Comparison of the Impacts of Benson Relaxation Technique and Foot Reflexology Massage on Sleep Quality of Patients with Systolic Heart Failure: A Randomized Clinical Trial

Masoumeh Emami Bakavoly, Moosa Sajjadi, Reza Ghasemi, Hosein Ajamzibad


Background: Cardiovascular diseases can affect sleep quality. The use of non‑pharmacological methods to improve the sleep quality of heart failure patients is essential. Therefore, this study compared the effects of the Benson relaxation technique and foot reflexology massage on sleep quality of those patients.

Materials and Methods: In this clinical trial study, 93 patients with systolic heart failure referred to Javad Al‑Aeme heart clinic in Torbat Heydarieh were selected with purposive sampling method and divided into the foot reflexology massage, Benson relaxation technique, and control groups using the balanced blocking randomization method. The Benson relaxation technique and the foot reflexology massage were performed for 20 and 30 minutes three days per week for four weeks, respectively. The control group only received routine care. Sleep quality was measured by the Pittsburgh sleep quality index and then compared among the groups before and after the intervention. The data were analyzed using ANOVA, Tukey’s post hoc tests, paired t test, and Chi‑square at the significant level of p < 0.05.

Results: After interventions, the mean (SD) quality of sleep significantly increased in both intervention groups (Reflexology: pre‑intervention 10.80 (3.40), post‑intervention 6.60 (3.10), Benson relaxation: pre‑intervention 15.50 (2.40) post‑intervention 12 (2.60), compared to the control group (pre‑intervention 10.50 (1.90) post‑intervention 9.40(1.70) (p < 0.001). There was no significant difference between the two intervention groups (p = 0.53).

Conclusions: The interventions improved the quality of sleep in patients with systolic heart failure. Therefore, these methods can be used as a suitable complementary treatment to improve the quality of sleep by nurses and midwives.


Heart failure, musculoskeletal manipulations, nursing, relaxation, sleep

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