The Sleep-Enhancing Effect of Lavender Essential Oil in Adults

Abstract

This systematic review examined the sleep-enhancing effect of lavender essential oil in adults. Randomized controlled trials (RCTs) regarding the sleep-enhancing effect of lavender essential oil in adults were searched in PubMed, Embase, Cochrane Library, CINAHL, and Web of Science. The retrieval period spanned from January 1, 2014 to September 4, 2024. Literature screening and data extraction were conducted by 2 researchers, and the risk of bias in the included studies was assessed. The data were analyzed using RevMan 5.4 software. Eleven RCTs, encompassing a total of 628 adult participants, were incorporated into this analysis. The outcomes of the meta-analysis indicated that the sleep-enhancing effect of lavender essential oil intervention in adults was significant (standardized mean difference = –0.56, 95% CI [−0.96, −0.17], P= .005). Current findings indicate that the use of lavender essential oil can enhance the sleep quality of adults. However, constrained by the quantity and quality of the incorporated studies, this conclusion requires verification in more high-quality studies.

INTRODUCTION

Sleep is an essential biological requirement for human existence and has a profound impact on an individual’s physical health, psychological state, and overall quality of life. During recent years, as the pace of life has accelerated, lifestyles have changed, and work pressure has arisen, a growing number of scholarly studies have found that the deterioration of sleep quality in adults has become a common and global problem, with nearly half of adults experiencing at least 1 sleep disorder.1-3 Poor sleep quality in adults not only affects daily work efficiency and social skills, but is also closely related to the incidence of chronic illnesses like obesity, cardiovascular ailments, depression, and diabetes.4-7

Medication can also improve sleep quality in adults. The latest research shows that ziprasidone significantly increases total sleep time and sleep efficiency, and decreases the number of awakenings.8 Additionally, melatonin treatment could make students feel more awake during the school day.9 While there are many drugs available to improve sleep quality or treat sleep disorders, long-term use may lead to adverse reactions, including the development of medication tolerance and addiction.

In the medical field, besides medication methods to improve sleep quality, there are also some invasive treatments such as transcranial magnetic stimulation,10,11 deep brain stimulation,12 continuous positive airway pressure,13 light therapy,14 and surgical intervention.15 These methods are primarily aimed at patients who do not respond well to medical therapy or who have contraindications. However, they are often associated with certain risks and limitations. At the same time, some of these treatments also require special equipment or long treatment cycles.

In contrast, nondrug-based therapeutic approaches, such as cognitive behavioral intervention, relaxation techniques, music therapy, and aromatherapy, offer more feasible and sustainable treatment options. These approaches are milder, more convenient, and personalized, thereby avoiding the high risks associated with invasive treatments.16-19 Consequently, an increasing number of research studies and clinical practices are exploring how to integrate non-pharmacological treatment plans to provide safer, more effective, and less side-effect-prone methods for improving sleep.

Aromatherapy is one of the alternative complementary therapies which can be utilized independently because of its straightforward application. It can be used for managing symptoms such as pain, anxiety, stress, and insomnia.20 Its benefits for alleviating stress and enhancing sleep quality include affordability, easy availability, minimal time and space requirements, and rapid effects.21 Engaging in aromatherapy means using essential oils through methods that include inhalation, massage, bathing and other forms of bodily application.22 Essential oils are the inherently fragrant and lipidic fluids secreted by botanical organisms, giving them their distinctive scents or essences. Essential oils are abundant within the plant’s specialized storage structures, such as oil sacs and oil glands. Extraction of essential oils is possible derived from various components of flora, including leaves, bark, blossoms, seeds, and rinds.23

Lavender oil is among the essential oils which are most often used in aromatherapy for a range of clinical uses, namely sleep, perioperative pain, depression, wound healing, and anxiety.24-28 Lavender essential oil contains natural compounds such as linalool and linalyl acetate, which have calming and soothing effects that help alleviate anxiety and stress, promote relaxation, and aid in falling asleep.29 Multiple studies have indicated that essential oil from lavender is effective in aiding individuals with insomnia and improving sleep quality.30,31

Clinical studies have been carried out using lavender essential oil for improving sleep. However, none of these studies have further analyzed and evaluated these research findings. Therefore, this study used a meta-analysis to scientifically assess the effectiveness of lavender essential oil in enhancing sleep quality among adults.

MATERIAL AND METHODS

This meta-analysis adhered to the standards set by the Preferred Reporting Items for Systematic Review and Meta-analysis, and it was officially recorded in the International Prospective Register of Systematic Reviews (with the registration number: CRD42024586560).32

Literature search strategy

A 2-step approach was employed in the search strategy to enhance the retrieval of relevant study materials. Initially, a systematic search was conducted across 5 databases from their inception to September 4, 2024, encompassing PubMed, Embase, Cochrane Library, CINAHL, and Web of Science. Second, the snowball sampling method was used to obtain other relevant studies from the reference lists of the identified studies. Figure 1 shows the search strategy for each database. Search terms involved “lavender/lavender essential oil/aromatherapy/essential oil/aromatic/aroma” and “sleep quality/sleep/insomnia/sleep disorder/sleep-wake disorders/sleep problem/dyssomnia” in all combinations. The search strategy using PubMed as an example is “(lavender OR lavender essential oil OR aromatherapy OR essential oil OR aromatic OR aroma) AND (sleep quality OR sleep OR insomnia OR sleep disorder OR sleep-wake disorders OR sleep problem OR dyssomnia), Filters: Randomized Controlled Trial.”

FIGURE 1.

PRISMA flow diagram.

Inclusion and exclusion criteria

The previously mentioned search tactic was formulated in accordance with the “PICOS” framework. Articles were qualified if they met the following criteria regarding participants, interventions, comparisons, outcomes, and research designs: (1) study subjects were 18 years of age or older; (2) the experimental group was subjected to an aromatherapy session with lavender essential oil; (3) the comparison interventions included usual care or placebo; (4) trials viewed sleep scores as a necessary outcome for assessment; (5) study followed an RCT methodology.

The criteria for exclusion were outlined as follows: (1) duplicates; (2) studies without full text; (3) studies which were published in languages other than English; (4) essential oils used other than lavender essential oil.

Selection of studies

Initially, all the collected articles were imported into the NoteExpress software (version 4.0.0.9855) to identify and eliminate any duplicates. Subsequently, 2 researchers (H.S. and L.-J.Z.) separately examined the titles and abstracts of all the articles and verified each other’s selections. After this, the complete manuscripts of the articles deemed potentially pertinent were assessed against the established criteria. In cases where the 2 researchers disagreed on the inclusion of a study, a third reviewer (W.-Y.Z.) was consulted to reach a consensus.

Extraction of data

Two researchers (H.S. and L.-J.Z.) autonomously performed data extraction from the enrolled studies utilizing a custom-designed data abstraction form. The form comprised the subsequent parameters: author, publication year, nation, sample size, experimental group (intervention method, frequency, and duration of intervention), control group (measures), outcome measurement, and outcomes. After extraction, the 2 researchers cross-checked the data. Any disputes were resolved through consultation with a third reviewer (W.-Y.Z.).

Evaluation of study quality

Two researchers (H.S. and L.-J.Z.) separately assessed the quality of the incorporated studies by utilizing the Cochrane Collaboration’s risk of bias assessment tool for RCTs.33 If any disagreement occurred during the study quality evaluation, a group discussion was carried out with a third reviewer (W.-Y.Z.) to reach an agreement. The Cochrane Collaboration tool consists of 7 items (random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other sources of bias), and the bias risk of each item was considered low, uncertain, or high.

Data analysis

Statistical analysis was carried out using Review Manager software (RevMan5.4). The average discrepancy or standardized mean difference (SMD) along with the 95% confidence interval (CI) were computed to serve as the combined effect measures for continuous outcomes. A P value less than .05 was considered significant. The chi-squared test was employed to evaluate the variability among the included studies. If I² was less than 50%, the fixed-effects model was employed; otherwise, a random-effects model was chosen. An I² value of 50% or greater was deemed to signify significant heterogeneity across the studies, with subgroup or sensitivity analyses conducted to identify the origin of this heterogeneity.

RESULTS

Selection of studies

The search yielded a cumulative total of 2015 articles, with 2010 retrieved from electronic databases and an additional 5 from manual databases. After duplicates were removed, 1923 articles remained, and among them, 1884 were excluded through screening the titles and abstracts. Additionally, 28 articles were eliminated following a comprehensive examination of the full texts. In the end, 11 articles were incorporated into this meta-analysis.27,28,30,34-41 Figure 1 provides an overview of the procedure for searching and selecting studies.

Characteristics of included studies

The meta-analysis included 628 participants across all studies, with 309 in the experimental group and 319 in the control group. The research studies were conducted over a span of 10 years, from 2014 through 2024. There were 5 studies conducted in Turkey, 2 in the United States, 2 in China, 1 in Brazil, and 1 in Iran, respectively. Respectively, 6 studies utilized 100% lavender essential oil, 3 studies involved inhaling diluted lavender essential oil, and 2 studies applied lavender essential oil topically to the skin. Regarding the scales used for sleep quality assessment, 5 studies employed the Pittsburgh Sleep Quality Index (PSQI),35 3 used the Richard Campbell Sleep Questionnaire (RCSQ),34 and 1 each used the Chinese version of Pittsburgh Sleep Quality Index (CPSQI),36 Visual Analog Scale (VAS),40 and St. Mary’s Hospital Sleep Questionnaire (SMSHQ).41 The PSQI is a self-reported questionnaire designed to assess sleep quality, consisting of 19 individual items grouped into 7 components. A higher total score on the PSQI indicates more significant sleep-related problems. The CPSQI is a localized revision of the original PSQI scale, designed to better adapt to the Chinese cultural background and population characteristics. Its questionnaire items, total score, and the meaning of the scores are the same as those of the original PSQI. The RCSQ uses the VAS method to assess subjective sleep experiences, where patients mark their responses directly on the scale. It comprises 5 core items, with higher scores indicating better sleep quality. The VAS has been frequently employed across various studies to gauge sleep quality, akin to assessing pain, as it is based on personal perception. The higher the VAS score, the worse the sleep quality. The SMSHQ is used to assess a person’s mental state during the last night’s sleep. The questionnaire contains 14 questions regarding last night’s sleep quality, the time it takes to fall asleep, and the time to wake up, where higher scores imply better sleep quality. Table 1 summarizes the characteristics of the included studies.

TABLE 2.

Assessment of Risk of Bias in the Methodological Quality of Randomized Controlled Trials

References	Random Sequence Generation	Allocation Concealment	Blinding of Participants and Staff	Blinding of Outcome Assessors	Incomplete Outcome Data	Selective Reporting	Other Sources of Bias
Lytle et al34	Low	Uncertain	High	Uncertain	Low	Uncertain	High
Karadag et al35	High	Uncertain	Uncertain	Uncertain	Low	Uncertain	Uncertain
Hsu et al36	Low	Low	Uncertain	Low	Uncertain	Uncertain	Low
Yin et al27	Low	Low	Low	Uncertain	Low	Low	Uncertain
Dos et al37	Low	Low	Low	Uncertain	Low	Uncertain	Uncertain
Genç et al38	Low	Uncertain	Uncertain	Uncertain	Low	Uncertain	Uncertain
Kavuran and Yurtta39	Low	Low	Low	Uncertain	Low	Low	Uncertain
Şentürk and Tekinsoy Kartın40	Uncertain	High	High	Uncertain	Uncertain	Uncertain	High
Shammas et al28	Uncertain	Uncertain	High	Uncertain	Low	Low	Uncertain
Yıldırım et al30	Low	Uncertain	High	Uncertain	High	Uncertain	Uncertain
Rafi et al41	Uncertain	Uncertain	Uncertain	Uncertain	Low	Uncertain	Uncertain

TABLE 1.

Characteristics of Studies Included in the Systematic Review

Author	Year	Nation	Sample Size		Experimental Group		Control Group	Outcomes/Scale
			Experimental Group	Control Group	Intervention Method	Frequency and Duration of Intervention	Measures
Lytle et al34	2014	The United States	25	25	Inhale the 100% lavender essential oil that was placed 1 m away	1 time/every night, 1 day	Usual care	RCSQ
Karadag et al35	2017	Turkey	30	30	Inhale diluted lavender essential oil placed 12 inches away	1 time/every night, 15 days	No intervention	PSQI
Hsu et al36	2021	China	54	56	Apply lavender essential oil to the skin	1 time/every week, 4 weeks	No intervention	CPSQI
Yin et al27	2024	China	20	20	Inhale 100% lavender essential oil which was placed beside the pillow	1 time/every night, 4 weeks	Placebo (empty)	PSQI
Dos et al37	2021	Brazil	17	18	Inhale diluted lavender essential oil which was placed beside the pillow	1 time/every night, 29 days	Placebo (sunflower oil)	PSQI
Genç et al38	2020	Turkey	30	29	Inhale the 100% lavender essential oil that was placed 20-30 cm away	1 time/every night, 1 month	No intervention	PSQI
Kavuran and Yurttaş39	2024	Turkey	31	32	Inhale the 100% lavender essential oil that was placed 15-20 cm away	1 time/every night, 30 days	No intervention	PSQI
Şentürk and Tekinsoy Kartın40	2018	Turkey	17	17	Inhale the 100% lavender essential oil that was placed 15-20 cm away	1 time/every night, 7 days	No intervention	VAS
Shammas et al28	2021	The United States	16	23	Apply lavender essential oil to the skin	1 time/preoperative, 1 time/every 2 hours/Intraoperative, 1 time/every 4 hours/Postoperative	Placebo (coconut oil)	RCSQ
Yıldırım et al30	2020	Turkey	34	34	Inhale the 100% lavender essential oil that was placed 1 m away	1 time/every night, 2 days	No intervention	RCSQ
Rafi et al41	2020	Iran	35	35	Inhale diluted lavender essential oil which was placed beside the pillow	1 time/every night, 1 day	Placebo (water)	SMSHQ

Assessment of bias risk

Overall, the 11 studies included had a moderate bias risk. Among the studies reviewed, 7 delineated the protocol for random sequence generation, whereas a subset of 4 provided comprehensive elucidation concerning the mechanisms of allocation concealment. The majority of studies lacked sufficient details to allow for an assessment of blinding. Figure 2 presents an overview of the risk of bias.

FIGURE 2.

Risk of bias assessment for the methodological quality of randomized controlled trials.

Meta-analysis results

Overall effect test of the intervention outcome

Eleven studies have reported the effects of lavender essential oil intervention on the sleep quality of adults. The SMD was chosen for the combination of effect size, and significant heterogeneity was found among the study results (I² = 82%, P < .00001). In the meta-analysis, a random effects model was utilized. The “–” sign before the effect size indicated that lavender essential oil intervention exerted a positive influence on sleep quality. The combined effect size SMD for enhancing sleep quality through lavender essential oil intervention was –0.56 (P = .005), with a 95% CI of (–0.96, –0.17). This implies that lavender essential oil intervention is effective in improving sleep quality among adults. The sensitivity analysis revealed no significant variability or heterogeneity across the studies (Figure 3).

FIGURE 3.

Forest plot showing the sleep-enhancing effect of lavender essential oil in adults.

Analysis of sleep quality subgroups

Subgroup analyses were conducted with methods of application (inhale lavender essential oil, administer lavender essential oil topically), duration of intervention (<2 weeks, ≥2 weeks), control group interventions (placebo, no intervention, or usual care), inhalation of lavender essential oil (including inhaling 100% lavender essential oil, and inhaling diluted lavender essential oil), and different placement of lavender essential oil when using inhalation method (beside the pillow, ≥15 cm away from the pillow) as the grouping indicators.

Methods of application

Nine studies used inhalation as an application method for lavender essential oil. The findings indicated that the combined effect sizes were statistically significant (SMD = –0.62, 95% CI [–1.12, –0.12], P = .02). The sensitivity analysis, with the exclusion of the study by Yin et al,27 demonstrated no heterogeneity among the studies. Two studies applied lavender essential oil to the skin as application method. The findings showed that the combined effect sizes were notably significant (SMD = –0.33, 95% CI [–0.66, –0.01], P = .04) (Figure 4).

FIGURE 4.

Subgroup analysis according to methods of application.

Duration of intervention

Five studies used lavender essential oil for no more than 2 weeks. The findings showed that the combined effect sizes were not significant (SMD = –0.20, 95% CI [–0.90, 0.49], P = .57). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies. Six studies used lavender essential for ≥2 weeks. The findings showed that the combined effect sizes were notably significant (SMD = –0.84, 95% CI [–1.20, –0.47], P < .00001). The sensitivity analysis revealed no significant variability or heterogeneity across the studies (Figure 5).

FIGURE 5.

Subgroup analysis according to duration of intervention.

Control group interventions

A placebo control group intervention was employed in 4 studies. The findings showed that the combined effect sizes were notably significant (SMD = –0.87, 95% CI [–1.37, –0.38], P = .0005). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies. Seven studies utilized either standard care or a no-intervention approach as the control group. The findings showed that the combined effect sizes were not significant (SMD = –0.39, 95% CI [–0.91, 0.12], P = .14). The sensitivity analysis, with the exclusion of the study by Yıldırım et al,30 demonstrated no heterogeneity among the studies (Figure 6).

FIGURE 6.

Subgroup analysis according to control group interventions.

Inhale different concentrations of lavender essential oil

Six studies used 100% lavender essential oil when using the inhalation method. The findings showed that the combined effect sizes were not significant (SMD = –0.58, 95% CI [–1.35, 0.19], P = .14). The sensitivity analysis, with the exclusion of the study by Yıldırım et al,30 demonstrated no heterogeneity among the studies. Three studies used diluted lavender essential oil in the inhalation method. The findings showed that the combined effect sizes were notably significant (SMD = –0.73, 95% CI [–1.04, –0.41], P < .00001). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies (Figure 7).

FIGURE 7.

Subgroup analysis according to inhale different concentrations of lavender essential oil.

Different placement of lavender essential oil when using inhalation method

In 3 studies, lavender essential oil was used beside the pillow via the inhalation method. The findings showed that the combined effect sizes were notably significant (SMD = –1.03, 95% CI [–1.60, –0.47], P = .0003). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies. Six studies employed lavender essential oil placed at a distance of 15 cm or more from the pillow for inhalation purpose. The findings showed that the combined effect sizes were not significant (SMD = –0.41, 95% CI [–1.06, 0.24], P = .22). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies (Figure 8).

FIGURE 8.

Subgroup analysis according to different placement of lavender essential oil when using inhalation method.

Different assessment tools

Five studies employed the PSQI The findings showed that the combined effect sizes were notably significant (SMD = –0.97, 95% CI [–1.29, –0.64], P < .00001). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies. Three studies used the RCSQ. The findings showed that the combined effect sizes were not significant (SMD = –0.26, 95% CI [–0.40, 0.93], P = .44). The sensitivity analysis indicated no substantial variability or heterogeneity across the studies (Figure 9).

FIGURE 9.

Subgroup analysis according to different assessment tools.

DISCUSSION

This research assessed the impact of lavender essential oil on sleep quality by conducting a meta-analysis. The findings revealed that lavender essential oil significantly enhanced sleep quality, with the intervention group exhibiting notably higher sleep quality scores compared to the control group. Nevertheless, a certain level of variability was observed among the studies, which may be related to the characteristic differences, such as duration of intervention, the interventions implemented in the comparison group, the level of lavender essential oil concentration breathed in, and the distance between the pillow and the inhaled lavender essential oil.

Different methods can be used to deliver lavender essential oil (such as inhalation, massage, bathing, etc).28,37,42 In this study, 9 studies used the inhalation method, and 2 studies used the massage method. The findings indicated no significant difference between the 2 intervention methods. Nevertheless, there was a marked disparity in the number of studies employing each method. Furthermore, the massage method can be divided into partial or whole-body massage. Does lavender essential oil delivered by different methods produce different effects? Further RCTs are still required in the future to substantiate the effects of various intervention methods on adult’s sleep quality.

The duration of the intervention was also an important variable affecting effectiveness. The research revealed that utilizing lavender essential oi for a brief duration (<2 weeks) did not notably enhance sleep quality, whereas extended usage (≥2 weeks) yielded a substantial improvement. Additionally, the daily frequency of the intervention, the duration of each session, and the time of intervention delivery may have impacted the intervention effect; however, these factors were not standardized in the included studies. We suggest that future research should explore the duration needed to achieve effective results and investigate the optimal frequency of daily use, the length of each session, and the most appropriate time of day for application. Therefore, these studies could provide more detailed guidelines and practical recommendations.

This study found that the placebo-control group had a significant improvement in sleep quality, whereas the group with usual care or no intervention had no significant impact on sleep quality improvement. This indicates that variations in the control measures employed in the control group can lead to differences in the intervention effects. It is recommended that future study designs standardize the application of placebos for interventions in the control group whenever feasible.

Additionally, the findings of this study indicated that inhaling various concentrations of lavender essential oil had differing impacts on enhancing sleep quality. Breathing in undiluted lavender essential oil did not notably enhance sleep quality, whereas inhaling a diluted version of the lavender essential oil significantly improved sleep quality. This was an interesting outcome, which, in fact, should not have occurred. However, currently, there is a lack of relevant research on the inhalation concentrations of essential oils. Perhaps this result was due to different concentrations of inhaled essential oils or other factors; nevertheless, further research and discussions will be necessary in the future.

Furthermore, the method of administering the essential oil during inhalation could introduce bias in the study’s findings. For instance, when lavender essential oil was inhaled at night with essential oil placed at a distance of ≥15 cm from the pillow, the intervention did not demonstrate a significant impact on enhancing sleep quality. However, when placed closer to the pillow, it significantly improved sleep quality. This study had certain limitations. Among the articles with a length of ≥15 cm, the distances were not the same. Some were about 15 to 20 cm from the pillow and others were about 60 cm from it, which may have caused a biased result.

Finally, the use of different sleep quality assessment tools in this study may lead to bias. For instance, when using the RCSQ, the effect of lavender essential oil on sleep quality was not significant, whereas it showed a significant impact when assessed with the PSQI. This discrepancy might be attributed to the specific applications of the tools: the RCSQ is mainly validated for the measurement of sleep quality in ICU patients,43 while the PSQI is suitable for the general population. Additionally, the RCSQ focuses on short-term sleep quality, whereas the PSQI assesses sleep quality for 1-week period or more.35 Because the effects of lavender essential oil on sleep quality may require a period of consistent use to become evident, this could have contributed to the observed bias in the study results.

When discussing the advantages and contributions of this study, the first thing we notice is that this study combines the data from multiple studies through the method of meta-analysis, overcoming the problems of small sample size and limited conclusions in a single study. Its advantages in research design, methods, and data analysis can effectively improve the scientificity and credibility of the research results. We followed strict inclusion and exclusion criteria, screened relevant studies from multiple databases to ensure the reliability and extensiveness of the results. Moreover, the literature included in this study were RCTs, which helped to reduce bias and improve the validity of the results. To deal with the heterogeneity among studies, we adopted a random-effects model, thus drawing more robust conclusions. We also carried out sensitivity analysis and subgroup analysis, enhancing the credibility of the research results.

Despite the strengths mentioned above, this study also has several limitations. First, the included studies varied in sample size, study design, and intervention measures, which may have led to heterogeneity in the results. Second, the quality of some of the original studies was low, which might have affected the accuracy of the meta-analysis findings. Additionally, due to language restrictions, we only included English-language literature, potentially overlooking relevant studies in other languages, thus affecting the generalizability of the results. Finally, differences in the duration of lavender essential oil use, the type of interventions in the control groups, varying concentrations of inhaled lavender essential oil, and different distances at which the lavender essential oil was placed during inhalation across different studies may have led to imprecise assessments of the impact of lavender essential oil on sleep quality.

In summary, although this study reveals that lavender essential oil may have a certain positive effect on improving sleep quality in adults, due to the aforementioned limitations, we should exercise caution when generalizing this conclusion.

CONCLUSION

Despite thorough descriptions of lavender essential oil usage in current literature, there was inconsistency in how the oil was incorporated into the research designs across studies, which could be attributed to its adaptable usage. However, in future research, the intervention design should be further standardized, the sample size should be expanded, and the intervention effect should be explored over a longer period so as to verify its long-term effectiveness and safety on sleep quality. Conclusively, the meta-analysis revealed that the use of lavender essential oil as a non-pharmacological approach can contribute to the improvement of sleep quality in the adult population to a degree. Future research ought to delve deeper into the optimal application and long-term effectiveness of this approach, laying the groundwork for comprehensive management of sleep disorders.