Effect of Rosa damascene aromatherapy on sleep quality in cardiac patients: A randomized controlled trial

https://doi.org/10.1016/j.ctcp.2014.05.001Get rights and content

Highlights

  • Rosa damascene aromatherapy can improve sleep quality in cardiac patients.

  • Rosa damascene aromatherapy can reduced sleep latency and sleep disturbances.

  • Rosa damascene aromatherapy can also effective in alleviating daytime dysfunction.

Abstract

Objective

Sleep disorders are common among patients hospitalized in coronary care unit (CCU). This study aimed to investigate the effect of Rosa damascene aromatherapy on sleep quality of patients hospitalized in CCU.

Methods

In this randomized controlled trial, 60 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups. Patients in the control group received routine care. In the experimental group, patients received routine care and Rosa damascene aromatherapy for three subsequent nights. In the both groups the sleep quality was assessed using the Pittsburgh Sleep Quality Index.

Results

After the study, the mean scores of five domains of Pittsburg Sleep Quality Index as well as the mean of total score of the index in the experimental group were significantly lower than the control group.

Conclusion

Rosa damascene aromatherapy can significantly improve the sleep quality of patients hospitalized in CCUs.

Introduction

Sleep is a fundamental human need and also a determinant of health maintenance and recovery from diseases [1]. Most of hospitalized patients, particularly patients who are hospitalized in coronary care units (CCU), have some degrees of sleep disorders [2]. In CCUs, environmental factors such as noises, intervention-related pain and discomfort, psychological stress of having an acute disease, and disease complications may put patients at risk for developing sleep disorders [3], [4]. Wenham and Pittard (2009) reported that in intensive care units, patients cannot sleep well and may stay awake for about 30–40% of their sleep time [2].

Sleep disorders can be associated with increased sympathetic activity and subsequent increased blood pressure and heart rate, raising the risk for developing cardiovascular problems among patients hospitalized in CCU [1]. Consequently, improving sleep quality in cardiac patients is a matter of great importance. Many strategies have been developed for improving sleep quality. For example, sedative-hypnotic agents can increase the quality of sleep significantly. However, pharmacologic agents are usually associated with different side-effects [5]. Complementary therapies—including aromatherapy, muscle relaxation, and using eye mask and earplug—can also improve the sleep quality without causing serious side-effects [3], [6], [7].

Aromas can increase patients' calmness through affecting the limbic system [8]. However, research findings about the effectiveness of aromatherapy in improving sleep quality are conflicting. For example, Moeini et al. found that aromatherapy enhanced sleep quality among cardiac patients [3]. Chen et al. also found that valerian aromatherapy increased sleep duration and decreased insomnia among patients hospitalized in intensive care unit [9]. However, a systematic review revealed that lavender aromatherapy has no significant effect on sleep quality [10]. Williams also found that aromatherapy has no effect on sleep quality among children with autism [11].

Rosa damascene aroma is also used as a complementary therapy. According to Boskabady et al., Rosa damascene has hypnotic, sedative, and anticonvulsive effects on the central nervous system [12]. Studies have shown that Rosa damascene alleviates anxiety and promotes relaxation [13], [14], [15]. As anxiety negatively contributes to sleep quality [16], Rosa damascene aroma may also have potential effect on the quality of sleep among patients. However, to the best of our knowledge, this effect has not been examined yet. Accordingly, we conducted this study aiming at investigating the effect of Rosa damascene aromatherapy on sleep quality among patients hospitalized in CCU.

Section snippets

Design

This was a non-blind randomized controlled trial conducted in September–December 2013. The study setting included the two CCUs of a teaching hospital affiliated to Kashan University of Medical Sciences, Kashan, Iran.

Participants

The study population comprised all patients hospitalized in the study setting. The inclusion criteria were being oriented to time, place, and person, having a cardiac ejection fraction of at least 40%, having no known sleep-disturbing diseases (such as rheumatoid arthritis and

Findings

Thirty patients were enrolled in each group (Fig. 1). The mean and standard deviation of participants' age in the experimental and the control groups were 61.40 ± 11.64 and 63.9 ± 10.23 years, respectively. Most of the participants were married (88.3%), literate (61.70%), and male (58.30%). The medical diagnosis for most participants was acute coronary syndrome (66.70%). Most of the participants (68.30%) had been previously hospitalized for at least one time. The statistical analysis showed no

Discussion

This study investigated the effect of Rosa damascene aromatherapy on sleep quality among patients hospitalized in CCU. The findings revealed that Rosa damascene aromatherapy significantly improved the participants' sleep quality. This is in line with the findings of studies conducted by Chien et al. and Soden et al. [22], [23]. Moreover, Lewith et al. found that aromatherapy significantly alleviated insomnia and improved the quality of life [24]. However, Williams et al. and Lytle et al. found

Conclusion

The findings of this study indicate that Rosa damascene aromatherapy can significantly improve the sleep quality of cardiac patients hospitalized in CCU. Accordingly, healthcare providers can use Rosa damascene aroma—either in combination with current treatments or alternatively—for promoting patients' sleep without causing them the adverse side-effects of routine sleep medications. However, conducting further long-term, large-scale studies on cardiac patients as well as other patient

Conflict of interest statement

The authors have no conflict of interest to declare.

Acknowledgment

This article is the report of a Master's thesis funded by Kashan University of Medical Sciences with the number 9276. The recorded code in the registration center of clinical trials is IRCT2013052013403N1. We would like to gratefully thank the Research Administration of the funding university as well as the administrators and the staffs of the study setting who helped and supported us during the study. We also are thankful of the patients for their participation in this study.

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