The effects of sleep hygiene education and reflexology on sleep quality and fatigue in patients receiving chemotherapy

Authors: Zengin Leyla, Aylaz RukuyeJournal: European journal of cancer carePublished: May 1, 2019DOI: 10.1111/ecc.13020

Q2 JournalSJR: 0.6h-index: 62

Moderate EvidenceRandomized Controlled Trialn=167 participants

In Plain Language: reflexology for sleep, explained

This study was conducted to determine the effects of sleep hygiene education and reflexology on sleep quality and fatigue in the patients receiving chemotherapy. The sample of the study consisted of 167 patients (84 in the experimental and 83 in the control group). The data were collected between October 2016 and November 2017 using an Introductory Information Form, the Pittsburgh Sleep Quality Index (PSQI) and the Fatigue Severity Scale (FSS). The mean -test score from the PSQI was 5.5 ± 2.1 for the experimental group and 13 ± 2.4 for the control group. The mean post- test score from the FSS was 22.6 ± 1.9 for the experimental group and 41.0 ± 4.2 for the control group. The difference between the mean scores of the groups was statistically significant (p = 0.000). The patients receiving chemotherapy had lower mean scores from the PSQI and the FSS while they had increased sleep quality and decreased fatigue after sleep hygiene education and reflexology.

Key Findings: what this randomised trial found about sleep

✓Sleep hygiene education and reflexology significantly improved sleep quality in chemotherapy patients, with the experimental group achieving a mean PSQI score of 5.5 compared to 13.0 in the control group (p = 0.000).
✓Fatigue severity was substantially reduced in patients receiving the intervention, with the experimental group showing a mean FSS score of 22.6 compared to 41.0 in the control group (p = 0.000).
✓The combination of sleep hygiene education and reflexology resulted in statistically significant improvements in both sleep quality and fatigue levels among chemotherapy patients.

What This Means for You

If you're undergoing chemotherapy, combining reflexology with sleep hygiene education may meaningfully reduce fatigue and improve sleep quality, though more research is needed to confirm these benefits.

What This Means for Practitioners

This study provides moderate evidence that reflexology combined with sleep hygiene education can reduce fatigue and improve sleep in chemotherapy patients—consider offering these as complementary interventions.

Study Design: how this randomised trial was run

Sample Size

167 participants

Read Full Paper↗

Reflexology for sleep: common questions

Does reflexology help with sleep?

What did this study find?

Sleep hygiene education and reflexology significantly improved sleep quality in chemotherapy patients, with the experimental group achieving a mean PSQI score of 5.5 compared to 13.0 in the control group (p = 0.000). Fatigue severity was substantially reduced in patients receiving the intervention, with the experimental group showing a mean FSS score of 22.6 compared to 41.0 in the control group (p = 0.000). The combination of sleep hygiene education and reflexology resulted in statistically significant improvements in both sleep quality and fatigue levels among chemotherapy patients.

How strong is this evidence?

This is a randomised trial and we rate its evidence moderate. It covers 167 participants. It was published in European journal of cancer care, a Q2 journal. Reflexology is a complementary therapy, not a replacement for medical treatment.