The Effect of Foot Reflexology on Sleep Quality Among Female Health Sciences University Students: An Experimental Study

Abstract

Background: Impaired sleep quality negatively impacts university students' health and academic performance. Sleep disorders are also more common among female university students than among male students. Objectives: The objective of this study is to determine the effect of foot reflexology on sleep quality among Health Sciences University female students. Methods: This experimental study was conducted in Estonia. A total of 20 participants aged 18 - 25 with impaired sleep quality [evaluated by Pittsburgh Sleep Quality Index (PSQI) score] from Tartu Applied Health Sciences University from October 2022 to March 2023 were randomly allocated into reflexology (RFLX, n = 10) and control (CONT, n = 10) groups by Random Sequence Generator. The RFLX received foot reflexology therapy twice weekly during the four-week study period, with each session 20 minutes long. The CONT did not receive any treatment and continued their everyday habitual life. To evaluate changes in sleep quality, the PSQI was completed by the participants in both groups before and after the study period. Data were analyzed using appropriate parametric and non-parametric statistical tests, including t-tests and rank-based methods, to compare changes within and between groups over a period. Results: A significant difference in the mean scores of PSQI was observed in the RFLX group after the study (9.9 ± 2.85 vs 4.2 ± 2.49; P < 0.001), whereas the CONT group showed a nonsignificant change (9.1 ± 3.96 vs 7.6 ± 3.53). After the intervention period, a significant difference was observed between the changes in the two groups (P = 0.006). In addition, the most changed PSQI component in the RFLX was sleep latency (P = 0.004), with a statistically significant mean change (P = 0.005) compared to the CONT group. Conclusions: Four-week foot reflexology effectively improves sleep quality in Health Sciences University female students. These findings suggest that reductions in PSQI scores may have meaningful clinical value by indicating improved sleep quality among participants; however, the relatively small sample size warrants cautious interpretation and underscores the need for larger studies to confirm these results.