THE EFFECT OF AL-QURAN THERAPY TO SLEEP QUALITY IN ELDERLY

Poor sleep quality is associated with poor quality of life, high morbidity


Pendahuluan
The elderly are said to be part of the age group that has been said to have entered the final stage of a person's life phase, a category categorized as the elderly group which will be referred to as the aging process by another name, the aging process. The country of Indonesia has entered this period, namely the aging population, as evidenced by an increase in life expectancy followed by an increase in the number of elderly people. The increase in the number of elderly people itself, can be seen from the data where the number of elderly people in Indonesia always increases from year to year, including in 2020 the number of elderly people who come (27.08 million). .69) million), and even continues to increase in 2035 to 48.2 million people (15.77%). West Sumatra Province is one of the provinces with the largest population of provinces in Indonesia, which is 2,188,550 million people (Kemenkes RI, 2019).
The impact or consequence of the population in a country or aging is the increasing number of people in a country. The increase in life expectancy along with the increasing number of aging or elderly can also cause various health problems and other life problems which can ultimately reduce the quality of life of the elderly.
This aging process occurs naturally in humans, where there is a decrease or loss of the ability of tissues in a person's body to maintain and repair themselves, resulting in a gradual decrease in body resistance and the inability to function again. One of the problems that are often complained of and encountered in the elderly is the poor quality of sleep experienced by the elderly (Mubarak W. I, 2015).
Several research results and data obtained from both the world and national data where many elderly experience poor sleep quality, including data from the National Sleep Foundation (NSF) in the United States found as many as 67% of elderly people aged 65 years and over were detected having sleep disorders or difficulty maintaining sleep. Likewise in Indonesia, the elderly experience insomnia about 50% aged 65 years, it is even estimated that every year around 20-50% of the elderly report insomnia (Kemenkes RI, 2019). Based on the results of Jepisa et al's research in West Sumatra PSTW, it was found that 75% of the elderly complained of poor sleep quality.
Sleep quality is a condition that is expected or lived by an individual to get fitness and freshness as soon as a person wakes up from sleep. Sleep quality can be seen from various aspects that include quantitative aspects of sleep such as sleep latency, sleep duration and subjective aspects of sleep. A person's sleep quality is said to be good where a person does not show signs of sleep deprivation and does not experience problems in his sleep (Hidayat, 2012).
The elderly need quality rest to maintain their health and recover from illness. Poor sleep quality can lead to things like thinking disorders, confusion and lack of attention. If a person does not get physiological sleep, he will experience effects such as confusion, forgetfulness, and can be disorientated. Health problems can occur due to poor sleep quality such as the elderly, often forgetting, the elderly are susceptible to disease, experiencing disorientation, decreased concentration, reduced independence, of course this has a negative impact on the personal satisfaction of the elderly, therefore the quality of sleep is problematic for people with the elderly need to be resolved immediately (Stanley, 2015).
Several ways can be done to overcome the problem of sleep quality disorders, including pharmacological therapy and nonpharmacological therapy. Using pharmacological therapy will generally provide a faster reaction but is not good enough to have a negative impact on long-term health. Some studies state that the use of sleeping pills can lead to a decrease in kidney function. This shows that there is a need for safer non-pharmacological therapies, one of which is murothal Al-Qur'an therapy.
In various references, murottal therapy is therapy using a sound recording of the Qur'an which is read or sung by a trained qori. In another reference it is also said that murottal is defined as a chanting of the holy verses of the Qur'an which is read or sung by a qori, nurottal is also said to be recording, recited and listened to with a slow and harmonious tempo. Murotal is one part of music that has a positive influence on the listener.
In listening to the verses of the Qur'an or those that are read correctly and tartil, it will foster peace of mind by both listeners and readers. The chanting of the holy verses of the Qur'an can physically produce or contain human elements, listening to this murottal can be said to be a kind of instrument or healing tool that is the easiest to get and reach. Sounds in listening to murottal can also reduce stress, stabilize heart rate, pulse, activate natural endorphins hormones, increase feelings of relaxation, improve the body's chemical system so that it lowers blood pressure and slows breathing.
This murottal therapy can work on the brain immediately there is a kind of impulse by the brain that produces or produces chemicals which can be called neuropeoptide substances (Hairuddin & Herlina, 2015). In these molecules will be attached or attached to various receptors so as to provide feedback in the form of comfort and enjoyment and the formation of alpha waves which are more dominant when the murottal Al-Qur'an is heard and provides a significant relaxing effect. Murottal Al-Qur'an as sound therapy can have the effect of increasing brain waves by producing high alpha activity associated Jurnal Health Sains, Vol. 3, No. 10, Oktober 2022 1569 with a state of rest and calm. When listening to the earlobe, it picks up sound waves through the air to the cochlea, which vibrates the tympanic membrane and is transmitted to the middle ear through the ossicles. Stimulation of the sense of hearing through sound waves sourced from murottal Al-Qur'an can reduce cortisol levels which cause relaxation and help improve sleep quality (Silverthorn, 2013). Various research studies that have been done previously include research that shows results, music therapy is a solution to sleep problems and can improve sleep quality in the elderly. Study (Sukmawati, 2020) found that music that has been listened to and received by the right brain can stimulate the release of endorphins from the pituitary gland and can increase the perception of pleasure and happiness through decreasing levels of adrenocorticotropic hormone (ACTH) in the blood, thereby helping to reduce stress. Likewise with research (Agustin, 2020) concluded as many as 61.1% of respondents experienced an increase in sleep quality after being given murottal al-qur'an intervention.
The purpose of this study was to determine the effect of Al-Quran therapy on the sleep quality of the elderly at PSTW Kasih Sayang Ibu Batusangkar

Metode research
This type of research is quasiexperimental with one group pretest-posttest design. Held at the Tresna Werdha Social Home (PSTW) Kasih Sayang Ibu Batusangkar in July-August 2022. The quality of sleep for the elderly was measured using a Pittsburgh questionnaire Sleep Quality Index (PSQI (Buysse et al., 1989). Elderly with poor sleep quality are given Al-Quran Surah Ar-Rahman therapy for 30 minutes every day before going to bed for one month. From Table 1, it can be seen that as many as 65% of the elderly are at the age of <70 years. Based on gender, there are more elderly men than women, namely 80%. The level of education of the elderly is still high with low education as much as 75% and 80% of the elderly are married to widowers Based on the results of the study, it showed that from 20 respondents, the quality of sleep obtained after murottal Al-Qur'an therapy was p value = 0.000 with a difference of decrease before 10.93 and after 8.48. This means that after listening to the Murottal Al-Qur'an, there is a significant difference between before and after being given murottal Al-Qur'an therapy on the sleep quality of the elderly with a difference of 2.43.

Results and Discussion 1. Characteristics of Respondents
Where the findings are that there is a difference between the sleep quality of the elderly before and after being given murotal therapy. Research is also in line with what was done (Maulana, Kormatul. 2015) at the UPT Social Services for the Elderly Banyuwangi, where there is an effect of murottal Al-Qur'an therapy on the sleep quality of the elderly. (Hashim et al., 2017) stated that murottal Al-Quran therapy is part of sound therapy. Al-Quran murottal therapy is part of a complementary therapy that is used in the form of sound which can heal and improve a person's poor sleep quality.
Poor sleep quality can affect people of all ages. The age group that most often complains of sleep quality problems is the elderly. Several research results from Iran, India and the United States suggest that poor sleep quality attacks the elderly.
Elderly who have poor sleep quality are usually caused by various factors including unhealthy living habits, depression, anxiety, environmental factors and health conditions according to research results (Jepisa et al., 2020).
This study found that the elderly felt better sleep after being given murotal Al-Qur'an therapy. Sleep is of better quality with less frequent awakenings experienced by the elderly and wakes up feeling refreshed in the morning. This research is in line with research (Hariati & Idris, 2022) which shows that the sleep quality of the elderly who are given muraotal al-qur'an therapy has increased as indicated by the response of some respondents who sleep easier, more soundly, not easily wake up at night.
Listening to murotal al-qur'an is able to activate nerves to relax so that it can minimize pain, stress, lower blood pressure and be able to overcome insomnia problems in the elderly. (Mahlufi, 2016).
Various studies have explained that physically chanting the holy verses of the Qur'an which contains elements of the human voice, where the human voice can be used as a kind of instrument in healing an amazing disease and is also the fastest and most accessible tool. The sound of the human voice can also reduce hormones in the body including natural endorphins, and can also increase feelings of relaxation, fear, anxiety, distract one's attention and can improve the chemical system in the body so that there is a decrease in blood pressure, stable pulse, heart rate. controlled heart.
Sleep quality is a condition of a person to maintain sleep so that the next day he feels relaxed. Sleep quality was measured twice, including before listening to the murottal Al-Quran at the time of the initial screening to see the elderly who had poor sleep quality and after listening to the murottal Al-Quran.
Sleep quality was measured using the Indonesian version of the PSQI (Pittsburgh Sleep Quality Index) questionnaire. The PSQI questionnaire was measured to assess 7 components including sleep quality, sleep duration, sleep latency, sleep efficiency, problems or disturbances during sleep, sleeping medications used, and daytime activity disturbances.

Conclusion
Most of the respondents in this study were more than 70 years old. The average sleep quality of the elderly before murotal therapy of the Qur'an Surah Ar-Rahman is 10.93. The average quality of sleep of respondents after being given murotal therapy of the Qur'an Surah Ar-Rahman is 8.48. There is a significant effect between the provision of murotal therapy of the Qur'an Surah Ar-Rahman on improving the quality of sleep in the elderly with a p value of 0.000.