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Updated: Oct 26, 2026
Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
Effect of a Researcher-Supervised Walking Program With Smartphone-Based Step Monitoring on Sleep Quality in Older
Samin Khoshnoud Speily1, Roya Mansour-Ghanaei1,2, Robabeh Soleimani3
1Zeynab (P.B.U.H) School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran.
Background And Aims:
Sleep disorders are common among hospitalized older adults with psychiatric conditions and may adversely affect health. Structured walking is a promising nonpharmacological intervention, and smartphone-based step monitoring may support adherence. This study evaluated the effect of a researcher-supervised walking program supported by smartphone-based step monitoring on sleep quality in older adults admitted to a psychiatric hospital in Guilan Province, Iran.
Methods:
In this randomized controlled trial, 62 hospitalized older adults were randomly assigned to the intervention or control groups. The intervention group received routine care plus a 4-week researcher-supervised walking program supported by smartphone-based step monitoring, consisting of 30-min outdoor walking sessions three times weekly. The control group received routine care alone. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at baseline and postintervention. The primary outcome was global PSQI score, assessed at baseline and postintervention. The prespecified primary analysis was ANCOVA; because its assumptions were not fully met, a post hoc change score analysis was conducted using Welch's t-test. Cohen's d with 95% confidence intervals was reported.
Results:
Complete outcome data were available for 55 of the 62 randomized participants, and the primary analysis used a complete case approach without imputation. The mean PSQI score decreased from 12.93 ± 3.94 to 5.89 ± 3.48 in the intervention group and from 11.64 ± 3.94 to 9.39 ± 3.07 in the control group. The intervention group demonstrated significantly greater improvement in PSQI scores (between-group mean difference in change: -4.79, 95% CI -6.05 to -3.52; Cohen's d = 2.09, 95% CI 1.44-2.77).
Conclusion:
A researcher-supervised walking program supported by smartphone-based step monitoring was associated with improved sleep quality in hospitalized older adults with psychiatric disorders and may be a feasible non-pharmacological adjunct to routine inpatient care.
