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Massage and Sleep Patterns in Critically Ill Patients
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Critically ill patients are deprived of sleep and its potential healing qualities, although many receive medications to promote sleep. No one has adequately evaluated holistic nonpharmacological techniques designed to promote sleep in critical care practice. This study was conducted to determine the effects of a 1) back massage and 2) a combination of muscle relaxation, mental imagery and a music audiotape on the sleep of older men with a cardiovascular illness who were hospitalized in a critical care unit. Sixty-nine patients were randomly assigned to one of three groups. A control group received routine nursing care before bedtime and a six-minute rest period at bedtime. Group two received a six-minute back massage (effleurage). Group three received a teaching session on relaxation and a 7.5-minute audiotape at bedtime consisting of progressive muscle relaxation, mental imagery and relaxing background music.
Because the intervention, if found effective, was to be used by practising nurses, no special massage training other than basic nursing education was acquired. Polysomnography was used to measure one night of sleep for each patient.
Results showed improved quality of sleep among the back massage group. Descriptive parameters revealed that patients in the back-massage group experienced higher quality and quantity of sleep than did patients in the control group. Sleep efficiency index was 14.7% higher in the massage group than in the control group. The relaxation-audiotape intervention did not have a statistically significant effect on sleep. This study concludes that the use of back massage, as an alternative or adjunct to pharmacological treatment, is a clinically effective nursing intervention for promotion of sleep.
Culpepper-Richards K University of Arkansas College of Nursing and Veterans Affairs Medical Centre, Little Rock, Arkansas:American Journal of Critical Care: 7(4):288-299, 1998 July
The Effectiveness of Acupressure in Improving the Quality of Sleep of Institutionalized Residents
Elderly people often suffer from disturbed sleep. This study tested the effectiveness of acupressure in enhancing the quality of sleep of institutionalized residents. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used as a screening tool to select 84 subjects with sleep disturbance.
These subjects were randomly assigned to an acupressure group, a sham acupressure group and a control group. The same massage routine was used for the acupressure and sham acupressure groups, with the difference that five acupoints to enhance sleep were chosen for the acupressure group, while non-acupoints were used for the sham group. Only conversation was employed in the control group.
Although there were some differences in PSQI scores after intervention in all three groups, improvements were greatest in the acupressure group, which experienced a significant reduction in the frequencies of nocturnal awakening and night wakeful time. The study confirmed the effectiveness of acupressure in improving the quality of sleep of elderly people and offered a non-pharmacological therapy method for sleep-disturbed elderly people.
NAMES: Chen ML, Lin LC, Wu SC, Lin JG; Department of Nursing, National Taipei Nursing College, Taiwan; Journal of Gerontology: MEDICAL SCIENCES, 1999 Aug, 54:8, M389-94
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