Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Michelle Kabakibi DNP, FNP-C, AGNP-C


Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to emphasize the importance of and educate patients on primary prevention techniques for sleep hygiene to use as a tool to enhance quality of life by increasing patient’s self-reported sleep quality.

Background: Sleep patterns change as we age, however, aging itself is not necessarily a cause of sleep problems. Sleep is one of the most important activities for a person’s health and overall well-being. A growing body of literature shows that not enough sleep and poor sleep quality is associated with hypertension, heart disease, stroke, diabetes, anxiety, and depression. In addition to physical manifestations of poor sleep, other life altering side effects including tiredness and fatigue play a role in daily quality of life perceptions. Hygiene practices have been recognized as a crucial aspect of promoting good sleep quality and preventing sleep disorders in older adults. This evidence-based project aimed to evaluate the impact of a sleep hygiene intervention on self-reported sleep quality in adults >55 years of age.

Methods: The Pittsburgh Sleep Quality Index (PSQI) was implemented and used to first assess patients' self-reported sleep quality and quantity of sleep, then patients were counseled one-on-one regarding recommended sleep hygiene practices and provided an educational handout. One month after implementation of the sleep hygiene teachings, the PSQI was administered again to assess for improvement.

Results: The results demonstrated that the sleep hygiene intervention significantly improved self-reported sleep quality in the patients who implemented the sleep hygiene practices. The average initial PSQI score was 7.5, while the average post-intervention score was 6.1; this represents a 22.9% decrease in the PSQI scoring. The findings are consistent with previous research demonstrating the effectiveness of sleep hygiene interventions in improving sleep quality in older adults. The PSQI consists of 19 self-evaluated questions and 5 questions rated by a partner sleeping in the same bed (if available); however, only the self-rated questions are considered for the scoring. The 19 self-evaluated items are amalgamated to shape seven component scores, each with a point range of 0-3. A score of "0" signifies no issues, whereas a score of "3" represents severe difficulties in all cases. The seven component scores are added together to calculate one "global" score, which ranges from 0-21 points, where "0" implies no difficulty and "21" indicates severe issues in all areas.

Evaluation: This evidence-based project highlights the importance of promoting primary prevention in patients, in this case, sleep hygiene practices among older adults. The results may have significant implications for improving the health and self-reported well-being of older adults. Results may also inform the development of future sleep hygiene interventions for this population and the implementation of the PSQI in elderly care.