اثربخشی یوگا بر کیفیت خواب سالمندان مرد

Poor sleep quality is one of the most common challenges faced by the older adults. Due to the many changes that occur during old age, doing some sports seems to be difficult for older adults. Yoga can be considered as a suitable option for anyone, at any age and with any physical condition, to improve the sleep quality of older adults. Therefore, the current research was conducted with the aim of determining the effectiveness of yoga on the sleep quality in older adults. This was a quasi-experimental with pretest-posttest design with a control group. The statistical population included all the older men who were member of day rehabilitation centers in Yazd, Iran in 2020, among whom 30 older men (65 to 80 years old) were selected using convenience sampling and according to inclusion and exclusion criteria, and were randomly assigned into experimental and control groups (15 people in each group). The data collection tool was the Petersburg sleep quality test. a 12-week intervention, attending two 90-minute sessions per week in the rehabilitation center, while the control group did not receive any yoga exercise program during this period. Research data were analyzed through univariate analysis of covariance in SPSS-22 software. The findings of the research showed that yoga has a positive effect on the quality of sleep of people over 60 years old and improves performance in this area. As a result, according to the findings, it is possible to advise the older adults to take advantages of yoga as a suitable method to increase their health and sleep quality.
EXTENDED ABSTRACT
Introduction
Studies have shown that aging leads to increased dependency, decreased memory performance, and reduced physical capabilities, posing physical and mental challenges. According to research, poor sleep quality ranks third among older age disorders, following headaches and gastrointestinal disturbances. Poor sleep quality contributes to stress, depression, and individual irritability. Sleep issues manifest themselves in the form of frequent nighttime awakenings, difficulty falling asleep, a strong need for daytime naps, and early morning awakening. Nowadays, Non-pharmacological interventions, particularly exercise, have gained attention as a more beneficial approach compared to other methods. Aerobic exercises are among these non-pharmacological methods. However, as aging progresses, disruptions occur in the physiological functions of older adults. In such a situation, yoga stands as a suitable option for individuals of all ages and physical conditions, due to attention to physical potential, mental discipline, and emotional balance. Yoga leads towards coherence and self-awareness, resulting in increased tranquility, reduced anxiety, and fatigue in individuals. However, to our knowledge, the impact of yoga exercises on the sleep quality of older men has yet to be investigated in research literature. Therefore, this study aims to explore the effectiveness of yoga on the sleep quality in older men.
Method
This was a quasi-experimental study with pretest-posttest with a control group. The statistical population consisted of all older men attending older adults’ day rehabilitation centers in Yazd, Iran in 2020, among whom 30 individuals were selected through convenience sampling and according to inclusion and exclusion criteria, and randomly assigned into experimental (N=15) and control (N=15) groups. During the intervention, the experimental group experienced two dropouts. To maintain equilibrium between the experimental and control groups, two individuals from the control group were excluded. The educational background of the sample ranged from illiterate to diploma holders, and their membership duration in the rehabilitation center varied from one year to over 10 years. Inclusion criteria comprised (1) being at least 60 years old, (2) ability to respond to questions, (3) complaints about poor sleep quality, and (4) obtaining a high score on the Sleep Quality Test (a high score indicates poor sleep quality). Exclusion criteria encompassed (1) the lack of complete consciousness (through psychological status examination), (2) suffering from Parkinson’s disease, and (3) dependence on others for daily activities. The Pittsburgh Sleep Quality Index was used as the data collection tool. The experimental group underwent a 12-week intervention, attending two 90-minute sessions per week at their exercise court in the rehabilitation center, while the control group did not receive any yoga exercise program during this period. The data were analyzed using univariate covariance analysis (ANCOVA) in SPSS-22.
Results
Before performing ANCOVA, the assumptions were examined. The results confirmed the assumptions of variance homogeneity, normal distribution of data, and homogeneity of regression coefficients. Therefore, used to investigate the effectiveness of yoga on sleep quality was ANCOVA. As it can be   seen   in    Table    1,   there    was     a significant difference between the experimental and control groups in terms of sleep quality. In other words, according to average score of sleep quality in the experimental group (5.08) in comparison with that in control group (7.08) the yoga-based trainings resulted in a significant increase in sleep quality. The effect size was 0.57, signifying that 57% of individual differences in sleep quality scores were attributed to the impact of yoga exercises. Thus, the research hypothesis was confirmed. Result can be seen in Table 1.   
Conclusion
With increasing age, the possibility of anomalies in the hormone regulation systems exists (Papalia et al., 2020). The hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-thyroid axis are two systems involved in the secretion of cortisol hormone and the level of stress in humans. Dysfunction in these hormonal systems can lead to the occurrence or exacerbation of disorders such as depression, stress, and anxiety, which, in turn, can cause sleep disturbances in older individuals. The practice of yoga, with its influence on various glands in the body, can regulate hormone secretion and prevent glandular dysfunction during aging. Inverted yoga poses such as shoulder stands and fish pose have a favorable effect on the thyroid and parathyroid glands, balancing hyperactivity and hypoactivity of the thyroid. Additionally, as reduced blood flow to the brain induces feelings of drowsiness or lethargy in individuals, yoga exercises, by improving blood circulation throughout the body, ensure proper and balanced blood supply to the head region. Consequently, individuals feel more cheerful and energetic during the day, experience less lethargy and fatigue, and have better quality sleep at night.
Ethical Consideration
Ethical Code
This study is extracted from the thesis of Mehdi Mohammadi Sharif Abadi's Master's degree.
Financial Support
 This study had no financial support.
Authors’ Contributions
A.C: Conceptualization, methodology, Resources, project administration, Formal analysis; Y.R: Project administration, validation, Formal analysis; M.M: Data Curation, Writing - Original Draft; A.S: Writing - Review & Editing, Formal analysis.
Conflict of Interest
 The authors had no conflicts of interest.
Acknowledgments
The authors extend their gratitude to all participating older individuals in this study
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