Improving Sleep Quality and General Health through a Sleep Promotion Program: Evidence from Institutionalized Older Adults in Punjab and Chandigarh

Shiva Sharma; Manu Kohli; Divya Thakur

doi:10.31584/jhsmr.20261405

Improving Sleep Quality and General Health through a Sleep Promotion Program: Evidence from Institutionalized Older Adults in Punjab and Chandigarh

Shiva Sharma, Manu Kohli, Divya Thakur

Abstract

Objective: Older adults living in institutional settings face multiple challenges to maintain good sleep, including environmental noise, irregular routines, reduced sunlight exposure, and psychosocial stressors such as loneliness. This study evaluated the effect of the Sleep Promotion Program on sleep quality and general health among older adults.
Material and Methods: A true experimental pre-test and post-test research design was adopted with a sample size of 94. A sleep promotion program was administered to the experimental group for four weeks, focusing on sleep hygiene, guided imagery, and aerobic exercises. The effect of the intervention was measured at baseline and on the 31st day through the scales: Pittsburgh Sleep Quality Index and General Health Questionnaire-28 (GHQ-28). Data were analysed using descriptive and inferential statistics.
Results: Post-intervention assessment after 4 weeks revealed improvement in sleep quality (U=772.00, Z=-2.565, p-value=0.010) and general health (Z=-2.074, p-value=0.038) among the older adults. The waitlist control group showed no significant change in either measure. A positive correlation was observed between better sleep quality and improved general health outcomes.
Conclusion: The Sleep Promotion Program effectively enhanced sleep quality and general health in institutionalized older adults. This low-cost, non-pharmacological intervention can be incorporated into routine elder care to promote healthy ageing.

Keywords

general health; older adults; sleep promotion program; sleep quality

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References

World Health Organization. World report on ageing and health. [homepage on the Internet] Geneva: WHO; 2015. [cited 2025 Nov 3]. Available from: https://iris.who.int/bitstream/handle/10665/186463/9789240694811_eng.pdf

Amarya S, Singh K, Sabharwal M. Ageing process and physiological changes in Gerontology [monograph on the Internet] 2018 [cited 2025 Nov 3]. Available from: https://www.intechopen.com/chapters/60564

United Nations. World Population Ageing 2023. [homepage on the Internet] New York: UN; 2023 [cited 2025 Nov 3]. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_2024_wpa2023-report.pdf

Soni A, Lodha RS. Comparative study of quality of life among elderly in old age homes and families. Int J Community Med Public Health 2024;11:2656–60.

Kumari R, Mahesh M. Breakdown of traditional joint family system and its impact on elderly care in India. Int J Curr Res Acad Rev 2025;13:112–20.

Thomas R. Quality of Life (QOL) of the institutionalized Elderly: A Comparative Study. HelpAge India Res Dev J 2025;27:18-25.

Kim JH, et al. Circadian rhythm sleep-wake disorders in older adults. Sleep Med Clin 2022;17:241–52.

Grandner MA. Sleep, health, and society. Sleep Med Clin 2017;12:1–22.

International Institute for Population Sciences. Longitudinal Ageing Study in India (LASI) Wave 1. Mumbai: IIPS; 2020.

Raja I, Sardar JC. Sleep quality and associated factors among elderly in rural West Bengal. Int J Community Med Public Health 2022;9:1360–5.

Kaur R. A comparative study on physical health problems of Institutionalized and non- institutionalized elderly in Selected communities of amritsar. Indian J Appl Res 2018;8:24-5.

Kaushal NY, Kausal NR, Sharma NI, Mittal NS. Assessment of sleep habits and quality among elderly in rural Patiala: a community-based survey. Int Healthc Res 2021;5:OR1–4. doi: 10.26440/ihrj/0507.10466.

Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis. J Clin Sleep Med 2023;19:605–20.

Rosewood-nursing.com. How nursing homes address sleep challenges in seniors. [homepage on the Internet] New York: Rosewood Nursing; 2023. [cited 2025 Nov 3]. Available from: https://www.rosewood-nursing.com/post/how-nursing-homes-address-sleep-challenges-in-seniors

Hassan M. Effect of sleep hygiene program on sleep quality, depression, anxiety and stress among resident older adults. IOSR J Nurs Health Sci 2020;9:45–56.

Capezuti E, et al. Non-pharmacological interventions to improve nighttime sleep in long-term care: a systematic review. BMC Geriatr 2018;18:143.

Jung SO, et al. Effects of non-pharmacological interventions on sleep among older adults in Korean long-term care facilities. J Korean Acad Community Health Nurs 2022;33:340–9.

Hariprasad VR, Sivakumar PT, Koparde V, Varambally S, Thirthalli J, Varghese M, et al. Effects of yoga intervention on sleep and quality-of-life in elderly: a randomized controlled trial. Indian J Psychiatry 2013;55(Suppl3):S364-8.

Singh M, Raj S. Poor sleep and functional independence among elderly residents of care homes. J Aging Health 2021;33:547–59.

Verma S, et al. Circadian rhythm disruption and sleep quality in institutionalized older adults. Sleep Med Rev 2019;45:123–30.

Das S, Singh R. Policy frameworks for integrating sleep health in geriatric care in India. Health Policy 2023;127:548–55.

Sandooja C, Panda M, Kumar V, Kishore J. Sleep quality index among elderly in Delhi: a community-based cross-sectional study. Int J Community Med Public Health 2023;10:1537–42.

Raja I, Sardar JC. Sleep quality and associated factors among elderly in rural West Bengal. Int J Community Med Public Health 2022;9:1360.

George S, Paul G, Paul N. Sleep quality and psychosocial factors among elderly in rural Kerala. Int J Community Med Public Health 2018;5:526.

Than NH, Le TVM, Nguyen TTT, Nguyen TV, Nguyen TC, Nguyen TV. Poor sleep quality and associated factors among community-dwelling older adults in Vietnam. Aging Med Healthc 2023;14:130–7. doi: 10.33879/amh.143.2022.02016.

Shahid A, Wilkinson K, Marcu S, Shapiro CM. Pittsburgh sleep quality index (PSQI). In: Springer eBooks [serial on the Internet]. 2011 [cited 2025 Nov 3];p.279–83. Available from: https://doi.org/10.1007/978-1-4419-9893-4_67

Sterling M. General health questionnaire–28 (GHQ-28). J Physiother 2011;57:259. doi: 10.1016/s1836-9553(11)70060-1.

Roffe L, Schmidt K, Ernst E. A systematic review of guided imagery as an adjuvant cancer therapy. Psychooncology 2005;14:607-17.

Posadzki P, Ernst E. Guided imagery for musculoskeletal pain: a systematic review. Clin J Pain 2011;27:648-53.

Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med 2010;11:934-40.

Kaewlue A, Banharak S, Panpanit L, et al. Multisensory sleep-promotion program effectiveness among hospitalized older adults: a quasi-experimental study. Behav Sleep Med 2022;1–16.

Patel N, Chokroverty S. Sleep intervention outcomes in elderly populations: a comparative analysis. J Clin Sleep Med 2020;16:889–96.

Mokhlesi B, Sanders MH. Treatment of insomnia in older adults: review of pharmacological and non-pharmacological interventions. Sleep Med Rev 2021;50:101265.

Li J, Wang Z. Structured sleep hygiene interventions and sleep disturbances in the elderly: a quasi-experimental study. BMC Geriatr 2020;20:315.

Martin S, Brown J. Effectiveness of sleep interventions on quality of life and health in elderly: a systematic review. Int J Nurs Stud 2019;96:65–78.

Kamel NS, Gammack JK. Insomnia in the elderly: cause, approach, and treatment. Am J Med 2006;119:463–9.

DOI: http://dx.doi.org/10.31584/jhsmr.20261405

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