اثربخشی آموزش بهداشت خواب بر کیفیت خواب، فشارخون، ضربان قلب و اکسیژن اشباع در خون سالمندان مبتلا به اختلال بی‌خوابی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روان‌شناسی، واحد یاسوج، دانشگاه آزاد اسلامی، یاسوج، ایران

2 مرکز تحقیقات اجتماعی عوامل مؤثر بر سلامت، دانشگاه علوم پزشکی یاسوج، یاسوج، ایران

چکیده

از جمله مشکلات دوران سالمندی مشکلات کیفیت و کمیت خواب می‌باشد، خواب یکی از مهم‌ترین رفتارهای ترمیم‌کننده سلامتی می‌باشد و باعث ایجاد احساس خوب در فرد می‌گردد. هدف این پژوهش تعیین اثربخشی آموزش بهداشت خواب بر کیفیت خواب و شاخص‌های فیزیولوژی فشارخون، ضربان قلب و اکسیژن اشباع در خون سالمندان مبتلا به اختلال بی‌خوابی بود. پژوهش حاضر نیمه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون و پیگیری با گروه گواه بود. جامعه پژوهش سالمندان مبتلا به بی‌خوابی کانون جهان دیدگان شیراز در سال 1398 بودند که از میان آنها 40 نفر با احتساب شرایط ورود به پژوهش با روش نمونه‌گیری تصادفی انتخاب و در دو گروه آزمایش و گواه قرار گرفتند. سالمندان با میانگین سنی 48/70 سال که مبتلا به بی‌خوابی بودند با شاخص کیفیت خواب پیتزبورگ، دستگاه فشارسنج خون و دستگاه پالس‌اکسیمتر مورد ارزیابی قرار گرفتند. گروه آزمایش تحت مداخله 4 جلسه 45 دقیقه‌ای آموزش بهداشت خواب بر اساس طرح اسپای، قرار گرفتند و گروه گواه آموزشی دریافت نکردند. تجزیه و تحلیل داده‌ها با بسته آماری SPSS-23و روش‌های آماری تحلیل کوواریانس تک‌متغیره انجام گردید. یافته‌ها نشان دادند که آموزش بهداشت خواب منجر به بهبود کیفیت خواب، فشارخون سیستولیک و اکسیژن اشباع در خون سالمندان مبتلا به بی‌خوابی شد (05/0>P)، اما بر فشارخون دیاستولیک و ضربان قلب تاثیری نداشته است. نکته حائز اهمیت این است که اثر بخشی آموزش بهداشت خواب و پایبندی سالمندان به آن، نیازمند گذشت زمان بوده تا بتواند بر اکسیژن اشباع در خون در سه ماه بعد تاثیرگذار شود. مطالعه حاضر نشان داد که درمان بی‌خوابی با آموزش بهداشت خواب باعث بهبود کیفیت خواب و سلامت جسمی و روانی سالمندان می‌شود. ازاین‌رو، به کلیه مسئولین و دست‌اندرکاران پشتیبانی از سالمندان به ویژه حیطه‌توان‌بخشی توصیه می‌شود که از فنون بهداشت خواب به منظور حمایت از سالمندان استفاده کنند.

کلیدواژه‌ها


عنوان مقاله [English]

The Effectiveness of Sleep Health Education on Sleep Quality, Blood Pressure, Heart Rate and Oxygen Saturation in Blood of the Elderly with Insomnia

نویسندگان [English]

  • Reza Mottaghi 1
  • Ali Reza Maredpour 1
  • Shirali Kharamin 2
1 Department of Psychology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
2 Social Determinants of Health Research Center, Yasooj University of Medical Sciences, Yasooj, Iran
چکیده [English]

One of the problems of the elderly seems to be problems with the quality and quantity of sleep. Sleep is one of the most important health-restoring behaviors, and makes a person feel good. The aim of this study was to determine the effectiveness of sleep hygiene education on sleep quality and physiological parameters of blood pressure, heart rate and oxygen saturation in the blood of elderly people with insomnia. This was a quasi-experimental study with pretest-posttest and follow-up design with a control group. The study population consisted all the elderly with insomnia in Shiraz in 2019, from which 40 were selected using random sampling method and according to inclusion criteria, and were assigned into experimental and control groups. The elderly with a mean age of 70.48 years with insomnia were assessed by the Pittsburgh Sleep Quality Index, Blood Pressure Monitor and Pulse Oximeter. The experimental group underwent the sleep hygiene training based on Spa plan for four weekly 45-minutes sessions, and the control group did not receive any training. Data were analyzed using univariate analysis of covariance in SPSS-23 statistical package. The results showed that sleep hygiene training improved sleep quality, systolic blood pressure and oxygen saturation in the blood of the elderly with insomnia (P<0.05), but it had no effect on diastolic blood pressure and heart rate. It is noteworthy that the effectiveness of sleep hygiene education requires time for affecting the oxygen saturation in the blood in the next three months. The present study showed that insomnia treatment through sleep hygiene education improves sleep quality and physical and mental health of the elderly. Therefore, all officials and stakeholders, especially who works in the field of rehabilitation, are recommended to apply the sleep hygiene education in order to support of the elderly.
References
Alemi, S., Abu al-Ma'ali al-Husseini, Kh., Malihi al-Dhakerini, S., & Khabiri, M. (1400). The effectiveness of aromatherapy massage awareness on pain perception, sleep quality and quality of life of elderly women with chronic pain, the effect of massage awareness on the mental health of elderly women with pain. Salmand (Iranian Journal of Aging), 16(2), 218-233. [Persian]
Azizi Aram, S., Freivar, M., & Basharpour, S. (2020). The role of sleep quality, morning-afternoon personality and sensory processing sensitivity in predicting nurses' job performance. Journal of Psychiatric Nursing, 8 (2), 14-23. [Persian]
Barbagallo, M., Veronese, N., & Dominguez, LJ. (2021). Magnesium in aging, health and diseases. Nutrients, 13(2),463. https://doi.org/10.3390/nu13020463
Buysse, DJ. Reynolds, CF 3rd. Monk, TH., Berman, SR., & Kupfer, DJ. (1989). The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. doi: 10.1016/0165-1781(89)90047-4. PMID: 2748771
Degnan, K.A., & Fox, N.A. (2007). Behavioral inhibition and anxiety disorders: Multiple levels of a resilience process. Development and Psychopathology, 19(3), 729-746.
Dehdari, T., Delorianzadeh, M., Ariaian, N., Khosravi, F., & Bahar, A. (2019). Nutrition status and related factors in the elderly living in nursing homes in Semnan province (2017). Elderly, Iranian Journal of Aging, 14(2), 235-224. [Persian]
Chen, T., & Saito, Y. (2021). Longitudinal effects of nocturnal insomnia symptom subtypes and no restorative sleep on the incidence of depression among community-dwelling older adults: results from the health and retirement study. Sleep Medicine, 79, 153-163.
Espie, CA. (2017). Overcoming Insomnia and Sleep Problems: A self –help guide using Cognitive Behavioral Techniques. London: Robinson.
Golafshani, A., Qaruni, M., & Ismaili, H. (2007). The effect of progressive muscle relaxation on hypertension in the elderly with myocardial infarction, Salmand (Iranian Journal of Aging), 2(5), 351-357. [Persian]
Hughes, LS., Clark, J., Colclough, JA., Dale, E., & McMillan, D. (2017). Acceptance and commitment therapy (ACT) for chronic pain: A systematic review and meta-analyses. The Clinical Journal of Pain, 33(6), 552-568.
Hazeri, A., & Farahzadi, H. (2015). Evaluation of the effectiveness of sleep health education on improving sleep disorders in nurses of Shahid Sadoughi Hospital in Yazd. Tolo Health Journal, 14 (2), 47-56. [Persian]
Johansson, M., Jansson-Frojmark, M., Norell-Clarke, A. & Steven, J. (2021). Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study. Sleep Science Practice, 5, 5. https://doi.org/10.1186/s41606-020-00053-z
Kusnanto­, K., Murtadho, MA., Herawati, L., & Arifin, H. (2019). The Comparison of progressive muscle relaxation Frequency on Anxiety, Blood Pressure, and Pulse of Hemodialysis Patients. Journal Ners, 14(1), 69-74.
Kyle, SD., Morgan, K., & Espie, CA. (2010). Insomnia and health-related quality of life. Sleep Medicine Review, 14(1), 69-82.
Kalhornia Golkar, M., Bani Jamali, Sh., Bahrami, H., Hatami, H., & Ahadi, H. (2014). The effectiveness of combining stress management training and spiritual therapy on blood pressure, anxiety and quality of life in patients with hypertension. Journal of Clinical Psychology, 6(3), 1-11. [Persian]
Kaplan, H., & Sadock, SV. (2015). Synopsis of psychiatry. behavioral sciences (11thed). Lippincott Philadelphia, William & Wilkins.
Meyers, L. S., Gamst, G., & Guarino, A.J. (2006). Applied multivariate research: Design and interpretation. Thousand Oaks, CA: Sage Publications, Inc.
Matthews, KA., Strollo, Jr., Hall, M., Mezick, EJ., Kamarck, TW., Owens, JF., Buysse, DJ., & Reis, SE. (2011). Associations of Framingham risk score profile and coronary artery calcification with sleep characteristics in middle-aged men and women, Pittsburgh Sleep Score study. Sleep. Jun 1, 34(6), 711-6.
Miri, L., Foroughan, M., Vahedi, M., & Shahbazi, A. (2020). The Relationships between daily sleepiness and cardiovascular Health Indicators in the Older Adults Salmand, Iranian Journal of Ageing. Forthcoming 2020. http://dx.doi.org/10.32598/sija.2021.3022.1 [Persian]
Musaddad, K., & Tuti, H. (2019). The effect of sleep hygiene and relaxation benson on improving the quality of sleep among health failure patient, A literature review. Ljnhs, 2(1), 101-107.
Mottaghi, R., Kamkar, A., & Mardpour, A., R. (2016). The effectiveness of cognitive-behavioral therapy on sleep quality in the elderly with insomnia, Elderly Journal, 11 (2), 234-243. [Persian]
Pio-Abreu, A., Moreno, H. & Drager, L.F. (2021). Obstructive sleep apnea and ambulatory blood pressure monitoring: current evidence and research gaps. Journal of HumanHypertension, 35, 3,15–24. https://doi.org/10.1038/s41371-020-00470-8
Prabhakar, A. R., Marwah, N., & Raju, OS. (2007). A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. The Journal of Indian Society of Pedodontics and Preventive Dentistry. 25(4), 177-182. https://doi.org/10.4103/0970-4388.37014.
Richards T, Johnson J., Sparks A, & Emerson, H. (2007). The Effect of music therapy on patients’ perception and manifestation of pain, anxiety, and patient satisfaction. The medical-surgical nurse, 16(1), 7-14.
Raymond, SU., Greenberg, HM., & Leeder, SR. (2005). Beyond reproduction: Women's health in today's developing world. International Journal of Epidemiology, 34(5), 1144-8. https://doi.org/10.1093/ije/dyi121
Rezaei, M., Sikaveh, H., Hatami, SA, Monadat Ziarat, H. & Ein Beigi, A. (2015). The effectiveness of metacognitive therapy on patients with insomnia. Journal of North Khorasan University of Medical Sciences, 2, 21-29. [Persian]
Sharifi, G., Tabatabai, H., Babaei, New Farm, A., & Talaei, M. (2015). The effect of eight weeks of yoga practice on non-athlete women's respiratory and heart rate. Health Dawn, (14)2, 69-78. [Persian]
Saeedi, M., Shamsikhani, S., Varvani Farahani, P., & Haghverdi, F. (2014). Sleep hygiene training program for patients on hemodialysis. Iran Journal Kidney Dis, (8), 9-65. [Persian]
Soleimani, F., Motaarefi, H., & Hasanpour Dehkordi, A. (2016). Effect of sleep hygiene education on sleep quality in hemodialysis patients. Journal of Clinical and Diagnostic Researh. [Persian]
Taheri, P., Khodabakhshi, H., Etemad, K., & Mohammadi, M. (2019). The effect of sleep health education on sleep quality
and general health of elderly women with sleep disorders in Birjand, Salmand, (Iranian Journal of Aging), (2), 248-259. [Persian]
Taban Sadeghi, M. R., Babapour Khairuddin, J., Aslanabadi, N., & Ezzati, J.A. (2012). The effect of stress stimuli on blood pressure and heart rate in patients with primary hypertension based on behavioral brain systems. Medical Journal of Tabriz University of Medical Sciences and Health Services, 34(6), 28-33. [Persian]
Thomas, SJ., Lichstein, KL., Taylor, DJ., Riedel, BW., & Bush, AJ. (2014). Epidemiology of bedtime, arising. Archives of Internal Medicine, 171(10), 895-896.
Zaidel, C., Musich, S., Karl, J., Kraemer, S., Charlotte, S., & Yeh, CS. (2021). Psychosocial factors associated with sleep quality and duration among older adults with chronic pain. Population Health Management. 101-109. http://doi.org/10.1089/pop.2019.0165
Zargar, Y., Hakimzadeh, G., & Davodi, I. (2019). The effectiveness of acceptance and commitment therapy on hypertension and emotion cognitive regulation in people with hypertension: Asemi-experiential study. Jundishapur Journal of Chronic Disease, 8(2), e79347. Doi:10.5812/jjcdc.79347 [Persian]
Zasyadko, K., Shinkarev, S., Dankovtsev, O., Tafintseva, L., & Maskalyanova, S. (2021). Physiological and psychophysiological indicators in the diagnosis of occupational maladaptation of doctors from oncology hospital. Amazonia Investiga10(38), 59-69. https://doi.org/10.34069/AI/2021.38.02.6

کلیدواژه‌ها [English]

  • Sleep hygiene
  • sleep quality
  • insomnia
  • physiological indicators
  • the elderly
منابع
تابان صادقی، م. ر.، باباپور خیرالدین، ج.، اصلان آبادی، ن.، و عزتی، ج.ع. (1391). تأثیر محرک‌های استرس‌زا بر فشارخون و ضربان قلب بیماران مبتلا به فشارخون بالای اولیه براساس سیستم‌های مغزی رفتاری. مجله پزشکی دانشگاه علوم‌پزشکی و خدمات بهداشتی ـ درمانی تبریز، 34(6)، 33-28.
حاضری، ا.، و فرحزادی، ح. (۱۳۹۴). بررسی اثربخشی آموزش بهداشت خواب بر بهبود اختلالات خواب پرستاران بیمارستان شهید صدوقی یزد. نشریه طلوع بهداشت، 14(۲)، 56-47.
دهداری، ط.، دلوریان زاده، م.، آریاییان، ن.، خسروی، ف.، و بهار، آ. ( ۱۳۹۸). وضعیت تغذیه و عوامل مرتبط با آن در سالمندان مقیم خانه­های سالمندان استان سمنان (۱۳۹۶). سالمند، مجله سالمندی ایران، 14(۲)، 235-224. 
رضایی، م.، سیکاوه، ح.، حاتمی، س.ا.، منادی زیارت، ح و عین بیگی، ا. (1394). اثربخشی درمان فراشناختی بر بیماران مبتلا به بی خوابی. نشریه دانشگاه علوم پزشکی خراسان شمالی، شماره 2، 29-21.
شریفی، غ.، طباطبایی، ح.، بابایی مزرعه نو، ع.، و طلایی، م. (1394). تأثیر هشت هفته تمرین یوگا بر روی شاخص‌های تنفسی و ضربان قلب زنان غیر ورزشکار. طلوع بهداشت، (14)2، 78-69.
طاهری، پ.، خدابخشی، ح.، اعتماد، ک.، و محمدی، م. (1398). تأثیر آموزش بهداشت خواب بر کیفیت خواب و سلامت عمومی زنان سالمند دارای اختلال خواب در شهر بیرجند. نشریه سالمند (مجله سالمندی ایران)، 2، 259-248.
عزیزی آرام، س.، فریور، م.، و بشرپور، س. (1399). نقش کیفیت خواب، شخصیت صبحی- عصری و حساسیت پردازش حسی در پیش‌بینی عملکرد شغلی پرستاران. نشریه روان پرستاری، 8(2)، 23-14.
عالمی، س.، ابوالمعالی الحسینی، خ.، ملیحی الذاکرینی، س.، و خبیری، م. (۱۴۰۰). اثربخشی ذهن‌آگاهی ماساژ آروماتراپی بر ادراک درد، کیفیت خواب و کیفیت زندگی زنان سالمند مبتلا به درد مزمن، اثر ذهن‌آگاهی ماساژ بر سلامت روان زنان سالمند مبتلا به درد. سالمند (مجله سالمندی ایران)، ۱۶(۲)، 233-218.
کلهرنیا گلکار، م.، بنی جمالی، ش.، بهرامی، ه.، حاتمی، ح.، و احدی، ح. (1393). اثربخشی ترکیب آموزش مدیریت استرس و معنویت درمانی بر فشارخون، اضطراب و کیفیت زندگی بیماران مبتلا به فشارخون بالا. روان­شناسی بالینی، 6 (3)، 1-11.
گل‌افشانی، ا.، قارونی، م.، و اسماعیلی، ح. (1386). تأثیر آرام‌سازی پیش‌رونده عضلانی بر پرفشاری خون سالمندان مبتلا به سکته قلبی. نشریه سالمند (مجله سالمندی ایران)، 2(5)، 357-351.
متقی، ر.، کامکار، ع.، و ماردپور، ع، ر. (1395). اثربخشی درمان‌شناختی ـ رفتاری بر کیفیت خواب سالمندان مبتلا به اختلال بی‌خوابی. نشریه سالمند (مجله سالمندی ایران)، 11(2)، 243-234.
میری، ل.، فروغان م.، واحدی، م.، و شهبازی، آ. (1399). ارتباط خواب آلودگی روزانه با شاخص­های سلامت قلب و عروق در سالمندان. نشریه سالمند (مجله سالمندی ایران)، آماده انتشار.
References
Alemi, S., Abu al-Ma'ali al-Husseini, Kh., Malihi al-Dhakerini, S., & Khabiri, M. (1400). The effectiveness of aromatherapy massage awareness on pain perception, sleep quality and quality of life of elderly women with chronic pain, the effect of massage awareness on the mental health of elderly women with pain. Salmand (Iranian Journal of Aging), 16(2), 218-233. [Persian]
Azizi Aram, S., Freivar, M., & Basharpour, S. (2020). The role of sleep quality, morning-afternoon personality and sensory processing sensitivity in predicting nurses' job performance. Journal of Psychiatric Nursing, 8 (2), 14-23. [Persian]
Barbagallo, M., Veronese, N., & Dominguez, LJ. (2021). Magnesium in aging, health and diseases. Nutrients, 13(2),463. https://doi.org/10.3390/nu13020463
Buysse, DJ. Reynolds, CF 3rd. Monk, TH., Berman, SR., & Kupfer, DJ. (1989). The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. doi: 10.1016/0165-1781(89)90047-4. PMID: 2748771
Degnan, K.A., & Fox, N.A. (2007). Behavioral inhibition and anxiety disorders: Multiple levels of a resilience process. Development and Psychopathology, 19(3), 729-746.
Dehdari, T., Delorianzadeh, M., Ariaian, N., Khosravi, F., & Bahar, A. (2019). Nutrition status and related factors in the elderly living in nursing homes in Semnan province (2017). Elderly, Iranian Journal of Aging, 14(2), 235-224. [Persian]
Chen, T., & Saito, Y. (2021). Longitudinal effects of nocturnal insomnia symptom subtypes and no restorative sleep on the incidence of depression among community-dwelling older adults: results from the health and retirement study. Sleep Medicine, 79, 153-163.
Espie, CA. (2017). Overcoming Insomnia and Sleep Problems: A self –help guide using Cognitive Behavioral Techniques. London: Robinson.
Golafshani, A., Qaruni, M., & Ismaili, H. (2007). The effect of progressive muscle relaxation on hypertension in the elderly with myocardial infarction, Salmand (Iranian Journal of Aging), 2(5), 351-357. [Persian]
Hughes, LS., Clark, J., Colclough, JA., Dale, E., & McMillan, D. (2017). Acceptance and commitment therapy (ACT) for chronic pain: A systematic review and meta-analyses. The Clinical Journal of Pain, 33(6), 552-568.
Hazeri, A., & Farahzadi, H. (2015). Evaluation of the effectiveness of sleep health education on improving sleep disorders in nurses of Shahid Sadoughi Hospital in Yazd. Tolo Health Journal, 14 (2), 47-56. [Persian]
Johansson, M., Jansson-Frojmark, M., Norell-Clarke, A. & Steven, J. (2021). Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study. Sleep Science Practice, 5, 5. https://doi.org/10.1186/s41606-020-00053-z
Kusnanto­, K., Murtadho, MA., Herawati, L., & Arifin, H. (2019). The Comparison of progressive muscle relaxation Frequency on Anxiety, Blood Pressure, and Pulse of Hemodialysis Patients. Journal Ners, 14(1), 69-74.
Kyle, SD., Morgan, K., & Espie, CA. (2010). Insomnia and health-related quality of life. Sleep Medicine Review, 14(1), 69-82.
Kalhornia Golkar, M., Bani Jamali, Sh., Bahrami, H., Hatami, H., & Ahadi, H. (2014). The effectiveness of combining stress management training and spiritual therapy on blood pressure, anxiety and quality of life in patients with hypertension. Journal of Clinical Psychology, 6(3), 1-11. [Persian]
Kaplan, H., & Sadock, SV. (2015). Synopsis of psychiatry. behavioral sciences (11thed). Lippincott Philadelphia, William & Wilkins.
Meyers, L. S., Gamst, G., & Guarino, A.J. (2006). Applied multivariate research: Design and interpretation. Thousand Oaks, CA: Sage Publications, Inc.
Matthews, KA., Strollo, Jr., Hall, M., Mezick, EJ., Kamarck, TW., Owens, JF., Buysse, DJ., & Reis, SE. (2011). Associations of Framingham risk score profile and coronary artery calcification with sleep characteristics in middle-aged men and women, Pittsburgh Sleep Score study. Sleep. Jun 1, 34(6), 711-6.
Miri, L., Foroughan, M., Vahedi, M., & Shahbazi, A. (2020). The Relationships between daily sleepiness and cardiovascular Health Indicators in the Older Adults Salmand, Iranian Journal of Ageing. Forthcoming 2020. http://dx.doi.org/10.32598/sija.2021.3022.1 [Persian]
Musaddad, K., & Tuti, H. (2019). The effect of sleep hygiene and relaxation benson on improving the quality of sleep among health failure patient, A literature review. Ljnhs, 2(1), 101-107.
Mottaghi, R., Kamkar, A., & Mardpour, A., R. (2016). The effectiveness of cognitive-behavioral therapy on sleep quality in the elderly with insomnia, Elderly Journal, 11 (2), 234-243. [Persian]
Pio-Abreu, A., Moreno, H. & Drager, L.F. (2021). Obstructive sleep apnea and ambulatory blood pressure monitoring: current evidence and research gaps. Journal of HumanHypertension, 35, 3,15–24. https://doi.org/10.1038/s41371-020-00470-8
Prabhakar, A. R., Marwah, N., & Raju, OS. (2007). A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. The Journal of Indian Society of Pedodontics and Preventive Dentistry. 25(4), 177-182. https://doi.org/10.4103/0970-4388.37014.
Richards T, Johnson J., Sparks A, & Emerson, H. (2007). The Effect of music therapy on patients’ perception and manifestation of pain, anxiety, and patient satisfaction. The medical-surgical nurse, 16(1), 7-14.
Raymond, SU., Greenberg, HM., & Leeder, SR. (2005). Beyond reproduction: Women's health in today's developing world. International Journal of Epidemiology, 34(5), 1144-8. https://doi.org/10.1093/ije/dyi121
Rezaei, M., Sikaveh, H., Hatami, SA, Monadat Ziarat, H. & Ein Beigi, A. (2015). The effectiveness of metacognitive therapy on patients with insomnia. Journal of North Khorasan University of Medical Sciences, 2, 21-29. [Persian]
Sharifi, G., Tabatabai, H., Babaei, New Farm, A., & Talaei, M. (2015). The effect of eight weeks of yoga practice on non-athlete women's respiratory and heart rate. Health Dawn, (14)2, 69-78. [Persian]
Saeedi, M., Shamsikhani, S., Varvani Farahani, P., & Haghverdi, F. (2014). Sleep hygiene training program for patients on hemodialysis. Iran Journal Kidney Dis, (8), 9-65. [Persian]
Soleimani, F., Motaarefi, H., & Hasanpour Dehkordi, A. (2016). Effect of sleep hygiene education on sleep quality in hemodialysis patients. Journal of Clinical and Diagnostic Researh. [Persian]
Taheri, P., Khodabakhshi, H., Etemad, K., & Mohammadi, M. (2019). The effect of sleep health education on sleep quality
and general health of elderly women with sleep disorders in Birjand, Salmand, (Iranian Journal of Aging), (2), 248-259. [Persian]
Taban Sadeghi, M. R., Babapour Khairuddin, J., Aslanabadi, N., & Ezzati, J.A. (2012). The effect of stress stimuli on blood pressure and heart rate in patients with primary hypertension based on behavioral brain systems. Medical Journal of Tabriz University of Medical Sciences and Health Services, 34(6), 28-33. [Persian]
Thomas, SJ., Lichstein, KL., Taylor, DJ., Riedel, BW., & Bush, AJ. (2014). Epidemiology of bedtime, arising. Archives of Internal Medicine, 171(10), 895-896.
Zaidel, C., Musich, S., Karl, J., Kraemer, S., Charlotte, S., & Yeh, CS. (2021). Psychosocial factors associated with sleep quality and duration among older adults with chronic pain. Population Health Management. 101-109. http://doi.org/10.1089/pop.2019.0165
Zargar, Y., Hakimzadeh, G., & Davodi, I. (2019). The effectiveness of acceptance and commitment therapy on hypertension and emotion cognitive regulation in people with hypertension: Asemi-experiential study. Jundishapur Journal of Chronic Disease, 8(2), e79347. Doi:10.5812/jjcdc.79347 [Persian]
Zasyadko, K., Shinkarev, S., Dankovtsev, O., Tafintseva, L., & Maskalyanova, S. (2021). Physiological and psychophysiological indicators in the diagnosis of occupational maladaptation of doctors from oncology hospital. Amazonia Investiga10(38), 59-69. https://doi.org/10.34069/AI/2021.38.02.6