Running head: GROUP PROJECT ON SLEEP WELL

Report on Group Project: Sleep Well

Adibah Amni Binti Mohd Nordin (1715594)

Ain Najwa binti Mohd Rozi (1718666)

Alia binti Shahbani (1715812)

Ezzura binti Justin Merjang (1711834)

Farah Hanis binti Mohd Fairuz (1713352)

Khairunnisa Keisya Azizah (1724734)

Nor Hidayah binti Mohd Nizan (1716198)

Nur Amira Syuhada binti Abd Rahim (1718124)

Nur Azwana binti Hamzah (1718320)

Nur Najmina binti Zulkifli (1628078)

Nur Syakirah binti Mohamad Arif (1718652)

Siti Aishah binti Izzudin (1714602)

Kulliyyah of Islamic Revealed Knowledge and Human Sciences

Dr. Intan Aidura binti Alias

PSYC 4290 Health Psychology

Section 1

International Islamic University Malaysia

6th July 2020

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Sleep Well

1. Introduction

Sleep is crucial for human being as it serves multiple functions including

development, energy conservation, brain waste clearance, modulation of immune

responses, cognition, performance, vigilance, disease, and psychological state (Zielinski,

M. R., McKenna, J. T., & McCarley, R. W.,2016). This means that sleep is not optional

behavior, and it should be done in the best way possible. By sleeping well, the functions

that it serves can be optimized. The characteristics of normal and healthy sleep according

to Medic and his colleagues (2017) are sufficient duration, good quality, appropriate timing

and regularity, and the absence of sleep disturbances and disorders.

Sleep disturbances include reduced sleep time, poor sleep quality and delayed

bedtime can cause excessive sleepiness during the daytime. It may also lead to various

unfavorable medical and mental dysfunctions namely cardiovascular morbidity, diabetes

mellitus, obesity, derailment of cognitive functions, vehicular accidents, and accidents at

workplaces. Reduced sleep duration has been reported as 7 of the 15 leading causes of

death in the United States (Chattu, V. K. et al, 2018). In addition, insufficient sleep was

said to be prevalent across various ages from teenagers to adults and happened globally.

Furthermore, with the current era of electronic devices and smartphones, the sleep

disruption phenomena worsen (Chattu, V. K. et al, 2018).

Likewise, sleep is known to be a very crucial factor contributing to students’

academic performance and psychological well-being. However, past researchers showed

that sleep hygiene behavior in university students is not habitual rather need self-
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regulatory, thus a well-established model is needed to promote the behavior of sleep

hygiene. Pertaining to the issue, this project adapts the Health Belief Model (HBM) as a

guided intervention approach to improve university students’ sleep behavior.

As been specified by Taylor (2018), this model presented two dependent factors of

a person practicing a health behavior which are (i) whether the person perceives a personal

health threat, and (ii) whether the person believes that a particular health practice will be

effective in reducing that threat. According to Jones and his colleagues (2015), Health

Belief Model (HBM) can help in changing behavior when the intervention successfully

targets perceived barriers, benefits, self-efficacy, and threats. Thus, to change people’s

sleep behavior, based on this model, we need to focus on the barriers that prevent people

from sleeping well, the benefits of sleeping well, people’s self-efficacy or their perception

of their ability to sleep well and the threat when they are not sleeping well.

Aria R. Ruggiero and his colleagues (2019) found that sleep attitudes as defined by

sleep benefits or enjoyment and sleep as a time commitment have a positive relationship

with sleep hygiene which means a better sleep attitude leads to better sleep hygiene. This

shows that sleep behavior can also be successfully changed by manipulating the person’s

attitude of sleep, or by having them to perceive sleep as good and beneficial behavior.

Therefore, this study will examine the differences in sleep quality between before

and after the implementation of the sleep intervention based on the Health Belief Model

(HBM) in improving sleep quality. Besides, this study would like to answer the question

of; are there any differences in sleep quality between before and after the implementation

of sleep intervention on participants' sleep quality?

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2. Methods

2.1 Participants

This group project focused on participants aged 19 and above among IIUM

students. 10 participants were chosen randomly to be assisted for a week to improve their

sleep quality. The participants were selected using a voluntary response sampling

technique because of their convenient accessibility and proximity to the experimenters.

2.2 Research design

Repeated measure designs were used for this study in order to measure differences

in Pittsburgh Sleep Quality Index (PSQI) results between pre and post-test after one week

of sleep intervention took place. The results would determine either the sleep intervention

is working or not to the participants.

2.2 Materials

Study information will be presented to participants before any information was

collected. This form described the benefits and drawbacks of participation, the nature of

the study, and provided contact information for the participants and experimenters.

Information gathered during the study included the Pittsburgh Sleep Quality Index (PSQI)

as well as the informed consent. Pittsburgh Sleep Quality Index (PSQI) by Buysse,

Reynolds, Monk, and Kupfer (1989) will be used in order to assess sleep quality in

participants. This tool has nineteen items with lower scores indicating better sleep quality.

All the questions are self-rated questionnaires which only need around 10 minutes to be
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finished. Then, information on the Sleep Well Intervention will be explained to the

participants.

2.4 Sleep Well Intervention

An online health promotion program created based on the theory of the HBM. The

participants will be given suitable online materials in the forms of posters and videos for

references based on the model that were expected to promote the belief in health threat and

belief that specific health behavior can reduce the threat. An Islamic bedtime ritual will be

included in this intervention specifically in the poster. The sleep diary based on the

International Sleep Foundation will be used as a daily report and checklists for participants

in order to monitor the effectiveness of the intervention.

2.5 Procedures

The experimenters promote the online health promotion program through social

media such as Instagram while blasting the poster and video regarding Sleep Well

intervention. Participants who are interested to join will contact the person in-charged and

be invited to a Whatsapp group for convenience. Then, participants will be briefed about

the intervention used in this program. Informed consent will be given to participants to get

permission before conducting the experiment and ensuring confidentiality of personal

information. Next, participants need to answer a selected instrument which is the Pittsburgh

Sleep Quality Index (PSQI). Every day, participants need to update their Sleep Diary. In

the meantime, sleep intervention took place. The experimenter posted a poster and video

on the importance and benefits of sleep hygiene. They also were exposed to the

disadvantages of neglecting sleep hygiene in order to appeal the fear to the participants.
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Sleep bedtime rituals from the Islamic perspective were also promoted during this

intervention. Then, after a week, the participants were given the PSQI again to be answered

in order to check on their progress after joining this program. Lastly, participants are

encouraged to respond to participant feedback forms.

3. Result

3.1. PSQI

A paired sample t-test was conducted to evaluate the effectiveness of a sleep

intervention on IIUM students. The increment in the sleep quality was not statistically

significant from pre-test (M= 8.1, SD= 2.92) to post-test (M= 6.9, SD= 3.03), t(9)=.849,

p>.001 (two-tailed), with the lower score in PSQI indicating higher sleep quality. This

shows that the sleep intervention did not statistically increase sleep quality in IIUM

students.

4. Discussion & Islamic Perspective

The objective of this project is to educate and share with the participants about sleep quality

and the effectiveness of sleep intervention among IIUM students. Based on the result, most of the

participants show that sleep intervention does not statistically increase their sleep quality of time.

This may be due to the circumstances that prevent them from getting quality sleep or their habit to

stay up until the morning. Another factor is the limitation of the duration of the study as the

intervention program only be held for one week. More duration of the study might show different

results.
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In Islam, sleep considers as one of the important signs of the Greatness of Allah. The study

uses videos and posters which contain about sleep bedtime rituals from Islamic perspectives such

as dusting the bed, taking ablution, turning off light and lying on the right rib, it is aimed to assist

the participants on how to improve their sleep quality and help them to understand the benefits of

Islamic teaching. There are also specific explanations about the sleep etiquettes which are first,

performing ablution. It can help to relax the body and thus prepares it for deep sleep. Second, the

sleeping position which lies on the right rib. It is recommended because the human left lung is

smaller than the right lung, so by doing this thing, it can help to reduce the pressure to the heart

while sleeping. It is also proven can help to avoid shortness of breath. Third, turning off the light

before sleep is good in order not to disrupt the circadian rhythm. In addition, a recent study found

that sleep deprivation impairs metabolic functions and endocrine. All these scientific explanations

have shown that Islam is a comprehensive way of life which guide human have a healthy life by

its teaching.

The Quran discusses the benefit of getting enough and good quality of sleep as the Quran

emphasizes the importance of maintaining a pattern of light and darkness. Prophet Muhammad

also promoted the benefit of taking a nap for human beings and highlight mid-day nap as an

important practice of Muslims. Islam also has clear instructions and guidance for people about the

nature of good sleep as it is mention frequently in the Qur’an. This can be seen in a well-known

verse “And among his signs in your sleep by night and by day and your seeking of His bounty,

verily in that are signs for those who hearken” [Verse 30:23]. In addition, Islam also emphasizes

the importance of getting enough sleep and this was proven by one hadith from the Prophet in

Sahih Al-Bukhari says “If anyone of you feels drowsy while praying he should go to bed (sleep)

till his slumber is over” (SB 21).

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Besides all of the aspects, we also faced a problem with the limitation of time to finish the

intervention. Furthermore, assuming that in order to form or change a new habit a person needs

sufficient time to reach the target. We were given 3 weeks for about 21 days and this duration does

not really work for the participant to adapt to the intervention. The results reported using a sleep

diary are not applicable and cannot be used since some data are lost and participants did not write

it regularly. Therefore, a sleep diary only can be used as a personal self-behavior monitor for

participants only in this study.

5. Conclusion

The importance of university students' sleep can take a backseat to all the new and exciting

opportunities that college experience offers. However, lack of sleep in some students can hinder

academic performance and possibly disrupt mental health. There is limited knowledge of ways to

cope with sleepiness in this population. Therefore, our findings suggest the online health promotion

program based on HBM might be effective in improving sleep in adolescents. However, given the

limitations of this project, caution must be applied in the interpretation of the findings. Future

research is still needed to determine what components of an online sleep intervention are most

useful for students and investigate the long-term effect of a sleep hygiene intervention on various

physiological, psychological, and behavioral health outcomes in youth.

References

Aria R. Ruggiero, Hannah D. Peach & Jane F. Gaultney (2019) Association of Sleep

Attitudes with Sleep Hygiene, Duration, and Quality: A Survey Exploration of the

Moderating Effect of Age, Gender, Race, and Perceived Socioeconomic Status, Health

Psychology and Behavioral Medicine, 7(1), 19-44.

Chattu, V. K., Manzar, M. D., Kumary, S., Burman, D., Spence, D. W., & Pandi-Perumal, S. R.

(2018). The Global Problem of Insufficient Sleep and Its Serious Public Health

Implications. Healthcare (Basel, Switzerland), 7(1), 1.

Jones, C. L., Jensen, J. D., Scherr, C. L., Brown, N. R., Christy, K., & Weaver, J. (2015).

The Health Belief Model as an Explanatory Framework in Communication Research:

Exploring Parallel, Serial, and Moderated Mediation. Health communication, 30(6), 566–

576.

Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of

sleep disruption. Nature and science of sleep, 9, 151–161.

Zielinski, M. R., McKenna, J. T., & McCarley, R. W. (2016). Functions and Mechanisms of

Sleep. AIMS neuroscience, 3(1), 67–104.

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Appendix

Appendix A (consent form)

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Appendix B (contact information)

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Appendix C (PSQI)
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Appendix D (sleep diary)

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Appendix E
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Figure 1. Poster given to participants

Appendix F

Link for video given to participants:

https://youtu.be/xxxWv6PM4EM

Appendix G
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Paired Sample Test Table from SPSS analysis.