Efficacy of Automated Text Messaging Services on Sleep Health, Stress, Pain, and Function in Physical Therapy Patients

Purpose: Physical therapy (PT) patients have been shown to have greater sleep disturbances and poor sleep hygiene compared to the general population. Automated text messaging has emerged as one possible strategy to assist with improving sleep hygiene. The purpose of this study was to trial sleep hygiene education for improving PT patients’ sleep through the use of daily automated text messaging.

Methods: Adult PT patients completed an electronic survey consisting of five questionnaires: Pittsburgh Sleep Quality Index (PSQI), Sleep Hygiene Index (SHI), Patient Specific Functional Scale (PSFS), Perceived Stress Scale (PSS), and the Numeric Pain Rating Scale (NPRS). Participants were randomly assigned into groups. The intervention group received PT services along with daily text messages on sleep hygiene tips. The control group only received PT services. At the end of four weeks, questionnaires were repeated.

Results: A marginally significant difference was seen between conditions on the PSQI, F(1, 20) = 4.11, p = .056, np2 = .17. A significant effect difference between time of testing was seen on the SHI scale. F(1, 20) = 8.15, p = .010, np2 = .29, and the PSFS scale, F(1, 20) = 20.97, p < .001, np2 = .58.

Conclusions: The intervention group was trending towards significance on the PSQI, suggesting improved sleep quality. Improvements were seen in sleep hygiene and overall function over the four weeks regardless of group assignment. It appears automated text messaging is a means to increase sleep function in PT patients, a larger sample size would confirm this finding.

Keywords:Sleep Hygiene; Physical Therapy; Automated Text Messaging

Abbreviations:RT: PT: Physical therapy; PSQI: Pittsburgh Sleep Quality Index; SHI: Sleep Hygiene Index; PSFS: Patient Specific Functional Scale; PSS: Perceived Stress Scale; NPRS: Numeric Pain Rating Scale