Structured Self-Care for Sleep Disturbance in a Menopausal Woman: A Case Report
DOI:
https://doi.org/10.56359/kian.v5i2.1003Keywords:
menopause, nursing intervention, self-care, sleep quality, sleep disturbanceAbstract
Introduction: Menopause is associated with physiological and psychological changes that may contribute to sleep disturbances and affect women’s daily functioning. Structured self-care may provide a practical nursing approach to support women in managing menopausal symptoms and developing healthier daily behaviors. Objective: This case report aimed to describe the implementation of a structured self-care intervention and the associated changes in self-care practices and sleep quality in a menopausal woman experiencing sleep disturbance. Method: A descriptive case report was conducted involving a 51-year-old woman who had experienced menopause for approximately two years and reported difficulty initiating sleep, frequent nighttime awakenings, nonrestorative sleep, daytime fatigue, and excessive daytime sleepiness. The intervention was implemented over four weeks in the patient’s home and consisted of menopause and self-care education, sleep hygiene, slow deep-breathing relaxation, light physical activity, healthy dietary practices, adequate fluid intake, stress management, regular monitoring, and family support. Self-care practices were assessed was assessed using the Menopausal Self-Care Questionnaire (MSCQ), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Result: During the four-week intervention period, the patient demonstrated increased self-care practices and improved sleep-related outcomes. The MSCQ score increased from 85 at baseline to 168 at the final assessment, while the PSQI score decreased from 12 to 4. The patient also reported reduced difficulty initiating sleep, fewer nighttime awakenings, decreased daytime fatigue and sleepiness, and feeling more refreshed upon waking. Conclusion: The four-week structured self-care intervention coincided with improvements in self-care ability and sleep quality in this individual case. However, the observed changes cannot be attributed solely to the intervention because the report involved one patient without a comparison group
Downloads
References
Aksu, S. P., & Şentürk Erenel, A. (2022). Effects of health education and progressive muscle relaxation on vasomotor symptoms and insomnia in perimenopausal women: A randomized controlled trial. Patient Education and Counseling, 105(11), 3279–3286. https://doi.org/10.1016/j.pec.2022.07.015
Baker, F. C., Lampio, L., Saaresranta, T., & Polo-Kantola, P. (2018). Sleep and sleep disorders in the menopausal transition. Sleep Medicine Clinics, 13(3), 443–456. https://doi.org/10.1016/j.jsmc.2018.04.011
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4
Dharmarajlu, S. M. (2024). Effect of lifestyle modification education on knowledge, attitude, and quality of life on menopause among middle-aged teachers. African Journal of Reproductive Health, 28(11), 170–180. https://doi.org/10.29063/ajrh2024/v28i11.17
Duman, M., & Timur Taşhan, S. (2018). The effect of sleep hygiene education and relaxation exercises on insomnia among postmenopausal women: A randomized clinical trial. International Journal of Nursing Practice, 24(4), e12650. https://doi.org/10.1111/ijn.12650
Hachul, H., Hachul de Campos, B., Lucena, L., & Tufik, S. (2023). Sleep during menopause. Sleep Medicine Clinics, 18(4), 423–433. https://doi.org/10.1016/j.jsmc.2023.06.004
Ha, B., Kim, J., So, W.-Y., & Kim, S. (2023). Effects of nonpharmacological interventions on sleep quality and insomnia in perimenopausal and postmenopausal women: A meta-analysis. Healthcare, 11(3), 327. https://doi.org/10.3390/healthcare11030327
Hartweg, D. L., & Metcalfe, S. A. (2022). Orem’s self-care deficit nursing theory: Relevance and need for refinement. Nursing Science Quarterly, 35(1), 70–76. https://doi.org/10.1177/08943184211051369
Haufe, A., Baker, F. C., & Leeners, B. (2022). The role of ovarian hormones in the pathophysiology of perimenopausal sleep disturbances: A systematic review. Sleep Medicine Reviews, 66, 101710. https://doi.org/10.1016/j.smrv.2022.101710
Hossein Mirzaee Beni, Z., Sadeghi, R., & Ghaffari, M. (2022). The effect of self-care education based on health literacy on self-care and quality of life among menopausal women: A randomized clinical trial. BMC Women’s Health, 22, 452. https://doi.org/10.1186/s12905-022-02007-2
Kafaei-Atrian, M., Solhi, M., Azar, F. E. F., & Atoof, F. (2019). Development and psychometric evaluation of the menopausal self-care questionnaire in a sample of Iranian postmenopausal women. Nursing and Midwifery Studies, 8(4), 210–216. https://doi.org/10.4103/nms.nms_9_18
Karimi, L., Mokhtari Seghaleh, M., Khalili, R., & Vahedian-Azimi, A. (2022). The effect of self-care education program on the severity of menopause symptoms and marital satisfaction in postmenopausal women: A randomized controlled clinical trial. BMC Women’s Health, 22, 71. https://doi.org/10.1186/s12905-022-01653-w
Kingsberg, S. A., Schulze-Rath, R., Mulligan, C., Moeller, C., Caetano, C., & Bitzer, J. (2023). Global view of vasomotor symptoms and sleep disturbance in menopause: A systematic review. Climacteric, 26(6), 537–549. https://doi.org/10.1080/13697137.2023.2256658
Lam, C. M., Hernandez-Galan, L., Mbuagbaw, L., Ewusie, J. E., Thabane, L., & Shea, A. K. (2022). Behavioral interventions for improving sleep outcomes in menopausal women: A systematic review and meta-analysis. Menopause, 29(10), 1210–1221. https://doi.org/10.1097/GME.0000000000002051
Lin, M.-H., Hsiao, P.-R., & Hsu, H.-C. (2022). Comparing the effectiveness of multicomponent sleep-promoting interventions on the sleep quality of menopausal women: A quasi-experimental study. Healthcare, 10(3), 559. https://doi.org/10.3390/healthcare10030559
Lucena, L. dos R., Santos-Junior, J. G. dos, Tufik, S., & Hachul, H. (2021). Lavender essential oil on postmenopausal women with insomnia: Double-blind randomized trial. Complementary Therapies in Medicine, 59, 102726. https://doi.org/10.1016/j.ctim.2021.102726
Massoud, E. F., ElDeeb, A. M., Samir, S. H., & Shehata, M. M. A. (2023). Effect of resistive exercise on insomnia and sleep quality in postmenopausal women: A randomized controlled trial. Bulletin of Faculty of Physical Therapy, 28, 12. https://doi.org/10.1186/s43161-023-00124-z
Moradi Farsani, H., Afshari, P., Sadeghniiat Haghighi, K., Gholamzadeh Jefreh, M., Abedi, P., & Haghighizadeh, M. H. (2021). The effect of group cognitive behavioural therapy for insomnia in postmenopausal women. Journal of Sleep Research, 30(5), e13345. https://doi.org/10.1111/jsr.13345
Ökten, Ç., & Özer, Z. (2022). Orem’s theory with educational telephone follow-ups: A randomized controlled trial. Nursing Science Quarterly, 35(4), 444–454. https://doi.org/10.1177/08943184221115126
Salari, N., Hasheminezhad, R., Hosseinian-Far, A., Rasoulpoor, S., Assefi, M., Nankali, S., Nankali, A., & Mohammadi, M. (2023). Global prevalence of sleep disorders during menopause: A meta-analysis. Sleep and Breathing, 27(5), 1883–1897. https://doi.org/10.1007/s11325-023-02793-5
Schaedel, Z., Holloway, D., Bruce, D., & Rymer, J. (2021). Management of sleep disorders in the menopausal transition. Post Reproductive Health, 27(4), 209–214. https://doi.org/10.1177/20533691211039151
Setyowati, A., & Chung, M.-H. (2021). Validity and reliability of the Indonesian version of the Pittsburgh Sleep Quality Index in adolescents. International Journal of Nursing Practice, 27(5), e12856. https://doi.org/10.1111/ijn.12856
Tanaka, M. (2022). Orem’s nursing self-care deficit theory: A theoretical analysis focusing on its philosophical and sociological foundation. Nursing Forum, 57(3), 480–485. https://doi.org/10.1111/nuf.12696
Taylor-Swanson, L., Kent-Marvick, J., Austin, S. D., Ellis, J., Charles, C., Ward, R., Crandall, L., Negrete Macias, S., Moreno, C., & Simonsen, S. E. (2024). Developing a menopausal transition health promotion intervention with Indigenous, integrative, and biomedical health education: A community-based approach with urban American Indian/Alaska Native women. Women’s Health, 20, 27536130241268232. https://doi.org/10.1177/27536130241268232
Yip, J. Y. C. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s Self-Care Deficit Nursing Theory. SAGE Open Nursing, 7, 23779608211011993. https://doi.org/10.1177/23779608211011993
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Dima Kanu Almadani, Henny Dwi Susanti, Rusnani Ab Latif, Suryani Hartati
This work is licensed under a Creative Commons Attribution 4.0 International License.
