Morning or night rehab? new study tests best time for back pain Patients' sleep

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Individuals aged 18-65 years * High risk for obstructive sleep apnea, defined as a score \>4 on the STOP-Bang questionnaire (Snoring, Tiredness, Observed apnea, high blood pressure, Body mass index, Age, Neck circumference, and Gender) * Presence of lumbar disc herniation (bulging, protrusion, or extrusion) at L1-S1 levels confirmed by magnetic resonance imaging (MRI) * Chronic low back pain lasting at least 3 months with clinical symptoms consistent with imaging findings * Mild to moderate radicular symptoms For participants over 55 years of age: single-level or dominant-level protrusion or extrusion-type disc herniation to minimize confounding effects of multilevel degeneration * Pain intensity ≥4 on the Visual Analog Scale (VAS) within the last week * Ability to participate regularly in the physiotherapy and rehabilitation program * Willingness to provide written informed consent Exclusion Criteria: * Presence of sequestrated disc herniation or cauda equina compression confirmed by magnetic resonance imaging (MRI) * Progressive motor deficit or significant muscle weakness * Indication for urgent surgical intervention * History of previous lumbar spine surgery * Low back pain due to specific causes (e.g., spinal tumor, infection such as spondylodiscitis, inflammatory rheumatic diseases, or traumatic fracture) * Previous use of continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy * Shift work or irregular sleep patterns * Major changes in sleep medication within the last 4 weeks * Contraindications to electrotherapy (e.g., pacemaker or implanted electronic devices, suspected malignancy, sensory loss in the treatment area, open wounds, or infection) * Cardiopulmonary conditions that contraindicate exercise * Uncontrolled hypertension or advanced heart failure * Pregnancy * Severe psychiatric disorders or cognitive impairment * Neurological disorders (e.g., multiple sclerosis, stroke sequelae) * Epidural or facet joint injection within the last 3 months * Diagnosed severe obesity hypoventilation syndrome or severe chronic obstructive pulmonary disease (COPD) * Refusal to provide informed consent