| Summary: | 碩士 === 國立臺灣大學 === 職能治療研究所 === 107 === Background: Sleep disturbance severely impacts elderly’s health and quality of life. Non-pharmacological treatments are highly recommended by the National Sleep Foundation as the primary method for improving sleep quality. A sensory-based approach effective in affecting the sympathetic and parasympathetic nervous system can be a potential candidate. Music intervention and proprioceptive interventions can activate the different nervous systems to provide calming effects. However, the effects of these sensory-based interventions on insomnia in elderlies remain unclear. The study aims to investigate the effects of an auditory-based (e.g., listening to the music before sleeping) and a proprioception-based approach (e.g., joint compression exercises) on improving the sleep performance for elderlies. Both interventions can be easily accessed without interrupting their everyday life.
Methods: In this single-case designs study, we recruited three volunteering elderly with primary insomnia and use A-B-A-C-A-D design for 9 weeks including the three periods of baseline phases for 1 week(A), the music intervention phase for 2 weeks(B), the proprioceptive intervention phase for 2 weeks(C) and the combination phase for 2 weeks(D). The main outcome measures include the objective sleeping quality measured everyday by the actigraphy recording the sleeping performance and physiological data during sleep, and the subjective sleeping quality measured every week via the Pittsburgh Sleep Quality Index and the Insomnia Severity. The control variables measures, including the Center for Epidemiologic Studies Depression Scale, Geriatric Anxiety Scale – Chinese Version and WHOQOL-BREF, will be assessed weekly. The above results will present in visually analyzing graphed data to compare the performance among different phases and to evaluate the impacts of different interventions.
Results: Participants have better subjective sleeping quality during the different phase in the 9-weeks of stimulative activities intervention. The degree of self-conscious anxiety and depression are declined, and thus they experience a better quality of life. The music intervention had a positive feedback of sleep efficiency, sleep latency and awakening at night during the two-week intervention. The proprioceptive intervention might have a improvement of sleep latency and still requires comprehensive research to confirm the effect of proprioceptive intervention in improving the sleep efficiency and awakening at night.
Conclusion: Sensory stimulative intervention can improve the subjective sleep quality of the elderly with sleep problems, and then affect their emotional and quality of life feelings. In the improvement of objective sleep performance, the effect of music intervention is more obvious, and may have a maintenance effect. The study found that the sleep performance has obvious instability, and the daily variability is large, which is easily affected by many factors. A large sample size will be needed to further validate the generalization of current results. The base period can be extended to two weeks, and the tracking period can be increased for two weeks to determine the benefit and maintenance effect of sensory stimulation intervention on the improvement of sleep quality in the elderly.
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