Volume 15, Issue 1 (Spring 2020)                   Salmand: Iranian Journal of Ageing 2020, 15(1): 67-54 | Back to browse issues page

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Saffarinia M, Mehdizadeh A. The Relations of Locus of Control and Behavioral Approach and Inhibition Systems to General Health in Elderly Nursing Home Residents in Dubai. Salmand: Iranian Journal of Ageing. 2020; 15 (1) :67-54
URL: http://salmandj.uswr.ac.ir/article-1-1304-en.html
1- Department of Psychology, Payeme Nour University, Tehran, Iran. , m.saffarinia@yahoo.com
2- Department of Psychology, Payeme Nour University, Tehran, Iran.
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1. Introduction
he elderly population in the world is increasing on a daily basis. Aging is not a phenomenon that alone causes disease, there is an obvious link between aging and diseases. Aging and sleep-related problems increase mortality from serious illnesses [1].
In the texts of traditional medicine, sleep is defined as follows: Sleep is the return of the instinctual heat to the inward to rest the forces and digest food; in other words, sleep is the cessation of the movement of the soul from the use of the external and natural senses. Sleep has four causes: the material cause of sleep is moderate humidity; the formal cause of sleep is the amount, time, and form of sleep; the actual cause of sleep is the animal soul; and the ultimate cause of sleep is the gathering and return of forces to the inward to seek rest [2]; But modern medicine sources say that sleep and rest is a complex and dynamic physiological state that is necessary for survival and if it is not met, human life is endangered [3] and sleep deprivation causes neurological, autonomic and biological changes [4]. 
Some elderly may consider sleep-related problems to be natural age-related changes and may not seek appropriate treatment. There are several pharmacological and non-pharmacological treatments for sleep-related problems, including methods such as sleep hygiene, pharmacotherapy, cognitive-behavioral therapies, bright light therapy, complementary and traditional medicine methods (such as hydrotherapy, herbal medicine, acupressure, acupuncture, relaxation, etc.) [4, 10, 14-17]. According to research, sleep problems are solved in 20% of the elderly with the help of painkillers, anti-anxiety and hypnotic drugs, and for 57% of the elderly, behavioral therapy methods are used [3, 18]. When considering medication for a patient with sleep disorders, in addition to the possibility of several diseases, related therapies should also be considered. Some drugs are stimulants and may cause insomnia, including central nervous system stimulants, beta blockers, diuretics, bronchodilators, calcium channel blockers, corticosteroids, decongestants, antidepressants, and thyroid hormones [19].
One of the effects mentioned in the texts that may occur after consuming lippia citriodora (lemon verbena), is sedation and subsequent improvement of sleep disorders. Its properties have been mentioned many times in traditional medicine texts, but in modern medicine, no research has been found that shows the effect of lemon verbena on sleep disorders; So far, no extensive studies have been conducted in the country or abroad on the use of lippia citriodora or its products in the treatment of insomnia, and the studies that have been done -especially at home - have been very brief. Therefore, we decided to investigate the effects of lippia citriodora oil on sleep disorders in the elderly. We hope that the results of this study contain useful information and solutions for the elderly and their caregivers regarding the use of lippia citriodora oil to improve the effects of insomnia.

2. Methods & Materials  
The present study was a double-blind randomized controlled clinical trial, which is also called “stratified design”. Inclusion criteria were: willingness to participate in the study; age 60 years and older; self-reported sleep disorder at the clinical level and according to the Pittsburgh questionnaire; ability to answer questionnaire items; no history of any allergies to lippia citriodora or any type of verbenaceae; lack of continuous consumption (twice or more per week) of lippia citriodora herbal tea or essence during the past 1 month; no nasal airway obstruction. Exclusion criteria were: inclination to leave the study; depression, anxiety or severe stress during the intervention (for example, due to the death of a loved one); discontinuation or less consumption of lippia citriodora oil by the subject for less than 24 consecutive days before completion of intervention period; showing any allergic reaction to lippia citriodora oil during the research; dependence or addiction to alcohol, drugs and medications; kidney disease; heart failure; respiratory disorders and sleep-wake cycle diseases such as respiratory apnea and restless legs syndrome; the use of drugs that affect the sleep-wake cycle (except for previously prescribed drugs). 
After evaluating the patients for inclusion criteria, the baseline information including the Pittsburgh Sleep Quality Index and demographic information were asked.
Lippia citriodora oil preparation process: 50g of the prepared and approved sample of lippia citriodora is poured into 200cc of inert oil and then 200cc of distilled water is added to it and subjected to indirect heat until its water evaporates completely and finally, the plant residue is obtained from the refined oil to the final product of the lippia citriodora oil. The method of using inert oil (placebo) and lippia citriodora oil (intervention) was by dripping a drop of the corresponding oil in the morning and night.

3. Results
Descriptive statistics on sleep disorder indices are presented in Table 1.


4. Conclusion
The aim of this study was to investigate the effect of lippia citriodora oil in comparison with inert oil on sleep disorders in the elderly. At the beginning of the intervention, in a few cases, the problem of headache was mentioned. After examining the problem, it was found that due to the fact that part of the intervention was performed in autumn and winter, and considering that the drops were oily and dripped into the nose, in the elderly with a history of sinusitis these concentrated drops were less absorbed and caused occasional and short-term headaches. Finally, it was decided that either the elderly should be excluded from the study or the oil should be poured on cotton tampons and placed in their noses. In the selection of other subjects, they were asked about their sinusitis or occasional headaches, and if they had a history of these diseases they were excluded from the intervention. The hypothesis was that the mean score of sleep disorders in the elderly in the intervention and control groups before and after the intervention were different. According to the results of the study, the hypothesis was examined and the score of sleep disorders in the elderly in the intervention group decreased compared to the control group. In other words, lippia citriodora oil was effective on sleep disorders in the elderly.
Based on the results of the present study, the use of lippia citriodora oil is recommended as a complementary and uncomplicated treatment for sleep disorders in the elderly. Due to the low price and low complication of herbal treatments and the favorable tendency and mentality of the majority of the elderly to use these treatments, by conducting scientific studies and documenting the desired effects (such as the results of the present dissertation), these treatments can be integrated in conventional medicine and recommended to medical staff and health care system managers.

Ethical Considerations
Compliance with ethical guidelines

All ethical principles were considered in this article. The participants were informed about the purpose of the research and its implementation stages; they were also assured about the confidentiality of their information; Moreover, They were allowed to leave the study whenever they wish, and if desired, the results of the research would be available to them.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions
All authors contributed equally in preparing all parts of the research.
Conflicts of interest
The authors declared no conflict of interest.
The researchers appreciate the Professors of the Department of Aging of the University of Social Welfare and Rehabilitation Sciences, Department of Traditional Medicine of Tehran University of Medical Sciences, and the Management and the Distinguished Staff.

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Type of Study: Research | Subject: Psychology
Received: 2017/03/01 | Accepted: 2019/06/12 | Published: 2020/04/01

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