Comparative Efficacy of Progressive Muscle Relaxation Versus Sleep Hygiene in Psychiatric Outpatients with Insomnia suffering from Anxiety and Depression: A Quasi-Experimental Study

Background: Insomnia is a prevalent concern among individuals with anxiety and depression, often exacerbating their psychological distress and impairing daily functioning. While non-pharmacological approaches have shown promise, limited data exists from Pakistan comparing these strategies in psychiatric populations. Objective: This study aimed to compare the effectiveness of Progressive Muscle Relaxation (PMR) and Sleep Hygiene (SH) education in improving sleep quality among psychiatric outpatients with anxiety and/or depression, including adolescents. Methods: A quasi-experimental study was conducted in the psychiatric outpatient department of CMH Kohat, Pakistan from March 2024 to August 2024. One hundred participants aged 13 to 60 years were purposively assigned into two groups: Group A received PMR training and Group B received SH education over a four-week period. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at baseline and post-intervention. Subgroup analysis was performed for pediatric participants. Results: Both interventions led to significant improvements in PSQI scores. However, the PMR group demonstrated a significantly greater reduction in PSQI scores compared to the SH group (p < 0.01). Pediatric participants in the PMR group also showed marked improvements in sleep quality and anxiety levels, along with high adherence and satisfaction. Conclusion: Progressive Muscle Relaxation was more effective than Sleep Hygiene education in improving sleep quality among psychiatric patients, including adolescents. This study supports the integration of PMR as a practical, non-pharmacological intervention in outpatient psychiatric care in Pakistan