Program helps residents improve their sleep

For Mary Jo Beveridge, Lynne Braun and Michael Tofflemire, getting a good night’s sleep can be challenging. Like many older people, they struggle with insomnia, sleep-related disturbances or other sleep issues.

“My heart disease causes me to wake up, and I don’t sleep very well,” says Michael, 73. “Or I can’t fall asleep. I get the shakes, and I can’t control them.”

Michael, Mary Jo and Lynne are three of seven residents who participated in the Better Sleep program launched at St. Teresa Place, a Covenant Care community in Calgary, earlier this year. The program was created by Mandy Wright, recreation therapist, to help residents improve their sleep by learning about and practicing leisure activities that promote sleep and developing a personal sleep hygiene plan. She based the program on research and activities that helped her improve her own poor sleep and quality of life after becoming a new parent.

“After having firsthand experience of what lack of sleep does to you and your well-being, I saw a need that I could help with,” says Mandy.

Research shows that there is a higher prevalence of poor sleep and sleep-related disturbances in older people, Mandy says. And severe sleep issues can lead to depression, stress, lower quality of life and impaired function. Developing healthy leisure habits, including purposeful activities, may help people in supportive living improve their sleep and well-being.

The Better Sleep program included seven sessions held once a week between late May and mid-July. Participants were selected based on their needs and goals as well as ability to engage in activities. To establish baseline data, Mandy and her team assessed each participant before the program began using the Pittsburgh Sleep Quality Index (PSQI), which looks at factors such as length and efficiency of sleep. During each session, the participants also completed a self-assessment of their sleep patterns the week before, and they learned about a new leisure activity that promotes sleep. The activities included therapeutic light exposure, breath work, meditation, mindful movement (muscle relaxation, yoga and tai chi), gratitude practice and social-intellectual leisure (cognitive games). The participants then practiced the activity on their own the following week and tracked their habits and sleep patterns in a Better Sleep workbook.

Throughout the program, the participants were enthusiastic and enjoyed doing the activities, says Mandy. “Their dedication to the program and commitment to tracking were amazing. They were really invested in it because they saw the benefit.”

While some of the leisure activities were new for participants, others were familiar, Mandy says. In introducing each activity, she shared research evidence that it promotes sleep. For example, the session on practicing gratitude looked at research that supports the role of gratitude in promoting positive thinking and eliminating negative thinking, which often keeps people awake.

During the final group session, with Mandy’s support, the participants created their own sleep hygiene plan based on the activities they felt improved their sleep and activities they enjoyed. Of all the activities, gratitude practice, breath work and meditation were the top three included in participants’ plans.

Michael had been practicing meditation for many years, and it continued to be a beneficial activity for him during the program. “Meditation and mindful movement ― doing body scans ― were very useful and would help me relax,” he says.

For Lynne, 85, meditation, gratitude practice and social-intellectual games were the most helpful and enjoyable activities. “It’s better to select two to four habits rather than trying to take on all of them and biting off more than you can chew,” she says. “Then you can formalize what you do with those tools, and they will become part of your life routine.”

Meditation and gratitude practice were also favourite activities for Mary Jo, 80, who was often kept awake by nerve pain resulting from a car accident. Muscle relaxation was helpful as well, she says. “I would lie on my bed and rest and relax my body, and that helped the pain, so I am doing that and continue to do that before I go to bed.”

The overall results of the program were positive, says Mandy. She and her team assessed each participant again using the PSQI within two days of completing the sessions. The PSQI scores showed that 57 per cent of the participants were experiencing better sleep at the end of the program. The self-ratings they completed before each session also showed improvement.

“The average participant sleep improved 16 per cent overall, and during week five when we had our gratitude practice, we saw a jump of 26 per cent, which was really wonderful to see,” says Mandy.

By the end of the program, the participants were also able to showcase their newly acquired knowledge of how to improve their sleep in a group game of Jeopardy and had incorporated their new habits into their daily routine, says Mandy.

“In the sixth week, we played Jeopardy, and it was a beautiful moment for me as the facilitator to see what they took away from the program.”

Given its initial success, Mandy has now launched the Better Sleep program with a second group of residents at St. Teresa Place. She and her team also continue to follow up with the original group to track any changes in their sleep and to see what activities they are still practicing.

Michael, Mary Jo and Lynne all experienced better sleep by engaging in the program’s leisure activities, and they would all recommend the program to other residents who struggle with poor sleep.

“It would be good to have a wide variety of people (participate),” says Lynne. “It would help with better statistics, and the program would be refined and give us a better understanding of how sleep affects us.”

Mary Jo agrees. “I am very grateful I took (the program). I would recommend it. We need our sleep. If we don’t get our sleep, we can’t function well the next day and life is more difficult.”