American Journal of Nursing Research, 2019, Vol. 7, No. 6, 903-911 Available online at http://pubs.sciepub.com/ajnr/7/6/1 Published by Science and Education Publishing DOI:10.12691/ajnr-7-6-1 Insomnia among Patients with Schizophrenia: The Effect of Sleep Hygiene Guidelines Lamiaa Hassnin Eita 1,* , Asmaa Hamed Abd Elhy 2 , Samira E. Aboalizm 2 1 Psychiatric and Mental Health Nursing, Faculty of Nursing, Menoufia University, Egypt 2 Medical Surgical Nursing, Faculty of Nursing, Menoufia University, Egypt *Corresponding author: Lamy20012002@yahoo.com Received June 19, 2019; Revised August 20, 2019; Accepted September 01, 2019 Abstract Schizophrenia is a major psychiatric disorder that has a massive, long-lasting negative impact on the patients as well as society, the vast majority of patients with schizophrenia report insomnia, which tend to precede illness onset and can predict an acute exacerbation of psychotic symptoms. The aim of this study is to evaluate the effect of sleep hygiene guidelines on insomnia among patients with schizophrenia. A quasi-experimental design (pretest - posttest) was used to achieve this aim. The study was conducted at The Psychiatric and Addiction Treatment Hospital in Meet-Khalaf at Menoufia Governorate, Egypt. A Purposive sample of 65 patients with schizophrenia from inpatient unit of the above mentioned setting was recruited for this study and randomly divided into two equal groups study and control group. Three tools for data collection were used: Tool (I): Structure interview schedule to assess socio demographic data, Tool (II): Insomnia Severity Index (ISI) to assess the subject's level of insomnia, Tool (III): Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The study illustrated that there was a statistically significant improvement in quality of sleep among patients with schizophrenia in study group compared to control group. Conclusions: the sleep hygiene guidelines were effective in improvement of sleep quality among patients with schizophrenia in study group. Recommendation: Sleep hygiene guidelines should be routinely applied to all patients with psychiatric illness to improve their quality of sleep and relive insomnia. Keywords: patients with schizophrenia, insomnia, the sleep hygiene guidelines. Cite This Article: Lamiaa Hassnin Eita, Asmaa Hamed Abd Elhy, and Samira E. Aboalizm, “Insomnia among Patients with Schizophrenia: The Effect of Sleep Hygiene Guidelines.” American Journal of Nursing Research, vol. 7, no. 6 (2019): 903-911. doi: 10.12691/ajnr-7-6-1. 1. Introduction Adequate sleep is a fundamental to health which effects on many aspects of individual's life as emotional, cognitive, and psychomotor abilities and also influence person physically and psychologically [1]. Sleep help in strengthening the memory, enhance immune system, and help in prevention of many diseases as diabetes, hypertension, heart disease stroke, and mental disorders additionally improve quality of life [2,3]. Although most of psychiatric patients know sleep is vital, many do not prioritize sleep and so they reported symptoms of sleep depravity [4]. There was growing experimental evidence that the relationship between psychiatric disorders and sleep was complex and included bi-directional causation and is considered as a separate entity, which can co-occur with psychiatric disorders. The highest prevalence of insomnia is observed in psychiatric patients as comorbidity in conditions such as posttraumatic stress disorder, mania, and depression [5,6,7]. It is essential symptom in 30% to 90% of psychiatric disorders and it is seen in clinical practices and characterized by difficulty falling, remaining sleeping, wake up in a mid-night and trouble going back to sleep [8,9,10,11]. Although sleep disturbance is not included in the diagnostic criteria for schizophrenia, it is consistently reported in those patients. That is unlike some psychiatric disorders such as major depression, generalized anxiety disorder, post-traumatic stress and bipolar disorder, sleep is not a core character of schizophrenia. However, sleep disturbances are common in schizophrenic patients and not studied [12,13]. Severe disturbance of sleep has been noticed to occur before the development of acute psychotic episode in schizophrenia and linked to worsening of psychosis symptoms and poorer quality of life, so schizophrenia and insomnia frequently co-occur [6,13,12,14]. Majority of patients with schizophrenia believed that pharmacotherapy could not an acceptable intervention, due to undesirable side effects and drugs interactions, they also reported that constant adherence on one type or dose of medication that is negatively affected their sleep. Cognitive and behavioral interventions had been perceived positively but patients were doubtful of their efficacy. So, active engagement in the intervention process was viewed positively, because it could provide a sense of autonomy [13].