Effect of Lavender Aromatherapy on Vital Signs and Perceived Quality of Sleep in the Intermediate Care Unit

A Pilot Study

Jamie Lytle, RN, BSN; Catherine Mwatha, RN, BS; Karen K. Davis, RN, PhD

Disclosures

Am J Crit Care. 2014;23(1):24-29. 

In This Article

Abstract and Introduction

Abstract

Background Sleep deprivation in hospitalized patients is common and can have serious detrimental effects on recovery from illness. Lavender aromatherapy has improved sleep in a variety of clinical settings, but the effect has not been tested in the intermediate care unit.

Objectives To determine the effect of inhalation of 100% lavender oil on patients' vital signs and perceived quality of sleep in an intermediate care unit.

Methods A randomized controlled pilot study was conducted in 50 patients. Control patients received usual care. The treatment group had 3 mL of 100% pure lavender oil in a glass jar in place at the bedside from 10 PM until 6 AM. Vital signs were recorded at intervals throughout the night. At 6 AM all patients completed the Richard Campbell Sleep Questionnaire to assess quality of sleep.

Results Blood pressure was significantly lower between midnight and 4 AM in the treatment group than in the control group (P= .03) According to the overall mean change score in blood pressure between the baseline and 6 AM measurements, the treatment group had a decrease in blood pressure and the control group had an increase; however, the difference between the 2 groups was not significant (P= .12). Mean overall sleep score was higher in the intervention group (48.25) than in the control group (40.10), but the difference was not significant.

Conclusion Lavender aromatherapy may be an effective way to improve sleep in an intermediate care unit.

Introduction

Sleep is an essential component of health and is related to physical and psychological well-being. Inadequate quality and quantity of sleep in hospitalized patients are common problems, particularly in intensive care or intermediate care units (IMCUs) and can have serious detrimental effects on health and recovery from illness.[1] The association between the severity of illness and sleep disturbance in patients in the intensive care unit has been evaluated.[2] Sleep disruption was greater in patients who died and in patients who had a higher disease severity score than in patients who survived and had lower scores. In addition, sleep deprivation has a adverse effect on the immune system and is associated with increased morbidity in critically ill patients. Among patients who received an influenza vaccine, patients who were sleep deprived produced less than half the level of antibodies produced by patients who had normal sleep times.[3] Also, sleep deprivation is one of the most frequent complaints of patients after hospital stays.[2]

A systematic review[4] of nursing interventions indicated that little research is available on use of aromatherapy to improve sleep in the hospital. Aromatherapy is the use of pure essential oils from fragrant plants to help relieve health problems and improve quality of life in general.[5] Aromatherapy has been used in a variety of settings to assist in relaxation and aid in sleep. In a study of 122 patients in an intensive care unit by Dunn et al,[6] patients exposed to aromatherapy had significantly greater improvements in mood and perceived levels of anxiety than did patients not exposed. In a randomized controlled study[7] in a hospice, the use of lavender and massage resulted in improved sleep scores, but the results were not significant because of the small number of patients in the sample. Several studies have indicated that lavender aromatherapy affects the autonomic nervous system, reducing anxiety in patients in different settings, such as inpatients and outpatients.[8] Sleep deprivation leads to markedly impaired glucose tolerance and reductions in acute insulin responses to glucose. Glucose control is an important marker in healing for critically ill patients.[9] Lavender aromatherapy can also reduce mild insomnia in patients in their home setting.[10] We chose lavender rather than another essential oil because of the studies that support using lavender to promote rest and relaxation in different settings. Little scientific research has been done to establish effects of lavender aromatherapy on sleep in an acute care hospital setting.

Investigating ways to promote and provide a restful night of sleep for hospitalized patients is important. Vital signs can be a measure of the body's response to stress, illness, and relaxation. A decrease in blood pressure, heart rate, and respiratory rate correlates with a greater relaxation state.[11] Our aim was to evaluate the effectiveness of inhalation of 100% lavender oil on the vital signs and perceived quality of sleep of IMCU patients. We hypothesized that patients who received the aromatherapy would experience a decrease in blood pressure, heart rate, and respiratory rate during the night and would report higher quality of sleep than would patients who did not receive the aromatherapy.

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