The effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality in pregnant women: a randomized controlled trial

Abstract

Abstract Background: Sleep disorder is very common during pregnancy; it threatens the health of mother and fetus. Non-pharmacological treatments are a priority to improve the sleep pattern. This study aimed to determine the effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality (primary outcome) and anxiety and quality of life (secondary outcomes) Methods: This randomized controlled trial was performed on 75 pregnant women in Tabriz-Iran. Participants were randomly assigned to the intervention and control groups. The first intervention group (n=25) received 8 sessions of cognitive-behavioral counseling and aromatherapy with Citrus aurantium essential oil 15-20 minutes before bedtime. The second intervention group (n=25) received cognitive-behavioral counseling and aromatherapy with placebo and the control group (n=25) received only routine prenatal care. Pittsburgh Sleep Quality Index, Pregnancy-Specific Quality of life Questionnaire and Pregnancy-Specific Anxiety Scale were completed before and after intervention. One-way ANCOVA were used to compare the outcomes between the groups after the intervention Results: There was no statistically significant difference between the two groups in terms of socio-demographic characteristics and the basic scores of sleep quality, quality of life and anxiety (P<0.05) except age. Also there was no statistically significant difference between the study groups in terms of sleep quality (P>0.05). After the intervention based on ANCOVA test and by adjusting the baseline score, the mean score of anxiety in the intervention group 1 (AMD: -4.54; 95%CI: -6.79 to -2.28) and intervention group 2 (AMD: -3.30; 95%CI: -5.60 to -0.97) was significantly lower than the control group. Also, the mean score of quality of life in intervention group 1 (AMD: 2.55; 95%CI: 0.45 to 4.65) and intervention group 2 (AMD: 2.72; 95%CI: 0.60 to 4.83) was significantly higher than the control group. Conclusion: Cognitive-behavioral counseling reduced anxiety and improved quality of life. However, it did not affect the sleep quality and further trials are required to reach a definitive conclusion.