Effect of Benson Relaxation Exercise on Anxiety Level and Sleep Quality in Adolescents Receiving Inpatient Treatment in a Psychiatric Clinic
A randomized controlled trial finds that a simple, nurse-led relaxation technique significantly reduces anxiety and improves sleep in hospitalized adolescents.
Lead
Adolescents admitted to psychiatric units face a double burden: the acute mental health condition that brought them to the hospital and the high levels of anxiety and poor sleep that accompany inpatient care. Medications are often the first line of defense, but nonpharmacologic interventions that patients can learn and use on their own offer important adjunctive benefits. A new randomized controlled trial published in the Journal of Psychosocial Nursing and Mental Health Services tested whether the Benson Relaxation Exercise (BRE), a structured mind-body technique, could reduce anxiety and improve sleep quality in adolescents receiving inpatient psychiatric treatment. The results are encouraging: after just five sessions over six days, adolescents who practiced BRE reported significantly lower anxiety and significantly better sleep compared with those who received standard care alone.
What They Found
Researchers at three institutions in Istanbul, Turkey recruited 60 adolescents ages 12 to 18 who were hospitalized in a child and adolescent psychiatric clinic. Patients were randomly assigned to either the intervention group (n=30), which performed the Benson Relaxation Exercise twice daily for five consecutive days, or the control group (n=30), which received standard inpatient care without any structured relaxation protocol. Both groups were assessed at three time points: a pretest before the intervention, a post-test on day six (immediately after the five-day intervention period), and a follow-up test on day 10 (four days after the intervention ended).
The Benson Relaxation Exercise is a straightforward technique that patients can learn in minutes. It involves sitting or lying in a comfortable position, closing the eyes, relaxing all muscle groups progressively, breathing slowly and rhythmically while silently repeating a simple word or phrase (such as “one”), and maintaining this passive focus for 10 to 20 minutes. In this study, trained nurses guided the adolescents through each session.
Anxiety was measured using the State-Trait Anxiety Inventory for Children, and sleep quality was assessed with the Pittsburgh Sleep Quality Index.
The results showed statistically significant differences between the two groups. At the post-test on day six, the intervention group had a mean state anxiety score of 37.50 (SD = 7.90) compared with 45.70 (SD = 8.20) in the control group. By the follow-up on day 10, the gap widened further: the BRE group scored 34.80 (SD = 7.10) versus 46.50 (SD = 8.60) in controls. Both differences were statistically significant (p < 0.001).
Sleep quality followed the same pattern. At post-test, the intervention group’s Pittsburgh Sleep Quality Index mean score was 6.30 (SD = 2.40), significantly better than the control group’s 9.10 (SD = 2.70). At follow-up, the BRE group maintained its advantage with a score of 5.60 (SD = 2.10) versus 9.40 (SD = 2.80) in the control group (p < 0.001). Notably, the intervention group’s sleep improved further between the post-test and the follow-up, suggesting that the benefits did not fade once the formal sessions ended and may even have strengthened as adolescents continued the practice independently.
Why It Matters
These findings carry clinical weight for several reasons. First, the BRE is low-cost, noninvasive, and requires no equipment or specialized training beyond a brief nursing instruction session. This makes it highly scalable across psychiatric units of any resource level. Second, adolescents in the study continued to show improvements at the 10-day follow-up, indicating that the technique may equip patients with a lasting self-management skill they can use after discharge.
Anxiety and sleep disturbance are pervasive in adolescent psychiatric populations. Poor sleep, in particular, is linked to emotional dysregulation, impaired executive function, and increased relapse risk. An intervention that improves both anxiety and sleep simultaneously, without the side effect burden of additional pharmacotherapy, is a valuable addition to the inpatient toolkit.
Nurses and other frontline staff are well positioned to deliver BRE. The protocol used in this study required approximately 15 minutes per session and was integrated into the daily ward routine without disrupting other treatment activities. For clinicians working in child and adolescent psychiatry, offering a simple structured relaxation exercise may be one of the most practical, evidence-based steps they can take to improve patient experience and outcomes.
Limits
Several limitations should be considered when interpreting these results. The sample size was relatively small (n=60), and all participants came from a single psychiatric clinic in Turkey, which limits generalizability to other settings and populations. The study did not include an active control group (such as a different relaxation technique or attention-control condition), so it is not possible to attribute the effects specifically to the BRE mechanism versus the general benefit of receiving structured one-on-one attention from a nurse. Additionally, the follow-up period was only four days after the intervention ended; longer-term data would help determine whether the benefits persist for weeks or months. Outcome measures were self-reported, which introduces the possibility of response bias, particularly in an unblinded study design where adolescents knew whether they were in the relaxation group.
Bottom Line
The Benson Relaxation Exercise is an effective, low-cost, and practical intervention for reducing state anxiety and improving sleep quality in adolescents hospitalized in psychiatric units. Five twice-daily sessions over six days produced clinically meaningful improvements that persisted and even strengthened at a four-day follow-up. Psychiatric nurses and clinicians should consider incorporating BRE into standard inpatient care as a safe, nonpharmacologic complement to existing treatment protocols.
Source: Aydan Akkurt Yalcinturk, Elcin Babaoglu Gulseven, Yeliz Bicer, Beyza Gul. “Effect of Benson Relaxation Exercise on Anxiety Level and Sleep Quality in Adolescents Receiving Inpatient Treatment in a Psychiatric Clinic: A Randomized Controlled Trial.” Journal of Psychosocial Nursing and Mental Health Services, published online July 17, 2026. DOI: 10.3928/02793695-20260710-03. PMID: 42461159.