PROJECT TOPIC ON EFFICACY OF COGNITIVE BEHAVIOUR AND RELAXATION TECHNIQUES ON INSOMNIA AMONG STUDENTS
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PROJECT
TOPIC ON EFFICACY OF COGNITIVE BEHAVIOUR AND RELAXATION TECHNIQUES ON INSOMNIA
AMONG STUDENTS
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Higher
institutions of learning like the universitiesare dominated in number by young
adult students,transitingto a world of relative freedom, new experiences and
choices, and based on the choices they made, their campus and off-campus
experiences can contribute to health or disor derpromoting lifestyles and
ultimately relate to their quality of lives and school activities. National
Sleep Foundation (2005), reported that young adults are at greater risk than
other age groups for developing first onset psychopathology (mental/behaviour
disorder), which may lead to lower social and academic performance, lethargy
and worse long-term outcomes such as school dropout and possibly poor
productivity at work or school.
The
foundation also noted that majority of students due to new environment; life
experiences and choices at schoolreceive significantly less sleep. A survey in
26 of 36 States in Nigeria on the prevalence of insomnia showed that 25.68% of
people aged 18 – 30 years had insomnia (Gureje, Oladeji, Abiona, Makanjuola
&Esan, 2011). A national survey in US byHicks and Pellegrini (2001), showed
that 68.3% of College students reported sleep problems, against 26.7% found in
1982.
This
suggests an upward trend. In 2009, Lund, Reider, Whiting and Prichard,found 60%
of College students reported poor sleep quality. Approximately 35% of students‘
population with sleep problems have reported experience of insomnia during the
course of a year in school (Walsh, Benca & Bonnet, 1999), 11.4% reported
that their symptoms started when they were between 21 and 30 years old
(Hardison, Neimeyer, & Lichstein, 2005).
A study in
Europe using randomly selected young adults ages 21-30 years found that 16.6%
reported experiencing insomnia. About 45% of these young adults with insomnia
continued to report sleep problems at a 3.5-year follow-up (Breslau, Roth,
Rosenthal,& Andreski, 1996). Out of over 1,000 College students surveyed by
Taylor and Bramoweth (2010), 6.8% of the students with insomnia used medication
(either prescription or over the counter) to help them sleep and 11.4% used
alcohol as a sleep aid.What precipitates and perpetuates insomnia among
students‘ population may vary from medical to non-medical reasons.However,
studies by Tagaya, Uchiyama, Ohida, Kamei, and Shibuti (2004), reported that
pressure from academic workload was one of the reasons for sleep disturbance
among students. Aside academic pressure, social activities, social pressures,
and college cultures contributed to the problem.
Harvey
(2000), stated that approximately 80% of individuals with insomnia reported an
inability to ―empty their mind,‖ and ―unwind their thinking‖ at bedtime. Harvey
stressed that the thought content of people with insomnia is full of worries,
emotionally arousing, and focused on daily and future concerns particularly,
their consequences. In addition, Gellis and Lichstein (2009), reported that
insomniac possess a number of behaviors that has to do with the frequency of
―worry, planning, or thinking about important matters at bedtime‖.
This
arousing pre-sleep cognitive activity is believed to be one of the causesof
insomnia among students. When the condition persists, it taxes its sufferer
mentally and physically, and can cause a lot of stress and distress for the
individual(Vgontzas, Liao, Bixler, Chrousos, & Vela-Bueno, 2009;
Byles,Mishra, Harris& Nair, 2003). However, despite the existence of
several psychological treatment options for insomnia, people who experience
sleep difficulties usually start with passive strategies. When surveyed, many
insomnia patients
reported
that they read, watch television, or listen to the radio when they are unable
to sleep. Many people with insomnia say that they ―do nothing‖ except lie in
bed, tossing and turning, waiting for sleep to come. The first level of active
treatment among sufferers is self-medication with alcohol, over-the-counter
sleep aids, or natural/herbal dietary supplements. If people with insomnia
eventually seek medical help for their condition, they are generally prescribed
hypnotic drugs as a second level of active treatment (National Sleep
Foundation, 2001).
Literature
have shown that psychological approaches like cognitive behavioral techniques
produced sustained benefits in management of insomnia without the risk for
tolerance or adverse effects associated with pharmacologic approaches.
Cognitive behaviour technique for insomnia (CBT) is a brief, sleep-focused,
multimodal intervention that includes psychological and behavioural
intervention such as stimulus control, sleep restriction, cognitive therapy,
and education about sleep hygiene, and sometimes combined with relaxation
technique (Morin & Benca 2012).
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Relaxation
technique,which improves calmness,may include deep breathing exercise,
progressive muscle relaxation, guided visualization among others (Ethan, 2014,
2008, NSF 2015). A combined approach is usually preferred because several
dimensions of insomnia can be addressed(Morin & Benca, 2012). The
techniques, when combined have shown high potency and are now commonly
recommended as first-line psychological treatment for insomnia due to its
success rateof 70 to 90% (Morin, 2004).
PROJECT
TOPIC ON EFFICACY OF COGNITIVE BEHAVIOUR AND RELAXATION TECHNIQUES ON INSOMNIA
AMONG STUDENTS
1.2 Statement of the Problem
Insomnia, a
sleep condition that is characterized by persistence difficulty in falling or
staying asleep long enough to feel refreshed the next morning, with daytime
side effects among young adult students studying in higher institutions of
learning is taking a worrisome proportion particularly in this computer age and
demanding 21st century academic environment.It was reported that insomnia
affects about a quarter of young people in Nigeria (Gureje, et al. 2011).
As a common
sleep, complain that makes restful and restorative sleep often a painstaking
and exasperating experience, this condition if not mitigated could give rise to
the development of other comorbidconditions.It has been reported that students
who experience persistence insomnia might suffer from fatigue, reduced quality
of life, and are likely to experience depression and engage in substance abuse
to enable them sleep.
Lack of
sleep may also weaken students‘ daytime performance, leading to falling asleep
in the class, lateness to lecture, lacking energy to perform academic tasks,
poor concentration, inattentiveness, indolence, and absenteeism and can escalate
tendency for memory deterioration, which might consequently affect negatively
on students‘ school outcomes. Despite theseeffects however, the condition is
still an under-recognized and under studied problem in this clime. Even
empirical studies examining remediation among young adult students of Ahmadu
Bello University,Zaria, Kaduna State, Nigeria are lacking.
Although,
studies (Edinger & Sampson, 2003;Fornal–Pawłowska & Szelenerger, 2013),
have supported the potency ofcognitive behaviour technique in reducing
insomniabut locally,studies investigating its relative effectiveness with
relaxation technique among young adults in the university domiciling in the
hotels are rare.Therefore, in view of the foregoing, and realizing the
importance of good sleep quality, particularly to students‘memory, and learning
outcome and other school activities, the need to address insomnia in a
psychologicalwaybecomes very essential. In the light of the above, this study
finds out the efficacy ofcognitive behavior and relaxation techniques on
insomnia among students of Ahmadu Bello University, Zaria, Kaduna State,
Nigeria.
1.3 Objectives of the Study
The
objectives of the study were to:
Determine
the effect of cognitive behaviour technique on insomnia among students of
Ahmadu Bello University, Zaria, Kaduna State, Nigeria
Determine
the effect of relaxation techniqueon insomnia among students of Ahmadu Bello
University, Zaria, Kaduna State, Nigeria
Determine
therelative effects of cognitive behaviour and relaxation techniqueson insomnia
among students of Ahmadu Bello University, Zaria, Kaduna State, Nigeria
Examine
thedifferential effects of cognitive behaviour technique on insomnia condition
of male and female students of Ahmadu Bello University, Zaria, Kaduna State,
Nigeria
Examine the
differentialeffects of relaxation techniqueon insomnia condition of male and
female students of Ahmadu Bello University, Zaria, Kaduna State, Nigeria
1.4 Research Questions
The study
was tailored towards answering the following research questions;
What is the
effect of cognitive behaviour technique on insomnia among students of Ahmadu
Bello University, Zaria, Kaduna State, Nigeria?
What is the
effect of relaxation technique on insomnia among students of Ahmadu Bello
University, Zaria, Kaduna State, Nigeria?
What is
therelativeeffects of cognitive behaviour and relaxation techniques on insomnia
among students of Ahmadu Bello University, Zaria, Kaduna State, Nigeria?
What is the
differentialeffect of cognitive behaviour technique on insomnia condition of
male and female students of Ahmadu Bello University, Zaria, Kaduna State,
Nigeria?
What is the
differentialeffect of relaxation technique on insomnia condition of male and
female students of Ahmadu Bello University, Zaria, Kaduna State, Nigeria?
1.5 Research Hypotheses
Based on the
research questions, the following non-directional hypotheses wereused to guide
the study;
H01 There is no significant effect of cognitive
behaviour technique on insomnia among
students
of Ahmadu Bello University, Zaria, Kaduna State, Nigeria
H02 There is no significant effect of relaxation
techniqueon insomnia among students of
Ahmadu
Bello University, Zaria, Kaduna State, Nigeria
6
H03 There
is no significant
differential effect of
cognitive behaviour and
relaxation
techniques
on insomnia among students of Ahmadu Bello University, Zaria, Kaduna
State,
Nigeria
H04 There
is no significant
differential effect of
cognitive behaviour technique
on
insomnia
condition of male and female students of Ahmadu Bello University, Zaria,
Kaduna
State, Nigeria
H05 There
is no significant
differentialeffect of relaxation
technique on insomnia
condition
ofmaleandfemale students of Ahmadu Bello University, Zaria, Kaduna
State,
Nigeria
1.6 Significance of the Study
The findings
will help students suffering from sleep initiation/maintenance difficulty by
providing them with tested techniques they can use to resolve such problem
without resorting to sleeping pills or substance abuse, which can lead to
dependence and addiction consequently. Using these techniques will help
students have a good sleep quality and enhanced daytime performance.
The study
will also benefit school psychologists andcounsellors by providing them with
tested cognitive and behavioural techniques that can be used to help students
who are suffering from insomnia or sleeplessness.It is hoped that when students
sleep needs are address, attention and concentration in class will likely
improve and teachers will need less effortin term of behavior modification or
management in the class most especially among students who are fond of sleeping
in the class while lecture is ongoing.
The findings
of this study will add to the existing body of literature and theories
concerning behavioural and psychological interventions formanagement of
Insomnia particularly among young adult students‘ population in Ahmadu Bello
University, and the community as a whole.
It will help
create awareness to the public in general and provide government and
non-governmental organizations with data about the existence and efficacy of
psychological and behavioural techniques in managing insomnia. This information
can help to improve public and mental health of students and the community in
general.
When
published, this study will provide future researchers, and readers with
valuable information and findings regarding the effectiveness of using various
psychological techniques and methods such as cognitive behaviour technique and
relaxation techniquein reducing insomnia.
The findings
from this study can lead to new methods or strategies for dealing with insomnia
and can shed more light on new findings, suggestions for improvements and
useful recommendations.
1.7 Basic Assumptions of the Study
Based on
available literature regarding the problem under investigation, the
studyassumes that;
Cognitive
behaviour technique might be effective inreducing insomnia amongstudents of
Ahmadu Bello University, Zaria, Kaduna State, Nigeria
Relaxationtechnique
mightbe effective inreducing insomnia amongstudents of Ahmadu Bello University,
Zaria, Kaduna State, Nigeria
Cognitive
behaviour technique might be more effective when compared to Relaxation
technique in reducing insomnia among students of Ahmadu Bello University,
Zaria, Kaduna State, Nigeria
The effect
of cognitive behavior technique on insomnia between male and female students of
Ahmadu Bello University, Zaria, Kaduna State, Nigeriamight not differ
The effect
of relaxation technique in reducing insomnia between male and female students
of Ahmadu Bello University, Zaria, Kaduna State, Nigeria might not differ
1.8 Scope and Delimitation of the Study
The scope of
the study was all students of Ahmadu Bello University, Zaria, Kaduna State,
Nigeria who show symptoms ofprimary insomnia. The study was delimitedto
assessing the efficacy of CBT (stimulus control instruction, sleep restriction,
sleep hygiene education, and cognitive technique) and Relaxation technique(deep
breathing exercise, progressive muscle relaxation, guided visualization
meditation, and mindfulness technique).
It was
delimited because of prevalence of insomnia,which is caused by cognitive and
behaviour problems among the target group. Another reason is the dearth of
research in this clime targeting young adults in the universities,and toexamine
whethercognitive behaviour and relaxation techniques can be applied effectively
in managing insomnia among young adults‘ university students of different
demography domiciling mostly on university facilities
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