INTRODUCTION:

Sleep is essential for normal physiologic function. Chronic sleep deprivation and poor-quality, fragmented sleep result in excessive daytime sleepiness, neuro cognitive dysfunction, and memory impairment and atherosclerosis, (Mangesh A, 2013). Sleep disturbances increase with aging and it is estimated that nearly 67% of the elderly people have at least one sleep-related complaint. Various sleep-related problems identified in elderly people include long time to fall asleep, disturbed sleep at night, and decreased daytime alertness etc, (Kiran D. Chaudhari, 2010).

Sleep disturbances are an extensive and common problem among menopausal women. There is an increased trend in the use of non-pharmacological methods to alleviate sleep disturbances, (Sadeka Tamanna, 2014). Yoga is a non- pharmacological intervention with the combination of various postures, breathing techniques, and meditation. Beneficial effects of Yoga like reduction of blood pressure, relieving of anxiety, delaying functional decline, decreasing sleep disturbances, and improvement in serum lipid profile have been observed. Manjunath and Telles (2011) reported in a randomized trial that after regular Yoga exercises for 6 months in a geriatric sample, there was significant reduction in time to fall asleep, decreased sleep disturbance during night time, better sleep quality, and decreased use of medications for sleep when compared with control group.

OBJECTIVES:

1. To assess the quality of sleep among menopausal women before and after yoga therapy.

2. To assess the effectiveness of yoga therapy on quality of sleep among menopausal women.

3. To find out the association between post test scores on quality of sleep among menopausal women with their demographic variables.

HYPOTHESIS:

H_1: There is a significant level of quality of sleep among menopausal women before and after Yoga Therapy.

H₂: There is a significant effectiveness of Yoga therapy on quality of sleep among menopausal women.

H₃: There is a significant association between post test scores on level of quality of sleep among menopausal women with their demographic variables

DELIMITATIONS:

The study was delimited to:

1. Assess the effectiveness of Yoga therapy

2. Identify changes in quality of sleep

3. Menopausal women

4. Selected village, Erode District.

RESEARCH METHODOLOGY:

Research Design:

The research design selected for the study was Pre - experimental research where one group pre and post test design.

Setting:

The setting for study was Nathagoundampalayam village, Erode (District).

Sample and sample size:

The samples for the present study were menopausal women residing in Nathagoundampalayam village at Erode District, who fulfill the sampling criteria. The sample size was 20 menopausal women.

Sampling Technique:

“Snowball sampling technique” was used to select cases.

SAMPLING CRITERIA:-

Inclusion Criteria:-

Menopausal women with,

· Age group between 45- 60 years

· Sleeping problems

· Who are present during the time of data collection.

· Who give consent to participate in this study

Description of the tool:

Section A: Demographic variables

Section B: MRS (Menopause Rating Scale) was used to identify the level of quality of sleep among menopausal women.

Scoring for quality of sleep

Level of quality of sleep	Actual score	Percentage of scores
None	0	0
Mild	1 – 3	Below 25
Moderate	4 – 6	26 – 50
Severe	7 – 9	51 – 75
very severe	10 - 12	76 -100

RESULTS:

Table 1 Frequency and percentage distribution of samples according to their demographic variables.

Demographic variables	Menopause women
Demographic variables	Frequency	%
Age in Years
45 – 48	4	20
49 - 52	6	20
53 – 56	5	25
57 – 60	5	25
Socioeconomic status
Rs.1000 – Rs. 2000	4	20
Rs.2001 – Rs. 3000	4	20
Rs.3001 – Rs. 4000	5	25
Rs.4001and>above	7	35
Education
No formal education	4	20
Primary education	5	25
Secondary education	7	35
Higher secondary education	2	10
Graduate	2	10
Occupation
Housewife	3	15
Sedentary workers	5	25
Moderate workers	6	30
Heavy workers	6	30
Age at menarche
Less than 12 Years	2	10
13 Years	7	35
14 Years	5	25
Above 14 years	6	30
Religion
a. Hindu	14	70
b. Muslim	4	20
c. Christians	2	10
d. Others	-	-
Types of habits
Tobacco chewing	8	40
Betal nut chewing	4	20
Smoking	-	-
None	8	40
Type of family
Joint family	12	60
Nuclear family	8	40
Extended family	-	-

Table 2: Frequency and percentage distribution of pre and post test scores on level of quality of sleep among menopausal women before and after yoga therapy.

Level of Quality of sleep	Pretest score		Post Test Score
Level of Quality of sleep	Frequency (N)	Percentage %	Frequency (N)	Percentage %
None	-	-	-	-
Mild	-	-	5	25
Moderate	9	45	15	75
Severe	11	55	-	-
Very severe	-	-	-	-

Table 3: The overall Area wise comparison of mean, SD and mean percentage of menopause women pre and post test scores on quality of sleep

Area wise Level of quality of sleep	PRETEST				POST TEST
Area wise Level of quality of sleep	Maxscore	Mean	SD	Mean %	Mean	SD	Mean %	Effectiveness
Difficulty in falling asleep	4	1.03	0.25	50	0.19	0.28	30	20
Difficulty in sleeping through the night	4	1.1	0.32	55	1.09	0.35	40	15
Waking up early	4	1.6	0.34	51	1.28	0.32	31	20
Overall	12	10.6	0.69	49.15	8.55	0.75	38.9	10.25

In pre test scores on level of quality of sleep among menopausal women depicts that majority 11 (55%) of them had severe sleeping problems and 9 (45%) of them had moderate sleeping problems whereas in post test 15 (75%) of them had moderate sleeping problems and 5 (25%) of them had mild sleeping problems. It seems that the yoga therapy was effective in improving the quality of sleep among menopausal women. Afonso RF, Hachul H, Kozasa EH et.al (2012) reported that the sequence of yoga practice had significantly lower insomnia severity and higher scores for quality of life among menopause women. The reduction in insomnia severity in the yoga group was significantly higher than that in the control and passive-stretching groups. Conclusion: The study showed that yoga might be effective in reducing insomnia and as well as improving quality of life in menopausal women with insomnia.

Table 4 Paired‘t’ values of Pre and Post test scores of level of quality of sleep experimental group and control group after yoga therapy

Areas	Paired ‘t’ value
Quality of sleep scores	7.461

Paired‘t’ test overall score was 7.461 and it is high when compared to table value (2.093). It shows that yoga therapy was effective in improving the quality of sleep among menopausal women.

CONCLUSION:

· Prior to implementation of yoga therapy, menopausal women had severe sleeping problems. The effectiveness was evaluated by post test scores; the mean quality of sleep score had reduced from 8.55 to 10.25 after implementation of yoga therapy. The study results shows that menopausal women showed highly significant level of quality of sleep (P<0.01).

· Highly significant association was found between pre and post test level of quality of sleep scores.

· No significant association was found between post test level of quality of sleep scores and their demographic variables.

DISCUSSION:

Highest percentage (25%) of menopausal women were in the age group of 53-56 and 57-60 years, 35% of them were belong to socio economic status of Rs. 4001 and above, 35% of them had secondary education and 35% of them were sedentary and heavy workers. 35% of them had attained their menarche at the age of 13 years, 70% of them were hindus. 40% of them had habit of tobacco chewing, 60% of them were in the joint family. The study findings reveals that in pretest (55%) of them had severe sleeping problems and 9 (45%) of them had moderate sleeping problems whereas in post test (75%) of them had moderate sleeping problems and (25%) of them had mild sleeping problems. The overall mean score was 49.15% in pretest and it was reduced to 38.9% in posttest with the difference of 10.25%. Paired‘t’ test scores on level of quality of sleep among menopausal women after yoga therapy shows moderately significant difference and the overall score was 7.461. There was no significant association between post test levels of quality of sleep scores when compared to demographic variables among menopausal women.

NURSING IMPLICATION:

NURSING EDUCATION:

By mass health education and through innovative measures, nurses and midwives educate regarding the practices of yoga among menopausal women.

NURSING PRACTICES:

The proper information regarding yoga on sleeping problems must be implicated in clinical areas to improve the quality of sleep level.

RECOMMONDATIONS:

· The replication of the present study can be conducted with large samples.

· A comparative study can be conducted on effectiveness of yoga therapy on quality of sleep among menopausal women in urban and rural areas.

· A similar study can be conducted with comparison between experimental and control group.

REFERENCES:

1. Bishnoi, S. Essential Midwifery. Lippincott William Wilkins Publication. Newyork. 6^th Edition. (2002).

2. Priya Bansal and Anurag Chaudhary, Menopausal problems among rural middle aged women of Punjab, International Journal of Research in Health Sciences. Oct–Dec 2013 Volume-1, Issue-3 103

3. Lo CM, Lee PH. Prevalence and impacts of poor sleep on quality of life and associated factors of good sleepers in a sample of older Chinese adults. Health Qual Life Outcomes. 2012; 10:72. Sundar Rao an Introduction to Biostatics, 4th edition, Vegas publications (P) Ltd, New Delhi.

4. Begg CB, In Handbook Of Research Synthesis, Publication Bias, Eds Cooper H,Hedges LV (Russell Sage Foundation, New York); 1994Pp; 399–409.

5. Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult-a mini-review. Gerontology. 2010; 56:181–9.

6. Sundar Rao an Introduction to Biostatics, 4th edition, Vegas publications (P) Ltd, New Delhi.

Received on 25.07.2016 Modified on 22.08.2016

Int. J. Adv. Nur. Management. 2016; 4(4): 365-368.

DOI: 10.5958/2454-2652.2016.00081.0