Use of theories of health behavior in sleep promotion studies: A scoping review

Abstract

Background: Sleep deprivation forms a vicious cycle with chronic diseases. This can be prevented by promoting behaviors conducive to restorative sleep. Although theories of health behavior can inform issues of behavior change, their use in the context of sleep promotion has not been yet comprehensively reviewed. Methods: A scoping review was conducted. Five electronic databases were searched: AgeLine, CINAHL, Embase, MEDLINE, and PsychINFO. Additional studies were identified through reference chaining. Studies were included if theories of health behavior were mentioned, referenced and applied in relation to a sleep behavior. Study characteristics and data on theoretical applications were collected using a charting form. Quantitative findings were analyzed through frequency count, while qualitative findings were thematically analyzed. Results: Thirty-five studies with various method designs were included. Most studies targeted adults with obstructive sleep apnea (n=18) and students at risk of poor sleep hygiene (n=12). The application of twenty-two theories of health behavior was identified with three main ways of informing sleep promotion initiatives. Most of the evidence obtained from theoretical applications related to how personal beliefs, intentions to change and social influences can explain adherence to treatment for obstructive sleep apnea or the adoption of healthy sleep hygiene, and how these factors can be changed via theory-based interventions and program evaluations. Conclusions: This study provides public health researchers and health promoters synthesized evidence to deploy theorybased interventions that address many factors shown to influence treatment adherence for obstructive sleep apnea and healthy sleep hygiene. Limited evidence is provided on sleep behaviors pertinent to individuals affected with insomnia.