Non-pharmacological interventions for sleep and quality of life: a randomized pilot study.
Mariana Alvina Dos Santos, Ana Paula da Conceição, Renata Eloah de Lucena Ferretti-Rebustini and 3 others
PMID 30462790WHAT IT FOUND
Sleep hygiene, morning light, and their combination did not significantly improve sleep or quality of life compared with the other groups.
All groups improved, including control, so this pilot cannot show which intervention worked.
Key findings
01After adjusting for baseline, the groups did not differ significantly in sleep quality or quality of life at 12 and 24 weeks.
02Sleep and quality-of-life scores decreased in all groups over follow-up.
03Self-reported adherence differed by group, with the phototherapy group having the lowest median adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This pilot had 32 participants, so it was not designed to prove effects. All groups received 20-minute orientation and weekly telephone calls for 12 weeks, so the control group was not usual care alone. Participants and the interventionist were not blinded. The phototherapy group's sunlight exposure was not measured for intensity. Adherence was self-reported and may be overestimated. One participant died before the 24-week assessment, and some outcome values were missing. No adjustment for multiple comparisons was made. The study was done in one specialized university hospital, so it may not represent all heart failure outpatients.
The easy way to misread this
Do not conclude that sleep hygiene or morning light improves heart failure outcomes more than standard guidance. The between-group differences were not significant, and the control group also improved because it received structured orientation and weekly telephone contact.