The Impact of Cognitive Behavioral Group Therapy with or withoutLavender Aroma on Sleep Quality in Menopausal Women: RandomizedControlled Trial

Introduction/ Objective: Menopause and the decrease in estrogen levels have numerous negative effects on sleep quality and mental health in women, potentially leading to anxiety and irritability. Non-pharmacological treatments have gained attention as alternative methods for improving sleep quality. This study aimed to evaluate the effectiveness of Cognitive Behavioral Group Therapy (CBGT) with or without lavender aroma on sleep quality in post-menopausal women. Methods: This randomized controlled trial (RCT), double-blind, enrolled 135 eligible menopausal women from health centers in Hamadan, Iran, between 2022 and 2023. Participants were randomly assigned to three groups: CBGT with placebo, CBGT with lavender aroma, and a control group. The intervention consisted of eight 60–90-minute CBGT sessions over one month for the first two groups, with placebo or lavender aroma administered. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. Data were analyzed using SPSS version 21, with statistical significance set at p < 0.05. Results:: Participants had a mean age of 60.1 ± 5.9 years and a menopause duration of 3.1 ± 1.2 years. In the CBT with lavender group, 79.1% achieved good sleep quality (PSQI ≤ 5) postintervention (p = 0.001), with significant improvements in subjective sleep quality (p = 0.001), sleep duration (p = 0.001), and sleep efficiency (p = 0.001), and reductions in sleep latency (p = 0.001) and sleep disturbances (p = 0.001). No significant improvements were observed in the CBT with placebo or control groups (p > 0.05). Conclusions: Combining CBGT with lavender aromatherapy is an effective nonpharmacological approach to improve sleep quality in menopausal women, potentially reducing reliance on pharmacotherapy and its associated side effects.