One hundred twenty-three patients with nonspecific chronic spinal pain and insomnia were randomized to receive either cognitive behavioral therapy for insomnia integrated into best-evidence pain management (CBTi-BEPM, n=61) or best-evidence pain management alone (BEPM, n=62). The primary outcome was mean pain intensity at 12 months. Secondary outcomes included insomnia severity, sleep quality, beliefs about sleep, depressive symptoms, and physical fatigue. Outcomes were assessed at baseline, post-treatment, and at 3-, 6-, and 12-month follow-ups. Overall, the results of the study revealed no statistically significant difference in pain intensity between groups at 12 months, but CBTi-BEPM was more effective at improving sleep and mood-related outcomes over time. The findings suggest that integrating CBTi into pain management improves sleep and related quality-of-life outcomes in patients with nCSP and insomnia, though not necessarily pain intensity.