Abstract
As physiotherapists are well known for their health promotion role, sleep is no different from any other major aspect of health promotion in physical therapy. The importance of sleep extends beyond its impact on various body functions; it can impact rehabilitation outcomes among various populations commonly seen in the physical therapy practice. This chapter describes the role of physical therapists in promoting sleep health and wellness, and it describes conditions commonly seen in different physical therapy practice settings who suffer from poor sleep. It also discusses the evidence on the impact of sleep disturbances on rehabilitation outcomes, providing examples from various populations. The remaining sections in this chapter discuss the literature regarding common treatment strategies to improve sleep that can be utilized by physical therapists. There is much room for physical therapists to intervene in sleep management. With proper training and evidence-based practice, physical therapists are confidently capable of managing sleep disturbances among their patients.
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References
Magnusson DM, et al. Population health, prevention, health promotion, and wellness competencies in physical therapist professional education: results of a modified Delphi study. Phys Ther. 2020;100(9):1645–58.
Siengsukon CF, Al-Dughmi M, Stevens S. Sleep health promotion: practical information for physical therapists. Phys Ther. 2017;97(8):826–36.
Albakri U, Drotos E, Meertens R. Sleep health promotion interventions and their effectiveness: an umbrella review. Int J Environ Res Public Health. 2021;18(11):5533.
Bezner JR. Promoting health and wellness: implications for physical therapist practice. Phys Ther. 2015;95(10):1433–44.
Association, APT. The Role of the Physical Therapist and the American Physical Therapy Association in Sleep Health HOD P06-20-39-09. 2020.
Lloyd-Jones DM, et al. Life’s essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022;146(5):e18–43.
Altevogt BM, Colten HR. Sleep disorders and sleep deprivation: an unmet public health problem. Washington, DC: National Academies Press (US); 2006.
Control, C.f.D. and Prevention. Insufficient sleep is a public health epidemic. 2015. http://www.cdc.gov/features/dssleep/index.html#References.
Jahrami HA, et al. Sleep disturbances during the COVID-19 pandemic: a systematic review, meta-analysis, and meta-regression. Sleep Med Rev. 2022;62:101591.
Sheikh IN, Roth M, Stavinoha PL. Prevalence of sleep disturbances in pediatric cancer patients and their diagnosis and management. Children. 2021;8(12):1100.
Halstead EJ, et al. Sleep disturbances and patterns in children with neurodevelopmental conditions. Front Pediatr. 2021;9:637770.
Cai H, Wang X-P, Yang G-Y. Sleep disorders in stroke: an update on management. Aging Dis. 2021;12(2):570.
Khot SP, Morgenstern LB. Sleep and stroke. Stroke. 2019;50(6):1612–7.
Minakawa EN. Bidirectional relationship between sleep disturbances and Parkinson’s disease. Front Neurol. 2022;13:927994.
Xu Z, et al. Progression of sleep disturbances in Parkinson’s disease: a 5-year longitudinal study. J Neurol. 2021;268:312–20.
Borges CR, et al. Alzheimer’s disease and sleep disturbances: a review. Arq Neuropsiquiatr. 2019;77:815–24.
Sunkaria A, Bhardwaj S. Sleep disturbance and Alzheimer’s disease: the glial connection. Neurochem Res. 2022;47(7):1799–815.
Foschi M, et al. Sleep-related disorders and their relationship with MRI findings in multiple sclerosis. Sleep Med. 2019;56:90–7.
Kołtuniuk A, et al. Sleep disturbances, degree of disability and the quality of life in multiple sclerosis patients. Int J Environ Res Public Health. 2022;19(6):3271.
Uchmanowicz I, et al. The influence of sleep disorders on the quality of life in patients with chronic low back pain. Scand J Caring Sci. 2019;33(1):119–27.
Beetz G, et al. Relevance of sleep disturbances to orthopaedic surgery: a current concepts narrative and practical review. JBJS. 2021;103(21):2045–56.
Miner B, Kryger MH. Sleep in the aging population. Sleep Med Clin. 2020;15(2):311–8.
Morse AM, Bender E. Sleep in hospitalized patients. Clocks Sleep. 2019;1(1):151–65.
Thomas KP, et al. Sleep rounds: a multidisciplinary approach to optimize sleep quality and satisfaction in hospitalized patients. J Hosp Med. 2012;7(6):508–12.
Hardin KA. Sleep in the ICU: potential mechanisms and clinical implications. Chest. 2009;136(1):284–94.
Meltzer LJ, Davis KF, Mindell JA. Patient and parent sleep in a children’s hospital. Pediatr Nurs. 2012;38(2):64.
Young JS, et al. Sleep in hospitalized medical patients, part 1: factors affecting sleep. J Hosp Med. 2008;3(6):473–82.
Truong KK, et al. Timing matters: circadian rhythm in sepsis, obstructive lung disease, obstructive sleep apnea, and cancer. Annal Am Thorac Soc. 2016;13(7):1144–54.
Rampes S, et al. Postoperative sleep disorders and their potential impacts on surgical outcomes. J Biomed Res. 2020;34(4):271.
Dobing S, et al. Sleep quality and factors influencing self-reported sleep duration and quality in the general internal medicine inpatient population. PLoS One. 2016;11(6):e0156735.
Ünsal A, Demir G. Evaluation of sleep quality and fatigue in hospitalized patients. Int J Caring Sci. 2012;5(3):311–9.
Kim DE, Yoon JY. Factors that influence sleep among residents in long-term care facilities. Int J Environ Res Public Health. 2020;17(6):1889.
Valenza MC, et al. Nursing homes: impact of sleep disturbances on functionality. Arch Gerontol Geriatr. 2013;56(3):432–6.
Garms-Homolovà V, Flick U, Röhnsch G. Sleep disorders and activities in long term care facilities—a vicious cycle? J Health Psychol. 2010;15(5):744–54.
Kalmbach DA, et al. Poor sleep is linked to impeded recovery from traumatic brain injury. Sleep. 2018;41(10):zsy147.
Fleming MK, et al. Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery. Neurorehabil Neural Repair. 2020;34(7):661–71.
Drerup M, et al. Therapeutic approaches to insomnia and fatigue in patients with multiple sclerosis. Nat Sci Sleep. 2021;13:201–7.
Iddagoda MT, et al. Post-stroke sleep disturbances and rehabilitation outcomes: a prospective cohort study. Intern Med J. 2020;50(2):208–13.
Devos H, et al. Real-time assessment of daytime sleepiness in drivers with multiple sclerosis. Mult Scler Relat Disord. 2021;47:102607.
Aricò D, et al. Effects of NREM sleep instability on cognitive processing. Sleep Med. 2010;11(8):791–8.
Kempler L, Richmond JL. Effect of sleep on gross motor memory. Memory. 2012;20(8):907–14.
DePietro RH, et al. Association between inpatient sleep loss and hyperglycemia of hospitalization. Diabetes Care. 2017;40(2):188–93.
Watson PL, Ceriana P, Fanfulla F. Delirium: is sleep important? Best Pract Res Clin Anaesthesiol. 2012;26(3):355–66.
Leukoff S, Evans D, Liptzin B. Delirium: the occurrence and persistence of symptoms among elderly hospitalised patients. Arch Intern Med. 1992;152(2):334–40.
Bolona E, Hahn PY, Afessa B. Intensive care unit and hospital mortality in patients with obstructive sleep apnea. J Crit Care. 2015;30(1):178–80.
Kaw R, et al. Postoperative complications in patients with obstructive sleep apnea. Chest. 2012;141(2):436–41.
Louis JM, et al. Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009. Sleep. 2014;37(5):843–9.
Frange C, et al. Practice recommendations for the role of physiotherapy in the management of sleep disorders: the 2022 Brazilian Sleep Association Guidelines. Sleep Sci. 2022;15(4):515.
Hauri PJ. Sleep hygiene, relaxation therapy, and cognitive interventions. In: Case studies in insomnia. Boston, MA: Springer; 1991. p. 65–84.
Sivertsen B, et al. Sleep problems in general practice: a national survey of assessment and treatment routines of general practitioners in Norway. J Sleep Res. 2010;19(1 Pt I):36–41.
Irish LA, et al. The role of sleep hygiene in promoting public health: a review of empirical evidence. Sleep Med Rev. 2015;22:23–36.
Cho S, Kim G-S, Lee J-H. Psychometric evaluation of the sleep hygiene index: a sample of patients with chronic pain. Health Qual Life Outcomes. 2013;11:1–7.
Lin C-Y, et al. A cluster randomized controlled trial of a theory-based sleep hygiene intervention for adolescents. Sleep. 2018;41(11):zsy170.
Dietrich SK, et al. Effectiveness of sleep education programs to improve sleep hygiene and/or sleep quality in college students: a systematic review. JBI Evid Synth. 2016;14(9):108–34.
Zengin L, Aylaz R. The effects of sleep hygiene education and reflexology on sleep quality and fatigue in patients receiving chemotherapy. Eur J Cancer Care. 2019;28(3):e13020.
Herscher M, et al. A sleep hygiene intervention to improve sleep quality for hospitalized patients. Jt Comm J Qual Patient Saf. 2021;47(6):343–6.
Chung K-F, et al. Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Fam Pract. 2018;35(4):365–75.
Drake CL, et al. Treating chronic insomnia in postmenopausal women: a randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restriction therapy, and sleep hygiene education. Sleep. 2019;42(2):zsy217.
Bogdanov S, Naismith S, Lah S. Sleep outcomes following sleep-hygiene-related interventions for individuals with traumatic brain injury: a systematic review. Brain Inj. 2017;31(4):422–33.
Xie Y, et al. Effects of exercise on sleep quality and insomnia in adults: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry. 2021;12:664499.
Lowe H, et al. Does exercise improve sleep for adults with insomnia? A systematic review with quality appraisal. Clin Psychol Rev. 2019;68:1–12.
Stutz J, Eiholzer R, Spengler CM. Effects of evening exercise on sleep in healthy participants: a systematic review and meta-analysis. Sports Med. 2019;49(2):269–87.
Park I, et al. Exercise improves the quality of slow-wave sleep by increasing slow-wave stability. Sci Rep. 2021;11(1):4410.
Hasan F, et al. Comparative efficacy of exercise regimens on sleep quality in older adults: a systematic review and network meta-analysis. Sleep Med Rev. 2022;65:101673.
Wang F, Boros S. The effect of physical activity on sleep quality: a systematic review. Eur J Physiother. 2021;23(1):11–8.
Youngstedt SD, O’connor PJ, Dishman RK. The effects of acute exercise on sleep: a quantitative synthesis. Sleep. 1997;20(3):203–14.
Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. J Psychiatr Res. 2015;60:56–64.
Hartescu I, Morgan K, Stevinson CD. Increased physical activity improves sleep and mood outcomes in inactive people with insomnia: a randomized controlled trial. J Sleep Res. 2015;24(5):526–34.
Sellami M, et al. The effect of exercise on glucoregulatory hormones: a countermeasure to human aging: insights from a comprehensive review of the literature. Int J Environ Res Public Health. 2019;16(10):1709.
Kubitz KA, et al. The effects of acute and chronic exercise on sleep: a meta-analytic review. Sports Med. 1996;21:277–91.
Riemann D, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675–700.
Buric I, et al. What is the molecular signature of mind–body interventions? A systematic review of gene expression changes induced by meditation and related practices. Front Immunol. 2017;8:670.
Wang W-L, et al. The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis. BMC Psychiatry. 2020;20:1–19.
Ai J-Y, et al. Effects of multi-component exercise on sleep quality in middle-aged adults. Int J Environ Res Public Health. 2022;19(23):15472.
Aiello KD, et al. Effect of exercise training on sleep apnea: a systematic review and meta-analysis. Respir Med. 2016;116:85–92.
Stavrou VT, et al. Obstructive sleep apnea syndrome: the effect of acute and chronic responses of exercise. Front Med. 2021;8:806924.
Lins-Filho OL, et al. Effect of exercise training on subjective parameters in patients with obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med. 2020;69:1–7.
Memon AA, Coleman JJ, Amara AW. Effects of exercise on sleep in neurodegenerative disease. Neurobiol Dis. 2020;140:104859.
Tai D, et al. Can exercise training promote better sleep and reduced fatigue in people with chronic stroke? A systematic review. J Sleep Res. 2022;31(6):e13675.
Al-Sharman A, et al. The effects of aerobic exercise on sleep quality measures and sleep-related biomarkers in individuals with Multiple Sclerosis: a pilot randomised controlled trial. NeuroRehabilitation. 2019;45(1):107–15.
Siengsukon CF, et al. Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: a pilot study. Mult Scler J Exp Transl Clin. 2016;2:2055217316680639.
Tse AC, et al. Effects of exercise on sleep, melatonin level, and behavioral functioning in children with autism. Autism. 2022;26(7):1712–22.
Kreutz C, Schmidt ME, Steindorf K. Effects of physical and mind–body exercise on sleep problems during and after breast cancer treatment: a systematic review and meta-analysis. Breast Cancer Res Treat. 2019;176:1–15.
Eadie J, et al. Physiotherapy for sleep disturbance in people with chronic low back pain: results of a feasibility randomized controlled trial. Arch Phys Med Rehabil. 2013;94(11):2083–92.
Akodu AK, Akindutire OM. The effect of stabilization exercise on pain-related disability, sleep disturbance, and psychological status of patients with non-specific chronic low back pain. Kor J Pain. 2018;31(3):199–205.
Spiegel K, et al. Effects of poor and short sleep on glucose metabolism and obesity risk. Nat Rev Endocrinol. 2009;5(5):253–61.
Qaseem A, et al. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–33.
Edinger JD, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17(2):255–62.
Van Straten A, et al. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis. Sleep Med Rev. 2018;38:3–16.
Hasan F, et al. Comparative efficacy of digital cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis. Sleep Med Rev. 2022;61:101567.
Siengsukon CF, et al. Feasibility and treatment effect of cognitive behavioral therapy for insomnia in individuals with multiple sclerosis: a pilot randomized controlled trial. Mult Scler Relat Disord. 2020;40:101958.
Williams-Cooke C, et al. The impact of cognitive behavioral therapy for insomnia on sleep log and actigraphy outcomes in people with multiple sclerosis: a secondary analysis. Nat Sci Sleep. 2021;13:1865–74.
Luo F, et al. Efficacy of cognitive behavioral therapy on mood disorders, sleep, fatigue, and quality of life in Parkinson’s disease: a systematic review and meta-analysis. Front Psychiatry. 2021;12:793804.
Vitiello MV, et al. Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. J Clin Sleep Med. 2009;5(4):355–62.
Kalmbach DA, et al. A randomized controlled trial of digital cognitive behavioral therapy for insomnia in pregnant women. Sleep Med. 2020;72:82–92.
Selvanathan J, et al. Cognitive behavioral therapy for insomnia in patients with chronic pain–a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2021;60:101460.
Martínez MP, et al. Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial. J Behav Med. 2014;37:683–97.
Alshehri MM, et al. The effects of cognitive behavioral therapy for insomnia in people with type 2 diabetes mellitus, pilot RCT part II: diabetes health outcomes. BMC Endocr Disord. 2020;20(1):1–9.
Redeker NS, et al. Effects of cognitive behavioral therapy for insomnia on sleep-related cognitions among patients with stable heart failure. Behav Sleep Med. 2019;17(3):342–54.
Ma Y, et al. Efficacy of cognitive behavioral therapy for insomnia in breast cancer: a meta-analysis. Sleep Med Rev. 2021;55:101376.
Chen H-Y, et al. Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients. Kidney Int. 2011;80(4):415–22.
Dantas DS, et al. Biopsychosocial model in health care: reflections in the production of functioning and disability data. Fisioterapia em Movimento. 2020;33:1.
Nielsen M, et al. Physical therapist–delivered cognitive-behavioral therapy: a qualitative study of physical therapists’ perceptions and experiences. Phys Ther. 2014;94(2):197–209.
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Aldughmi, M., Frange, C., Siengsukon, C.F. (2023). Physiotherapists: Sleep Health Promoters. In: Frange, C. (eds) Clinical Cases in Sleep Physical Therapy. Springer, Cham. https://doi.org/10.1007/978-3-031-38340-3_2
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DOI: https://doi.org/10.1007/978-3-031-38340-3_2
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