will be evaluated.
Change in Sleep Hygiene Index Score
Time frame: From baseline to immediately after the 4-week intervention period
Sleep hygiene behaviors will be assessed using the Sleep Hygiene Index (SHI). The change in SHI score from baseline to immediately after the 4-week intervention period will be evaluated.
Review the complete result tables and limitations in the official record.
Open official results ↗Research locations (1)
The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.
1 locations
Sultan 2.Abdulhamid Khan Educational and Research HospitalIstanbul, Turkey (Türkiye)Status unknown
Study team and timeline
- Lead sponsor
- Saglik Bilimleri Universitesi
- Study start
- 2026-12 Estimated
- Primary completion
- 2027-07 Estimated
- Study completion
- 2027-07 Estimated
- First posted
- Aug 18, 2026 Actual
- Last updated
- Nov 10, 2026 Actual
Official study contacts
Official study title
The Effects of Connective Tissue Massage in Patients With Chronic Insomnia: A Randomized Controlled Trial
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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.
Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026
