Authors (including presenting author) :
Fong CP, Tsang M, Lai A
Affiliation :
Central Nursing Division, Kwai Chung Hospital
Introduction :
Regular and acute exercise has a positive influence on total sleep time, sleep onset latency and slow-wave sleep (Kredlow, Capozzoli, Hearon, Calkins, & Otto, 2015). However, due to the restriction in the hospital, it is difficult for patients to do acute exercise to improve their sleep in the psychiatric intensive care unit. Therefore, the lifestyle-integrated approach of incorporating exercise into daily activities has been proposed. Zero Time Exercise (ZTE) is advocated by Lam’s research team in Hong Kong University to encourage people to increase physical activity by simple doing stretching and limb movements in daily activities (Lam, Lai & Wan, 2016). ZTE does not require extra time, money or equipment. ZTE training also showed high acceptability and exercise compliance and evidence of efficacy in reducing insomnia severity in inactive adults with an insomnia disorder (Yeung et al., 2018). Therefore, it is easy to motivate psychiatric patients with insomnia to practice ZTE to improve their sleep.
Objectives :
1. To motivate a client with chronic insomnia to master ZTE
2. To improve a client’s insomnia situation
Methodology :
A client with chronic insomnia and hypnotic dependence was invited to complete the Insomnia Severity Index (ISI) to assess his severity of insomnia, the distress and the functional impairment associated with insomnia (Bastien, Vallières, & Morin, 2001). Furthermore, the sleep diary was used to record his daily bedtime and rising time so that the total time in bed (TIB) could be calculated (Carney et al., 2012). The client’s ISI and TIB were assessed as baseline. ZTE and sleep hygiene were taught to the client before commencement of the program. The client was encouraged to practice ZTE such as stretching, foot pedaling and limb movement while sitting, standing and watching TV from 1 March to 30 April 2019. The client’s ISI and TIB were evaluated in the last session of program.
Result & Outcome :
In the end of March 2019, the client reported that he could fall into sleep without taking hypnotic and has an increase of TIB after practicing ZTE in his daily activities every day. There was a reduction in ISI scores in April 2019; the client’s insomnia condition was improved from moderated severity insomnia to subthreshold insomnia. The client gave positive feedback and commented that ZTE could alleviate his sleep onset latency problem.
