Title : Combined acceptance and commitment therapy and sleep hygiene education for improving sleep and physiological outcomes in older adults

Background: Sleep problems are common in older adults and may be accompanied by adverse physiological outcomes. This study compared the effects of Acceptance and Commitment Therapy (ACT), Sleep Hygiene Education (SHE), and their combination on sleep quality and physiological parameters in older adults.

Methods: This quasi-experimental study used a pre-test, post-test, and follow-up design with a control group. The study population consisted of older adults attending the Jahandidegan Center in Shiraz, Iran, in 2018. Using convenience sampling and specified inclusion and exclusion criteria, 80 participants were selected and randomly assigned to four groups: ACT, SHE, ACT+SHE, and control. The ACT and SHE interventions were delivered over four weeks, while the control group was placed on a waiting list. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Blood pressure was measured with a mercury sphygmomanometer, and oxygen saturation was assessed using a pulse oximeter. Data were analyzed using two-way mixed analysis of variance and multivariate analysis of covariance.

Results: The mean age of participants was 70.41±4.05 years. Following the intervention, changes in sleep quality, systolic blood pressure, and oxygen saturation were significant across the experimental groups (P<0.001). The largest effect on sleep quality was observed in the combined ACT+SHE group (0.83), followed by SHE (0.67) and ACT (0.60).

Conclusion: ACT, Sleep Hygiene Education, and particularly their combination can improve sleep quality and may consequently improve systolic blood pressure and oxygen saturation in older adults. The findings support the value of integrating psychological intervention with behavioral sleep education in programs designed to promote psychological and physical health in older adults.

Reza Mottaghi, PhD, is a psychologist and researcher with a focus on psychological interventions, sleep disorders, older adults, and mental health. His research has examined Acceptance and Commitment Therapy, sleep hygiene education, cognitive-behavioral approaches, and music therapy in relation to sleep quality and health outcomes in older adults. He is affiliated with Shiraz University of Medical Sciences, Iran, and has authored research articles in the fields of psychology, sleep, aging, and behavioral health.