MUROTTAL AL-QUR'AN AUDIO THERAPY COMBINED WITH AMBIENT NATURE SOUNDS IMPROVES SLEEP QUALITY IN HOSPITALIZED STROKE PATIENTS: A PRE-EXPERIMENTAL STUDY

Abstract

Introduction: Stroke is a leading cause of death and long-term disability worldwide, with post-stroke sleep disturbance independently impairing neurological recovery and rehabilitation outcomes. Despite its clinical significance, non-pharmacological sleep interventions for stroke inpatients remain insufficiently studied, particularly in Muslim-majority healthcare settings. Objective: This study aimed to determine the effect of Murottal Al-Qur'an audio therapy combined with ambient nature sounds on sleep quality in hospitalized stroke patients. Method: A pre-experimental one-group pretest-posttest design was employed with 37 stroke inpatients recruited through purposive sampling at a tertiary neurological referral center in Makassar, Indonesia. The intervention consisted of Murottal Al-Qur'an recitation combined with ambient nature sounds delivered for 10 to 15 minutes per session over three consecutive days. Sleep quality was measured using the validated Indonesian-language Pittsburgh Sleep Quality Index, and data were analyzed using the Wilcoxon signed-rank test (p < 0.05). Result: Prior to the intervention, all 37 respondents (100%) exhibited poor sleep quality with a mean Pittsburgh Sleep Quality Index score of 8.49. Following the intervention, 86.5% achieved good sleep quality, with mean scores declining to 4.57 — a clinically meaningful reduction of 3.92 points exceeding the recognized minimally important difference threshold. The Wilcoxon signed-rank test confirmed this improvement as statistically significant (p = 0.000). Conclusion: Murottal Al-Qur'an therapy combined with ambient nature sounds significantly improves sleep quality in hospitalized stroke patients. Its passive delivery, absence of adverse effects, cultural congruence, and minimal resource requirements position it as a promising complementary nursing intervention in stroke rehabilitation. RCTs with objective sleep measurement are warranted to confirm these findings