progressive muscle relaxation
chronic disease
outcome assessment
health care

How to Cite

Mirzanah, S., Yona, S., & Dahlia, D. (2020). EFFECT OF PROGRESSIVE MUSCLE RELAXATION ON SLEEP QUALITY AMONG PATIENTS WITH CHRONIC DISEASES: A LITERATURE REVIEW. Belitung Nursing Journal, 6(2), 30–34. https://doi.org/10.33546/bnj.1060
Google Scholar

Link to Google Scholar

Accepted for publication: 2020-03-24
Peer reviewed: Yes

Related articles in

Search Relations - Article by Author(s)

Share this article on:


Background: Sleep disturbance is prevalent among patients with chronic diseases. Thus, the use of non-pharmacological interventions is needed. Progressive muscle relaxation is considered effective to improve sleep quality, but its discussion is still limited.

Objective: To investigate the effect of progressive muscle relaxation on sleep quality among chronic disease patients.

Design: Literature review.

Data Sources: Search was performed through the CINAHL, Science Direct, and ProQuest database from 2014 to 2019 for English-based, full-text research articles.

Review Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods was used to select articles. Critical Appraisal Skills Programme was used for quality assessment.

Results: From the 644 articles yielded, six articles were included. Progressive muscle relaxation could be given alone or in combination with cognitive behavioural therapy. It also has been proven to improve sleep quality among patients with chronic diseases regardless their ages. Procedures in progressive muscle relaxation vary, but all studies reported significant improvements on sleep quality. Most of studies used audio as a medium for progressive muscle relaxation training.

Conclusion: Progressive muscle relaxation significantly improves the sleep quality among patients with chronic diseases. It is recommended for future studies to compare the effectivity between 4 or 7 muscle groups and 16 muscle groups on sleep quality.



Copyright (c) 2020 Syafa’atun Mirzanah, Sri Yona, Debie Dahlia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Article Metrics

Total views 4425 [Abstract: 2677 | PDF: 1748 ]


Download data is not yet available.

PlumX Metrics


Akgün Şahin, Zümrüt, & Dayapoğlu, Nuray. (2015). Effect of progressive relaxation exercises on fatigue and sleep quality in patients with chronic obstructive lung disease (COPD). Complementary Therapies in Clinical Practice, 21(4), 277-281. https://doi.org/10.1016/j.ctcp.2015.10.002

Alparslan, Güler Balci, Orsal, Özlem, & Unsal, Alaettin. (2016). Assessment of sleep quality and effects of relaxation exercise on sleep quality in patients hospitalized in internal medicine services in a university hospital. Holistic Nursing Practice, 30(3), 155-165. https://doi.org/10.1097/hnp.0000000 000000147

Alsaadi, Saad M., McAuley, James H., Hush, Julia M., & Maher, Chris G. (2011). Prevalence of sleep disturbance in patients with low back pain. European Spine Journal, 20(5), 737-743. https://doi.org/10.1007/s00586-010-1661-x

Amanda, Steffy Putri. (2019). Progressive muscle relaxation in improving sleep quality. Journal of Health (JoH), 6(2), 90-94. https://doi.org/10.30590/vol6-no2-p90-94

Bernstein, D. A., Borkovec, T. D., Hazlett-stevens, H., & Douglas, A. . (2000). New directions in progressive relaxation training: A guidebook for helping professionals. USA: Praeger Publishers.

Burke, Shanna L., Hu, Tianyan, Spadola, Christine E., Li, Tan, Naseh, Mitra, Burgess, Aaron, & Cadet, Tamara. (2018). Mild cognitive impairment: associations with sleep disturbance, apolipoprotein e4, and sleep medications. Sleep Medicine, 52, 168-176. https://doi.org/10.1016/j.sleep.2018.09.001

Chang, Chih-Hao, Chuang, Li-Pang, Lin, Shih-Wei, Lee, Chung-Shu, Tsai, Ying-Huang, Wei, Yu-Feng, . . . Yu, Chong-Jen. (2016). Factors responsible for poor sleep quality in patients with chronic obstructive pulmonary disease. BMC Pulmonary Medicine, 16(1), 118. https://doi.org/10.1186/ s12890-016-0281-6

Chegeni, Pooya Seyedi, Gholami, Mohammad, Azargoon, Alireza, Pour, Amir Hossein Hossein, Birjandi, Mehdi, & Norollahi, Hamed. (2018). The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice, 31, 64-70. https://doi.org/10.1016/ j.ctcp.2018.01.010

Critical Appraisal Skills & Programme. (2018). CASP (insert name of checklist i.e. Randomised Controlled Trial) Checklist. Retrieved from www.casp-uk.net

Elder, Stacey J., Pisoni, Ronald L., Akizawa, Tadao, Fissell, Rachel, Andreucci, Vittorio E., Fukuhara, Shunichi, . . . Port, Friedrich K. (2008). Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation, 23(3), 998-1004. https://doi.org/10.1093/ndt/gfm630

Han, Bin, Zhu, Fu-Xiang, Shi, Chao, Wu, Heng-Lan, & Gu, Xiao-Hong. (2017). Association between serum vitamin D levels and sleep disturbance in hemodialysis patients. Nutrients, 9(2), 139. https://doi.org/10.3390/nu9020139

Hou, Yongmei, Hu, Peicheng, Liang, Yanping, & Mo, Zhanyu. (2014). Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients. Cell Biochemistry and Biophysics, 69(3), 531-537. https://doi.org/10.1007/s12013-014-9828-4

Hyland, Michael E., Halpin, David M. G., Blake, Sue, Seamark, Clare, Pinnuck, Margaret, Ward, David, . . . Seamark, Dave. (2016). Preference for different relaxation techniques by COPD patients: comparison between six techniques. International Journal of Chronic Obstructive Pulmonary Disease, 11, 2315-2319. https://doi.org/10.2147/copd.s113108

Kobayashi, S., & Koitabashi, K. (2016). Effects of progressive muscle relaxation on cerebral activity: an fMRI investigation. Complementary Therapies in Medicine, 26, 33-39. https://doi.org/10.1016/j.ctim.2016.02.010

Koyanagi, Ai, Garin, Noe, Olaya, Beatriz, Ayuso-Mateos, Jose Luis, Chatterji, Somnath, Leonardi, Matilde, . . . Haro, Josep Maria. (2014). Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study. PloS one, 9(12), e114742. https://doi.org/10.1371/ journal.pone.0114742

Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. . (2014). Medical-surgical nursing assessment and management of clinical problems (9th ed.). St. Louis: Elsevier Mosby.

Mateu, Margarita, Alda, Olga, Inda, María-del-Mar, Margarit, César, Ajo, Raquel, Morales, Domingo, . . . Peiró, Ana M. (2018). Randomized, controlled, crossover study of self-administered Jacobson relaxation in chronic, nonspecific, low-back pain. Alternative Therapies in Health & Medicine, 24(6), 22-30.

Neuendorf, Rachel, Wahbeh, Helané, Chamine, Irina, Yu, Jun, Hutchison, Kimberly, & Oken, Barry S. (2015). The effects of mind-body interventions on sleep quality: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2015, 1-17. https://doi.org/10.1155/2015/902708

Ohkuma, Toshiaki, Fujii, Hiroki, Iwase, Masanori, Kikuchi, Yohei, Ogata, Shinako, Idewaki, Yasuhiro, . . . Nakamura, Udai. (2013). Impact of sleep duration on obesity and the glycemic level in patients with type 2 diabetes: the Fukuoka Diabetes Registry. Diabetes Care, 36(3), 611-617. https://doi.org/10.2337/dc12-0904

Omachi, Theodore A., Blanc, Paul D., Claman, David M., Chen, Hubert, Yelin, Edward H., Julian, Laura, & Katz, Patricia P. (2012). Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Medicine, 13(5), 476-483. https://doi.org/ 10.1016/j.sleep.2011.12.007

Pan, Kuei-Ching, Hung, Shih-Yuan, Chen, Chun- I., Lu, Chu-Yun, Shih, Mei-Ling, & Huang, Chiung-Yu. (2019). Social support as a mediator between sleep disturbances, depressive symptoms, and health-related quality of life in patients undergoing hemodialysis. PloS One, 14(4), e0216045. https://doi.org/10.1371/journal.pone.0216045

Pati, Debajyoti, & Lorusso, Lesa N. (2018). How to write a systematic review of the literature. HERD: Health Environments Research & Design Journal, 11(1), 15-30. https://doi.org/ 10.1177/1937586717747384

Pelekasis, Panagiotis, Matsouka, Ifigeneia, & Koumarianou, Anna. (2017). Progressive muscle relaxation as a supportive intervention for cancer patients undergoing chemotherapy: A systematic review. Palliative & Supportive Care, 15(4), 465-473. https://doi.org/10.1017/ s1478951516000870

Shang, Binghan, Yin, Huiru, Jia, Yong, Zhao, Jinping, Meng, Xiangfei, Chen, Li, & Liu, Peng. (2019). Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review. Geriatric Nursing. https://doi.org/ 10.1016/j.gerinurse.2019.01.001

Smith, J. C. (2005). Relaxation, meditation, & mindfulness a mental health practitioner’s guide to new and traditional approaches. New York: Springer Publishing Company.

Statista Research Department. (2020). Indonesia smartphone users 2011-2022. Retrieved from https://www.statista.com/ statistics/266729/ smartphone-users-in-indonesia/

Wolkove, Norman, Elkholy, Osama, Baltzan, Marc, & Palayew, Mark. (2007). Sleep and aging: 1. Sleep disorders commonly found in older people. Canadian Medical Association Journal, 176(9), 1299-1304. https://doi.org/10.1503/cmaj.060792

Yilmaz, Cemile Kutmec, & Kapucu, Sevgisun. (2017). The effect of progressive relaxation exercises on fatigue and sleep quality in individuals with COPD. Holistic Nursing Practice, 31(6), 369-377. https://doi.org/10.1097/hnp.0000000000000234

Zeng, Bin, Sun, Wenjie, Gary, Rebecca A., Li, Changwei, & Liu, Tingting. (2014). Towards a conceptual model of diabetes self-management among Chinese immigrants in the United States. International Journal of Environmental Research and Public Health, 11(7), 6727-6742. https://doi.org/10.3390/ijerph110706727

Zhu, Bingqian, Quinn, Laurie, & Fritschi, Cynthia. (2018). Relationship and variation of diabetes related symptoms, sleep disturbance and sleep‐related impairment in adults with type 2 diabetes. Journal of Advanced Nursing, 74(3), 689-697. https://doi.org/10.1111/ jan.13482

Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system