The Effectiveness of Sleep Hygiene Programs for improving Sleep Quality for Adults with an Acquired Brain Injury: A Systematic Review

Abstract

Background: Sleep disturbances are argued to be a pervasive symptom post acquired brain injuries (ABIs) and are associated with poor functional outcomes. While sleep hygiene is commonly used in clinical practice to improve sleep quality, it is frequently implemented in combination with other interventions. Consequently, the aim of this systematic review was to consolidate the effectiveness of sleep hygiene programs as a sole intervention for improving sleep quality for people with ABIs.  Methods: MEDLINE, Emcare, Embase, PsycINFO, Scopus and OTseeker were searched in October 2022. Studies were included if they investigated the effectiveness of sleep hygiene programs with adults with ABIs (18+). Studies were excluded if sleep hygiene programs were implemented in conjunction with other interventions. This review was conducted and reported in line with PRISMA guidelines. The Joanna Briggs Institute (JBI) critical appraisal tool for randomised control trials (RCTs) was used to assess the methodological quality of the included RCT study design. In addition, the Mixed Methods Appraisal Tool was used to appraise the methodological quality of the included mixed study design. Results: Out of 369 studies identified, two studies (one RCT and one quasi-experimental pre-test post-test study) met inclusion criteria. Across the included studies, there was homogeneity in the contents of the sleep hygiene programs, however heterogeneity was present in the outcome measures utilised. Summarised findings indicated that sleep hygiene programs have the potential to improve sleep quality in adults with ABIs. Conclusion: There is minimal support that sleep hygiene programs are effective at improving sleep quality in adults with ABIs when administered as a sole intervention. However, the small number of studies included in this review and their varying methodological qualities may have influenced these findings. Consequently, consideration should be taken when implementing sleep hygiene programs into clinical practice with ABI patients.