rTMS in Managing Individuals With Chronic Low Back Pain and Comorbid Insomnia

Inclusion Criteria: 1. participants aged between18 and 65 years; 2. willing to participate in the study and randomization; 3. having stable pharmacological or nonpharmacological treatments for pain or sleep at least one month prior to study participation; 4. having CLBP (defined as pain between 12 ribs and gluteal crease with or without leg pain that has persisted for at least three months) 5. diagnosing insomnia using the Brief Insomnia Questionnaire (BIQ) based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) Exclusion Criteria 1. specific causes of CLBP (e.g., spondylosis, spondyloarthropathy, or vertebral fracture); 2. pregnancy or nursing; 3. previous spinal surgery; 4. inflammatory or autoimmune diseases; 5. other sleep disorders (e.g., sleep apnea or restless leg); 6. presence of severe psychopathologies, neurological, or physical disease directly related to the onset of insomnia (e.g., depression, substance abuse, or alcohol abuse); 7. severe dependence on hypnotic drugs; 8. concurrent receipt of new treatments outside the scope of the study; 9. contraindications to use rTMS (e.g., severe head trauma, intracranial hypertension, implanted ferromagnetic devices, history of epilepsy).