Bedtime Inhalation-Based Relaxation for Sleep Quality and Depressive Symptoms in Institutionalized Older Adults: A Pilot Randomized Controlled Trial

Objectives Poor sleep quality and depressive symptoms are common among institutionalized older adults. This pilot study examined the preliminary effects of bedtime inhalation-based aromatherapy on sleep and mood.Methods A pilot, single-blind, two-arm randomized controlled trial was conducted in a Taiwanese long-term care facility. Thirty-seven residents completed the study (intervention: n = 19; control: n = 18). The intervention group inhaled bergamot and clary sage essential oils for 15 minutes nightly over four weeks, while the control group received unscented almond oil. Outcomes were assessed using the Geriatric Depression Scale–15 (GDS-15) and Pittsburgh Sleep Quality Index (PSQI). One participant in the intervention group discontinued due to mild intolerance.Results Compared with the control group, the intervention group showed greater improvements in sleep quality (B = 2.41, p < .001) and reductions in depressive symptoms (B = 2.28, p < .001). No serious adverse events occurred.Conclusions Bedtime inhalation-based aromatherapy appears safe and feasible, with potential to improve sleep and mood in institutionalized older adults.Clinical Implications Incorporating bedtime inhalation-based aromatherapy into routine care may provide a safe, complementary non-pharmacological approach to support sleep and mood in institutionalized older adults. These findings are preliminary and require confirmation in larger trials.