The Effects of Spiritual Interventions on Sleep Quality Among Patients with Chronic Diseases: A Systematic Review of Interventional Studies.

Abstract

The present study aimed to systematically examine the available evidence regarding the effects of spiritual interventions on sleep quality among patients with chronic diseases. This systematic review was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Web of Science, Scopus, Embase, ScienceDirect, Google Scholar, Magiran, and the Scientific Information Database (SID) were searched systematically from inception to May 26, 2026, with no time restrictions. Eligible studies included randomized controlled trials, controlled clinical trials, and quasi-experimental studies that investigated the effects of spiritual, religious, or spiritual care-based interventions on sleep quality among adults with chronic physical diseases. Study identification, screening, and selection were independently performed by two researchers, and the methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. A total of 3739 records were identified, and six studies involving 478 participants (239 in the intervention group and 239 in the control group) were included in the systematic review; four were randomized controlled trials and two were quasi-experimental studies. The studies were conducted between 2014 and 2025 in Iran and Indonesia and included patients with coronary artery disease, stroke, multiple sclerosis, and chronic kidney disease undergoing hemodialysis. The interventions included structured spiritual care, culturally and locally adapted spiritual care, theory-based spiritual care, religious interventions, and religious relaxation. Sleep quality was assessed in all studies using the Pittsburgh Sleep Quality Index (PSQI). Overall, the findings indicated that spiritual interventions were associated with improved sleep quality compared with control groups. However, differences in disease characteristics, participant characteristics, intervention content, number and duration of sessions, and methods of program delivery limited direct comparisons across studies. Based on the available evidence, spiritual interventions may be considered a complementary approach to the care of patients with chronic diseases and the management of sleep-related problems.