EFFECT OF SLEEP HYGIENE PRACTICES ON QUALITY OF SLEEP AMONG PATIENTS WITH PSORIASIS
To evaluate the effect of sleep hygiene practices on quality of sleep among psoriasis patients.
Rationale/ Background:
Psoriasis affects 2-3% of world population and 49.5% of patients with psoriasis reported sleep disturbance. Psoriasis patients experience sleep disturbance due to the active process of disease like pain and itching. Psoriasis negatively impacted their sleep at least once per month. Psoriasis is significantly associated with sleep disorders and insomnia. Sleep hygiene practices (SHP) are a set of simple practices incorporating importance of sleep, food selection, outfit selection, environment, napping tips, physical hygiene, regular exercise, follow-up of medications, habit formation, bed time rituals, sleeping posture and insistence on seeking help. The theoretical framework for this study was Weidenbach’s prescriptive nursing practice theory.
Methods:
Permission was obtained from University Institutional Ethics Committee to conduct a randomized controlled trial with 400 plaque type psoriasis patients with moderate severity (n = 200 intervention group, n = 200 control group). Psoriasis patients were inducted from a tertiary care university hospital in South India. Intervention group were given a 30 minute lesson on SHP along with routine dermatological care and the control group followed routine dermatological care alone. SHP was taught to small groups on day one through demonstrations by the researcher. Pamphlets were given as a reminder tool for regular practice of SHP. The researcher met participants after one month for direct re-enforcement of SHP there after weekly reinforcement was done through telephonic conversation. Data on participants’ background variables and Pittsburgh sleep quality index (PSQI) were collected on the day of intervention and 30th, 90th and 180th day post intervention. During each visit study participants’ sleep diary were checked for compliance. Data analysis was done using descriptive and inferential statistics.
Results:
Significant improvement in sleep quality (p <0.0001) was seen among intervention group when compared to the control group. Wilcoxon signed rank test revealed that the sleep quality improved across repeated tests over a period of time at p<0.0001
Implications:
These results show strong implications that SHP can be applied as a measure for improving sleep quality among psoriasis patients. Nurses in the clinical and community setting play a vital role is disseminating evidence based CAM practices. Widespread use of SHP could improve the quality of sleep thereby reduce psychological impact of disease like depression and suicidal ideations.