The Effect of Massage and Foot Reflexology on Sleep in Newborns
Moderate EvidenceIn Plain Language: reflexology, explained
Objective: This study was conducted to examine the effects of massage and foot reflexology on the sleep of premature infants. Materials and Methods: The research was designed as a randomized controlled experimental study. The study population consisted of premature infants born at 30-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of a hospital in the Central Anatolia Region. The sample included 108 premature infants divided into three groups: Massage group (n = 36), Foot reflexology group (n = 36), and Control group (n = 36). Data were collected using a neonatal follow-up form and actigraphy. Massage and foot reflexology interventions were administered to the respective groups twice daily (Morning: 07:00-09:00 and Evening: 19:00-21:00) for 15 minutes each session over two consecutive days, making up a total of four sessions. The control group received routine nursing care without any additional intervention. Pre-test (once) and post-test (once) measurements of 24-h sleep durations were assessed using actigraphy for all groups. Results: Sleep duration in the massage group increased compared to pre-intervention (251 minutes) and the control group (272 minutes), while the sleep duration in the foot reflexology group similarly increased compared to pre-intervention (268 minutes) and the control group (266 minutes) (p .001). Sleep efficiency also showed a significant increase post-intervention, rising to 73% in the massage group and 71.8% in the foot reflexology group compared to the control group (p .001). Furthermore, the number of awakenings and wakefulness duration significantly decreased in the massage and foot reflexology groups compared to the control group (p .05). Conclusion: The findings indicate that massage and foot reflexology are effective non-pharmacological methods for improving sleep duration and sleep efficiency while reducing wakefulness duration and the number of awakenings in premature infants.
Key Findings: what this randomised trial found
- ✓Both massage and foot reflexology interventions were administered twice daily for 15 minutes per session over two consecutive days to premature infants in the neonatal intensive care unit.
- ✓The study compared three groups of 36 premature infants each: a massage group, a foot reflexology group, and a control group that received only routine nursing care.
- ✓Sleep outcomes in premature infants were measured using actigraphy, a quantitative method for assessing sleep patterns and duration.
What This Means for You
While this study shows promising results for premature infants in hospital settings, more research is needed before reflexology can be confidently recommended as a sleep aid for newborns outside medical care.
What This Means for Practitioners
This RCT provides moderate evidence that foot reflexology administered twice daily can meaningfully improve sleep metrics in hospitalized premature infants, suggesting potential value in neonatal care protocols when properly trained.
Study Design: how this randomised trial was run
Common questions about this study
What does this study mean in practice?
While this study shows promising results for premature infants in hospital settings, more research is needed before reflexology can be confidently recommended as a sleep aid for newborns outside medical care.
What did this study find?
Both massage and foot reflexology interventions were administered twice daily for 15 minutes per session over two consecutive days to premature infants in the neonatal intensive care unit. The study compared three groups of 36 premature infants each: a massage group, a foot reflexology group, and a control group that received only routine nursing care. Sleep outcomes in premature infants were measured using actigraphy, a quantitative method for assessing sleep patterns and duration.
How strong is this evidence?
This is a randomised trial and we rate its evidence moderate. It covers 108 participants. It was published in Biological research for nursing. Reflexology is a complementary therapy, not a replacement for medical treatment.
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