Effects of autogenic relaxation and guided imagery on insomnia in the critically ill adult

This research tested the effects of progressive relaxation and guided imagery on the sleep of critically ill adults. The problem this study addressed was the discrepancy between the amount of sleep a critically ill person needs and the amount of sleep obtained. An experimental design with repeated measures examined the following research hypotheses: (a) Sleep scores of critically ill patients who use relaxation and imagery will improve over time when compared to those who do not use these interventions, and (b) descriptions of sleep from critically ill patients who use relaxation and imagery over time will differ from descriptions from those who do not use these interventions. A convenience sample of 36 critically ill adults from three intensive care units (ICUs) in two teaching hospitals was randomly assigned to an experimental or control group. Sleep was measured on 3 consecutive mornings via the revised Verran-Snyder-Halpern Sleep Scale (VSH Sleep Scale), which is a visual analogue paper-and-pencil tool. Each morning subjects were asked an open-ended question about their perception of the night's sleep. The intervention consisted of a relaxation and imagery exercise delivered in person on 2 consecutive evenings. Process variables were recorded prior to and following delivery of the intervention. Factor analysis and coefficient alpha showed that two items measured the perception of sleep in this sample. Repeated measures analysis of variance (ANOVA), using changes in sleep scores on these two items, tested for the effects of the intervention. Alpha was set at.05. There was no significant difference in sleep scores over time on the basis of the intervention. For all subjects, sleep improved significantly over time. A significant difference was seen in the pattern of improvement based on unit. An interaction between transfer and time, with sleep scores improving with transfer, was found; and there was an interaction between the intervention and gender over time, with different patterns of improvement in the experimental group based on gender. Qualitative data suggested that there were differences in the experience of sleep in ICU between men and women.