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

Document Type : Original Article

Authors

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

Abstract

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
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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

Keywords


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