Effect of Exercise on Sleep

A review of

Nalin A. Singh, Karen M. Clements, Maria A. Fiatarone, A Randomized Controlled Trial of the Effect of Exercise on Sleep, Sleep, Volume 20, Issue 2, February 1997, Pages 95–101, https://doi.org/10.1093/sleep/20.2.95

Reviewed by Dr. Justin Thompson

A Summarized Review of the Conclusion

Progressive resistance training has demonstrated benefits on subjective sleep quality, depression, strength, and quality of life without significantly changing habitual activity. Physical functioning, Vitality, Social functioning, Role emotional, and Mental health were improved over time in both groups. Vitality, Bodily pain, Role emotional, and Social functioning were significantly improved by exercise compared to the control condition.

Quotes from the Article

“However, compared to younger patients, sleep disturbance in the depressed elderly is likely to be multifactorial due to the medical-illness burden that accompanies advancing age and may correlate less with severity of depression and have a less predictable response to pharmacologic treatment”

“An intervention that could treat depression, increase activity levels, and favorably affect comorbidity would be an attractive alternative treatment option for sleep disturbance in depressed elders. Exercise may be such an intervention.”

“The exercise intervention significantly improved both long-term (PSQI) and short-term (Likert Scale) measures of self-reported subjective sleep quality compared to the control group”

“Physical functioning, Vitality, Social functioning, Role emotional, and Mental health were improved over time in both groups. Vitality, Bodily pain, Role emotional, and Social functioning were significantly improved by exercise compared to the control condition.”

“Baseline activity levels did not correlate significantly with any depression measure or PSQI score. Habitual physical-activity level was not significantly altered over time or by group assignment. Total physical-activity level (inclusive of the intervention) was significantly higher over time and with exercise group assignment (p = 0.008)”

Introduction to the Research

Most sleep surveys of the elderly report increased nocturnal awakenings and reduced quality of sleep. Such sleep disturbance is common because of the increased frequency of illness such as heart failure, respiratory complaints, sleep-disordered breathing, nocturia, pain, polypharmacy, menopausal status, headache, depression, and functional decline. In addition, factors such as inactivity, less light exposure, decreased arousal threshold, elevated-autonomic activity, and circadian-rhythm changes diminish the functional reserves for quality sleep as we age. Combine all of this with the lifestyles including more and more technology exposure, and it is a recipe for poor sleep quality. This research not only displays the importance of good sleep, but shows that an additional benefit of moving well or exercising can directly improve sleep quality.

Research Methodology

A total of 32 subjects aged 60-84 years with a mean age of 71.3 ::<:: 1.2 years was used. Intervention consisted of a supervised weight-training program three times a week or an attention-control group. Main outcome measures were Pittsburgh Subjective Sleep Quality Index (PSQI), Likert Scale of Subjective Sleep Quality and Quantity, Paffenbarger Activity Index, Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Hamilton Rating Scale of Depression (HRSD), and the Medical Outcomes Survey Short Form 36 (SF-36).

Research Findings

Results showed that exercise significantly improved all subjective sleep-quality and depression measures. Depression measures were reduced by approximately twice that of controls. Habitual activity was not significantly increased by exercise. Quality of life subscales significantly improved. In a forward stepwise multiple regression, percent improvement in GDS and percent increase in strength remained significant predictors of the improvement in total PSQI score (r = 0.71, P = 0.0002).

Research References

As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety. The references used in this article by the authors of this article are listed here.

Our Message

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