Pre–Post Evaluation of a Community-Based Sleep Training Program for Older Men with Sleep Disorders in Duhok Governorate
DOI:
https://doi.org/10.21580/teo.2026.37.1.30879Keywords:
Sleep quality, Older men, Sleep disorders, community-based intervention, pre–post studyAbstract
Sleep disorders are a common health concern among older adults and are often associated with reduced physical functioning, impaired cognition, and poorer psychological well-being. This study aimed to conduct a pre–post evaluation of a community-based sleep training program for older men with sleep disorders in Duhok Governorate, Iraq. A single-group pretest–posttest design was employed involving 10 community-dwelling men aged 60–63 years who reported sleep-related difficulties. Participants attended an 8-session training program delivered over four weeks in a community setting. The intervention included sleep hygiene education, relaxation techniques, behavioral strategies, and practical guidance to improve sleep-related habits. Outcome assessment was conducted before and after the intervention using the Pittsburgh Sleep Quality Index (PSQI) as the primary measure, supported by selected indicators of sleep pattern and daytime functioning. The findings showed improvement in overall sleep quality following participation in the program, reflected in lower PSQI scores, reduced sleep onset latency, improved sleep efficiency, and longer total sleep duration. Positive changes were also observed in daytime sleepiness and selected cognitive functioning outcomes. These findings suggest that a structured community-based sleep training program may provide short-term benefits for older men experiencing sleep disturbances. However, the results should be interpreted cautiously, given the small sample size, absence of a control group, and limited follow-up period. Further controlled studies with larger samples are needed to confirm the intervention's effectiveness and generalizability
Downloads
References
Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: A randomized clinical trial. JAMA Internal Medicine, 175(4), 494–501. https://doi.org/10.1001/jamainternmed.2014.8318
Buysse, D. J., Reynolds, C. F., III, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4
Campbell, S., Greenwood, M., Prior, S., Shearer, T., Walkem, K., Young, S., Bywaters, D., & Walker, K. (2020). Purposive sampling: Complex or simple? Research case examples. Journal of Research in Nursing, 25(8), 652–661. https://doi.org/10.1177/1744987120927206
Chung, K. F., Lee, C. T., Yeung, W. F., Chan, M. S., Chung, E. W. Y., & Lin, W. L. (2018). Sleep hygiene education as a treatment of insomnia: A systematic review and meta-analysis. Family Practice, 35(4), 365–375. https://doi.org/10.1093/fampra/cmx122
Dzierzewski, J. M., Dautovich, N. D., Ravyts, S. G., Perez, E., Soto, P., Donovan, E. K., & Castellanos, P. (2023). Sleep health and aging: Recommendations for promoting healthy sleep among older adults: A National Sleep Foundation report. Sleep Health, 9(6), 821–824. https://doi.org/10.1016/j.sleh.2023.08.018
Eldridge, S. M., Chan, C. L., Campbell, M. J., Bond, C. M., Hopewell, S., Thabane, L., & Lancaster, G. A. (2016). CONSORT 2010 statement: Extension to randomised pilot and feasibility trials. BMJ, 355, i5239, 1–29. https://doi.org/10.1136/bmj.i5239
Furukawa, Y., Sakata, M., Yamamoto, R., Nakajima, S., Kikuchi, S., Inoue, M., Ito, M., Noma, H., Takashina, H. N., Funada, S., Ostinelli, E. G., Furukawa, T. A., Efthimiou, O., & Perlis, M. (2024). Components and delivery formats of cognitive behavioral therapy for chronic insomnia in adults: A systematic review and component network meta-analysis. JAMA Psychiatry, 81(4), 357–365. https://doi.org/10.1001/jamapsychiatry.2023.5060
Ghasemi, A., & Zahediasl, S. (2012). Normality tests for statistical analysis: A guide for non-statisticians. International Journal of Endocrinology and Metabolism, 10(2), 486–489. https://doi.org/10.5812/ijem.3505
Grove, S. K., Burns, N., & Gray, J. R. (2016). Why is the one-group pretest–posttest design still used? Clinical Nursing Research, 25(5), 467–472. https://doi.org/10.1177/1054773816666280
Johns, M. W. (1991). A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep, 14(6), 540–545. https://doi.org/10.1093/sleep/14.6.540
Karimi, S., Soroush, A., Towhidi, F., Makhsosi, B. R., Karimi, M., Jamehshorani, S., Akhgar, A., Fakhri, M., & Abdi, A. (2016). Surveying the effects of an exercise program on the sleep quality of elderly males. Clinical Interventions in Aging, 11, 997–1002. https://doi.org/10.2147/CIA.S106808
Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, Article 863, 1–12. https://doi.org/10.3389/fpsyg.2013.00863
Langenberg, B., Janczyk, M., Koob, V., Kliegl, R., & Mayer, A. (2023). A tutorial on using the paired t test for power calculations in repeated measures ANOVA with interactions. Behavior Research Methods, 55(5), 2467–2484. https://doi.org/10.3758/s13428-022-01902-8
McCrae, C. S., Curtis, A. F., Stearns, M. A., Nair, N., Golzy, M., Shenker, J. I., Beversdorf, D. Q., Cottle, A., & Rowe, M. A. (2023). Development and initial evaluation of web-based cognitive behavioral therapy for insomnia in rural family caregivers of people with dementia (NiteCAPP): Mixed methods study. JMIR Aging, 6, e45859. https://doi.org/10.2196/45859
Mander, B. A., Winer, J. R., & Walker, M. P. (2017). Sleep and human aging. Neuron, 94(1), 19–36. https://doi.org/10.1016/j.neuron.2017.02.004
Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C. M., & Colantonio, A. (2016). The Pittsburgh Sleep Quality Index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Medicine Reviews, 25, 52–73. https://doi.org/10.1016/j.smrv.2015.01.009
Moore, G. F., Audrey, S., Barker, M., Bond, L., Bonell, C., Hardeman, W., Moore, L., O’Cathain, A., Tinati, T., Wight, D., & Baird, J. (2025). Sample size justification in feasibility studies: Moving beyond rules-of-thumb. Pilot and Feasibility Studies, 11, Article 88, 1–9. https://doi.org/10.1186/s40814-025-01675-9
Patel, D., Steinberg, J., & Patel, P. (2018). Insomnia in the elderly: A review. Journal of Clinical Sleep Medicine, 14(6), 1017–1024. https://doi.org/10.5664/jcsm.7172
Peterson, J. F., & Finkelstein, J. (2006). The use and interpretation of quasi-experimental studies in medical informatics. Journal of the American Medical Informatics Association, 13(1), 16–23. https://doi.org/10.1197/jamia.M1749
Reichardt, C. S., Storage, D., & Abraham, D. (2023). Quasi-experimental research. In A. L. Nichols & J. Edlund (Eds.), The Cambridge handbook of research methods and statistics for the social and behavioral sciences (pp. 292–313). Cambridge University Press. https://doi.org/10.1017/9781009010054.015
Reid, K. J., Martinovich, Z., Finkel, S., Statsinger, J., Golden, R., Harter, K., & Zee, P. C. (2006). Sleep: A marker of physical and mental health in the elderly. The American Journal of Geriatric Psychiatry, 14(10), 860–866.
Riemann, D., Benz, F., Dressle, R. J., Espie, C. A., Johann, A. F., Blanken, T. F., Leerssen, J., Wassing, R., Henry, A. L., Kyle, S. D., Spiegelhalder, K., & van Someren, E. J. W. (2022). Insomnia disorder: State of the science and challenges for the future. Journal of Sleep Research, 31(4), e13604. https://doi.org/10.1111/jsr.13604
Siu, P. M., Yu, A. P., Tam, B. T., Chin, E. C., Yu, D. S., Chung, K. F., Hui, S. S., Woo, J., Fong, D. Y., Lee, P. H., Ho, J. Y. S., Ngai, S. P. C., Wei, G. X., & Irwin, M. R. (2021). Effects of Tai Chi or exercise on sleep in older adults with insomnia: A randomized clinical trial. JAMA Network Open, 4(2), e2037199. https://doi.org/10.1001/jamanetworkopen.2020.37199
United Nations Department of Economic and Social Affairs, Population Division. (2023). World population ageing 2023: Challenges and opportunities of population ageing in the least developed countries (pp. 1–141). United Nations.
Urbanová, L., Vaníček, O., Červená, K., Bartoš, A., & Evansová, K. (2024). The impact of sleep education, light intervention and relaxation on sleep and mood in the elderly. Chronobiology International, 41(4), 567–576. https://doi.org/10.1080/07420528.2024.2337007
Vanderlinden, J., Boen, F., & van Uffelen, J. G. Z. (2020). Effects of physical activity programs on sleep outcomes in older adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 17, Article 11, 1–15. https://doi.org/10.1186/s12966-020-0913-3
World Bank. (2026). Population ages 65 and above (% of total population) – Iraq. World Development Indicators. Not paginated.
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Iman Mohammed Mustafa, Shireen Safar Mousa
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
