A Comparison Study on the Effectiveness of Acceptance and Commitment Therapy and Sleep Hygiene Education on Sleep Quality and Physiological Parameters in Older Adults

Abstract

Objectives Due to the high prevalence of insomnia and physiological problems in the elderly, this study aims to compare the effects of acceptance and commitment therapy (ACT), sleep hygiene education (SHE) and their combination on sleep quality and physiological parameters (blood pressure, heart rate, and oxygen saturation in the blood) in the elderly. Methods & Materials This is a quasi-experimental study with a pre-test/post-test/follow-up design using a control group. The study population consists of the elderly members of Jahandidegan center in Shiraz, Iran in 2018. Using a convenience sampling method and based on the inclusion and exclusion criteria, 80 subjects were selected and randomly divided into four groups, three experimental groups (ACT, SHE, and ACT+SHE) and one control group. The SHE and ACT programs each were presented for four weeks. The control group was put on a waiting list. The subjects were assessed with Pittsburgh Sleep Quality Index, a mercury sphygmomanometer, and a pulse oximeter. Data analyses were conducted in SPSS v. 23 using a two-way mixed analysis of variance and multivariate analysis of covariance. Results Participants had a mean age of 70.41±4.05 years. the changes in sleep quality, systole blood pressure, and oxygen saturation in three experimental groups were significant after intervention (P<0.001). The highest effect on sleep quality was related to the combined therapy (0.83), followed by SHE (0.67) and ACT (0.60). Conclusion All three treatment methods (ACT, SHE, and combined therapy) can improve the sleep quality and consequently systolic blood pressure and oxygen saturation in the blood of the elderly. Each of these methods are useful and can improve their psychological and physical health, where the combined therapy has superiority. Training and applying these methods are recommended for health care workers in elderly care.