A critical review of self-care for sleep disturbances: prevalence, profile, motivation, perceived effectiveness and medical provider communication

Abstract

Objective: This study aims to undertake the first critical review of self-care use among adults with sleep disturbances by focusing on the prevalence of self-care-the self-determined and self-administered use of products or practices-by adults with sleep disturbances. Methods: A comprehensive search of 2006-2016 international literature in CINAHL, AMED, Medline and EMBASE databases was conducted. The search was confined to empirical research findings regarding sleep disturbances -as indicated by a validated sleep scale/index or clinician diagnosis. Results: Of the 21 articles included in this review, only three reported on sleep disturbances other than insomnia disorder (ID) or insomnia symptoms (IS). Overall, a high prevalence of self-care use is reported among adults with sleep disturbances, particularly for ID and IS. Self-care products and practices are more likely to be used by adults with sleep disturbances, than those without sleep disturbances. Commonly used self-care products and practices include OTC hypnotics, antihistamines, diphenhydramine products, diet, exercise, painkillers, herbal medicines, vitamins, minerals and dietary supplements, yoga, tai chi, Qigong, meditation, exercise and relaxation. Conclusions: Many adults with sleep disturbances-particularly ID or IS-frequently use self-care products and practices. Self-care products are also used concomitantly with conventional prescription medications without disclosure to medical professionals. The current literature is of varied methodological caliber, frequently relies on small sample sizes and low-quality data collection therefore further rigorous health services research is required. There is an especial paucity of data regarding self-care for sleep disturbances such as restless legs syndrome and obstructive sleep apnea. Healthcare providers may find it beneficial to actively ask patients about their use of self-care for sleep disturbances to help avoid harmful drug-drug or drug-herb interactions.

Maladaptive coping mechanisms of sleep

“…Meredith and colleagues performed a critical review of literature regarding patients with sleep disturbances and self-care and found that the use of maladaptive coping mechanisms was common in this population. 14 Limitations. The study had signifi cant limitations.…”

“…While there were limited studies to review, our findings supported those of other researchers on this topic. Meredith and colleagues performed a critical review of literature regarding patients with sleep disturbances and self-care and found that the use of maladaptive coping mechanisms was common in this population 14…”

“…Stimulants such as caffeine, nicotine, and some drugs (both prescribed and illicit) have all been shown to affect sleep quality in different ways, and all increase sleep latency 13. Finally, researchers have shown that many patients tend to avoid seeing healthcare providers for help with sleep issues and instead will self-treat in order to maintain control of their health 14…”

“…13 Finally, researchers have shown that many patients tend to avoid seeing healthcare providers for help with sleep issues and instead will self-treat in order to maintain control of their health. 14…”

A review of available herbal medicine options for the treatment of chronic insomnia

“…These changes not only cause changes in the mechanism of depression and anxious behavior but causes sleep disorder. All these changes in the GABA receptors are induced by the sedative-hypnotic effects of some drugs [41].…”