Sleep disorder is very common during pregnancy. Non-pharmacological treatments are a priority to improve the sleep pattern. This study aimed to determine the effect of cognitive–behavioral counseling with or without Citrus aurantium essential oil on sleep quality (primary outcome) and anxiety and quality of life (secondary outcomes). This randomized controlled trial was performed on 75 pregnant women in Tabriz, Iran. Participants were randomly assigned to the intervention and control groups. The first intervention group received 8 sessions of cognitive–behavioral counseling and aromatherapy with Citrus aurantium essential oil 15–20 min before bedtime. The second intervention group received cognitive–behavioral counseling and aromatherapy with placebo and the control group received only routine prenatal care. Pittsburgh Sleep Quality Index, Pregnancy-Specific Quality of life Questionnaire, and Pregnancy-Specific Anxiety Scale were completed before and after intervention. After the intervention based on ANCOVA test and by adjusting the baseline score, the mean score of anxiety in the intervention group 1 (AMD: − 4.54; 95% CI − 6.79 to − 2.28) and intervention group 2 (AMD: − 3.30; 95% CI − 5.60 to − 0.97) was significantly lower than the control group. Also, the mean score of quality of life in intervention group 1 (AMD: 2.55; 95% CI 0.45–4.65) and intervention group 2 (AMD: 2.72; 95% CI 0.60–4.83) was significantly higher than the control group, but there was no statistically significant difference between the study groups in terms of sleep quality (P > 0.05). Also, there was no statistically significant difference between the two intervention groups after the intervention in terms of anxiety (P = 0.379) and quality of life (P = 0.996). Cognitive–behavioral counseling reduced anxiety and improved quality of life. However, further trials are required to reach a definitive conclusion. Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N63. Date of registration: 4/10/2020. URL: https://en.irct.ir/user/trial/54986/view; Date of first registration: 18/10/2020.

睡眠障碍在怀孕期间很常见。非药物治疗是改善睡眠模式的优先事项。本研究旨在确定使用或不使用枳实精油的认知行为咨询对睡眠质量（主要结果）以及焦虑和生活质量（次要结果）的影响。这项随机对照试验是在伊朗大不里士对 75 名孕妇进行的。参与者被随机分配到干预组和对照组。第一干预组接受8节认知行为辅导及枳实芳香疗法睡前 15-20 分钟使用精油。第二干预组接受认知行为咨询和安慰剂芳香疗法，对照组仅接受常规产前护理。匹兹堡睡眠质量指数、孕期特定生活质量问卷和孕期特定焦虑量表在干预前后完成。在基于 ANCOVA 检验并通过调整基线分数进行干预后，干预组 1（AMD：- 4.54；95% CI-6.79 至 - 2.28）和干预组 2（AMD：- 3.30；95）的平均焦虑得分% CI − 5.60 至 − 0.97) 显着低于对照组。此外，干预组 1（AMD：2.55；95% CI 0.45-4.65）和干预组 2（AMD：2.72；95% CI 0.60-4.83）的平均生活质量得分显着高于对照组，P  > 0.05）。此外，干预后两个干预组在焦虑（P  = 0.379）和生活质量（P  = 0.996）方面差异无统计学意义。认知行为咨询减少了焦虑并改善了生活质量。然而，还需要进一步的试验才能得出明确的结论。伊朗临床试验登记处 (IRCT)：IRCT20120718010324N63。注册日期：2020 年 4 月 10 日。网址：https://en.irct.ir/user/trial/54986/view；首次注册日期：18/10/2020。