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Changing times and advancements in technology have taken a toll on human health. Poor sleep quality is rampant in every age group thus an apharmacological cure is slowly becoming a necessity of the times. Exercises/physical activities are a strong contender in the race. But still a lot work has to be done to finally conclude about its efficacy as the treatment. This article aims at reviewing the relation between sleep quality and exercise. This article reviews the experimental and epidemiological work done on the topic along with the reviews published on the same. The emphasis here is on the studies done and the possible mechanisms underlying the relationship. The article also talks about the lacunae in research and future directions for research.
International Journal of Scientific and Research Publications, Volume 2, Issue 8, August 2012 1
ISSN 2250-3153
Sleep Quality Improvement and Exercise: A Review
ZubiaVeqar, M EjazHussain
Centre for physiotherapy and rehabilitation sciences, JamiaMilliaIslamia, New Delhi, India
Abstract- Changing times and advancements in technology
have taken a toll on human health. Poor sleep quality is rampant
in every age group thus an apharmacological cure is slowly
becoming a necessity of the times. Exercises/physical activities
are a strong contender in the race. But still a lot work has to be
done to finally conclude about its efficacy as the treatment. This
article aims at reviewing the relation between sleep quality and
exercise. This article reviews the experimental and
epidemiological work done on the topic along with the reviews
published on the same. The emphasis here is on the studies done
and the possible mechanisms underlying the relationship. The
article also talks about the lacunae in research and future
directions for research.
Index Terms- Acute exercises, chronic exercise, exercise,
physical activity, sleep, sleep quality
leep is a functional state that comprises a complex
combination of physiological and behavioural processes
which includes a natural lie down for humans.1,2. It is an
instinctive state of rest characterised by a reduction in voluntary
body movement and decreased awareness of the surrounding 3. It
has some characteristic manifestations, such as a cyclic pattern,
relative immobility and an increase in the response threshold to
external stimuli.
Since the discovery of REM sleep a number of articles/ reviews
have been published regarding the various mechanisms,
functions etc of sleep. But still we are very far away from
complete understanding of sleep which makes it an enigma even
now. In coming times because of the change in lifestyle and work
patterns the urgency of understanding it is even more. The
functions of sleep can be summarized as (1) boosts immune
function (2)has a role in brain maturation(4)development of the
body(5)increase in brain mass(6) memory
consolidation(7)increase in performance(8)modulates metabolic
processes at molecular level(10)maintains catecholamines in the
brain2-15. Sleep is multifaceted and hence difficult to review from
all aspects.
Exercise is physical activity that is planned, structured, and
repetitive for the purpose of conditioning any part of the body16.
For the purpose of this review the articles with physical activity
also have been considered and the term exercise will be used for
both. Exercise is used to improve health, maintain fitness and it
is a very important treatment method for physical therapist.
Exercise give various health benefits the details of which are out
of the domain of this article but the effects on quality of sleep
will be discussed in detail. There are various types of exercises
and with all of them having different effects.
The purpose of this article is to write a comprehensive review on
the effects of exercise on sleep. The article is planned as
1. Sleep-a basic understanding
2. Exercise- relevance and type
3. Sleep and exercise
4. Acute exercise studies
5. Chronic exercise studies
6. Possible mechanisms for the effects of exercise on sleep
7. Summary and conclusion
8. Future research
9. References
Sleep had always been an enigma because of its multifaceted and
multidimensional features. Even today it is difficult to
understand it completely without the holistic view. It has been a
topic of discussion right from biblical times. The Bible and the
Talmud have numerous references from varieties of sleep (“he
provides as much for his loved ones while they sleep
psalms127:2), to stages of sleep)”a sleep which is not sleep, a
wakefulness which is not wakefulness” Talmud Pesahim 120b),
functions of sleep, effects of deprivation etc.17. In some
references it has also been compared to death-“The deepest sleep
resembles death”(Bible, I Samuel 26:12)or it was also called the
brother of death(Homer’s Iliad, circa 700 BC).
Sleep was explained by people all over history in different
manners. Lucretius called it absence of wakefullness18. Santos
called it a functional state that comprises a complex combination
of physiological and behavioural processes2. But sleep can also
be defined by the physiological and physical changes which
occur during sleep18. This includes position and movement of the
body as a whole or its parts like eyes etc and physiological
changes like thermal changes, decreased brain activity etc. The
characteristics of sleep may be summarised as:
1. Decreased voluntary movement and appreciation of the
2. State of generally decreased activity.19
3. Human sleep involves lying down posture1,19
4. Even though it a state of decreased consciousness,
arousal is possible because of internal or external
stimuli 19
5. Brain activity has certain characteristic features 3,19
Depending upon the physical as well as the physiological
parameters sleep may be of two stages-Rapid eye movement
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(REM) sleep and Non rapid eye movement (NREM) sleep1,3,19.
According to American association of sleep medicine (AASM)
scoring manual NREM is further divided into N1, N2 ,N3 on the
basis of EEG waves. REM sleep has two phases Tonic and
Phasic ; REM and NREM move in a cyclic manner with an
average of 90-110mins.
The sleep patterns are also related and do get altered because of a
number of factors like age, sex stress, psychological state,
disease conditions, occupation1-20
Keeping in mind that almost all living beings have a phase of
sleep, the functions of sleep must be numerous and it must be
one of the most important things for survival. The postulated
functions of sleep have been discussed earlier. Most of these
functions have been deduced from sleep deprivation studies
which have also tried to establish that wakefulness is associated
positively with sleep propensity 21. Sleep propensity can be
explained as the likelihood of sleep at any level of organisation
(global or local) 21.
Sleep regulation will always have to be studied in relation to
wakefulness and they both are said to be regulated by basically
two factors circadian rhythm and homeostasis2, 3, 19, 22-25. The
need to sleep can be understood as physiological (highly
vulnerable periods of sleep) or subjective (individual’s
According to “The origin of species- Charles Darwin”
environment brings about a change in the genes, that indicates
that our day to day existence decides our fate26,27. Human beings
have always been a hunter-gatherer which most of the times
along with other factors like brain development made us superior
to other animals hence ensured better evolution26-28.
Development and technological advancements brought with them
the sedentary lifestyle which lead to an endemic of lifestyle
disorders 26-29. These effects of sedentary lifestyle can be tackled
by regular physical activity and/ or exercises thus decreasing
morbidity and mortality26,27.
Human body responds to progressively increasing repetitive
physical activity by introducing physiological, biochemical, and
anatomical changes in the major systems of the body even in
older adults29-32. These changes depend on a number of factors
like intensity, duration, frequency of exercises, age, sex and
physical condition of the person exercising 30,34. Body’s response
to exercise involves simultaneous coordination of multiple
systems of the human body 32.
In sleep literature exercise have been studied as acute or chronic
and as aerobic or anaerobic. They have been defined as following
for the purpose of this review:
Acute exercises: They are the set of exercises which are executed
as a single bout followed by the examination of the effects on
primary outcomes.
Chronic exercise: They are the set of exercises invoving multiple
sessions, longer in duration followed by analysis of its various
effects and benefits in a broad perspective.
Aerobic exercise: These are physical exercises of a relatively low
intensity and long duration. It depends primarily on aerobic
energy system. These can also be called endurance training or
conditioning exercises35.
Anaerobic exercise: These are physical exercises of a relatively
high intensity and short duration. It depends primarily on
anaerobic energy system36
According to the American sleep disorder association (ASDA)
exercise is one of the apharmacological intervention used to
promote sleep29, 37. The principle that exercise promotes to sleep,
remains a constant thus breaking all the barriers of civilizations,
races, religions even though empirical research does not support
it much38. It is one of the most widely studied daytime behaviour
associated with sleep. This was further reinforced by a landmark
survey conducted in Finland published in the year 1988.
Individuals were randomly selected (n=1190) and open ended
question about the factor which is the best for promotion of their
sleep was inquired. Results declared found exercise as the most
important factor 39, 40. Despite of all these numerous studies
conducted the results are still inconclusive. This difference in
belief and science can be attributed to following factors as
reported in various studies38-46.
1. Most of the studies were conducted on normals. This
can be explained on the basis of ceiling and floor effects
as described by Youngstedt43. According to this the
efficacy of sleep promoting stimuli should be
proportional to the degree of pre-stimulus sleep
impairment. Because of these it is difficult to achieve a
statistically significant improvement.
2. The sample sizes were generally small in interventional
3. Exercises prescribed are difficult to follow and
implementation of daily routine for sedentary workers
makes it a difficult permanent apharmacological
management especially for patients who are already
tight pressed for their time.
4. Most of the work done is on slow wave sleep.
5. Most of the studies are short term studies. There are no
studies to the best of my knowledge which have worked
on long term effects and followup.
6. Sleep itself is very subjective and difficult to study.
There is a vast amount of interplay between numerous
factors affecting it.
7. Smaller factors like age and sex of the participant, time,
duration and type of exercise have not been studied very
The studies done with exercise as an intervention can be broadly
be classified as:
1. Acute exercise studies
2. Chronic exercise studies
These studies have been done on normal individuals, certain
population eg geriatric46,44, medical students20etc, certain
conditions like insomnia44 etc.
This area of study is majorly unexplored. This may be due to
inconclusive evidence regarding the usage and implementation of
these exercises as a treatment strategy. It is speculated that acute
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exercise during the day time leads to an increase in sleep. This
was reported in an epidemiological study done in Finland which
also reported that it was the single most important factor in the
positive result 41, 45, 46. However some positive results have been
reported in a few studies following acute exercises. The effects
reported are on slow wave sleep (SWS), REM, repeated eye
movement latency (REM-L) and total sleep time (TST) 45 but
no effect has been reported on sleep latency (SL) and
wakefulness after sleep onset (WASO) 39. The improvement in
SWS is especially important as some studies have reported an
increase in SWS being associated with a decrease in REM
sleep39,47, 48.
But in spite of all these effects being quoted the major lacunae is
the focus on good sleepers who are unlikely to have any major
improvement due to floor- ceiling effect. So, further research is
indicated to validate the results on patients with sleep
deprivation, so that the results may be used as a standard adjunct
treatment protocol.
The studies included have used resistance exercise, moderate
intensity exercises, high intensity exercises, endurance exercises,
physical activity or regular exercises as an intervention38-54
A study on sedentary workers with 50% of 1RM concluded no
significant effect on the quality of sleep. This could be
contributed to various factors like type of exercise, sample type
or dose of exercise. The floor and ceiling effect was not ruled out
either51. In another study where older adults were prescribed
moderate intensity exercises positive effects was found on SWS.
On PSQI significant improvement was found on sleep duration,
sleep disturbance and daytime dysfunction. On PSG the numbers
of awakenings were lesser and stage 2 and SWS had increase. It
was concluded that there is a positive impact of regular moderate
intensity on sleep parameters 49.
A Cochrane review published on physical exercise on sleep
problems in adults aged 60+ have reported improvement in Sleep
Onset Latency (SOL), total sleep duration & global sleep quality.
But the review concluded that there was a lack of well-designed
trials to come to a conclusion but the intervention is worth
investigating 44.
The effects of chronic exercises include significant differences
on increased total sleep time, increased SWS and reduction in
sleep latency and reduction in REM38,39,41,42,46,50,53,54,55.
Some evidence also suggests that chronic endurance exercises
may be more helpful in enhancing SWS as compared to other
modes 38.
To summarize, it may be suggested that chronic exercise and its
effects may be used as behavioral modification tool to bring
about an improvement in quality of sleep but substantial data is
still required to calculate the exact dosimetry of the intervention
along with the time of intervention.
1. Effect On Mental Health
According to a number of studies done till date, the effect of
exercise on mental health is closely related to depression and
anxiety56-57. According to Daniel M Landers57, the benefits of
exercise on anxiety and depression are similar to as reported by
other treatment.
Table 1 Effects of exercise on mental health 39,42,46,49,56-57
Decreased Anxiety
Decreased Depression
Aerobic exercises
give best result
Patient who have
a high level of
anxiety to start
with respond
Patients who have
low fitness levels
to start with give
better results
Regular exercise
gives better result
if performed for
longer duration
Regular exercises
gives better
results if done
Exercises done
several times a
week gives better
exercises give
better results
Patients with an
increased level of
depression to start
with gives better
Number of awakenings in the night is one of the important
indicators of anxiety which is effectively decreased by exercises.
Various studies have been published about a positive role played
by acute exercises in decreasing trait anxiety 39,56,57. Petruzello et
al examined the results of 27 narrative reviews and concluded
that approximately 81% authors, physical activity and or fitness
led to a decrease in anxiety. 19% of the studies concluded that
most of the findings support reduction of anxiety with exercise.
But even though the results varied, none of the studies had
concluded that there was no relationship 57.
The work on exercises and depression can be traced long back in
history. Across the meta analysis published ,it was said that acute
and chronic exercises are related to a reduction in depression.
The effects were found to begin very early and they continued
even after the cessation of the exercises. These results were
found to be consistent across age, gender, exercises group size,
type of depression inventory 39,42,46,49,56-57.
2. Effects on thermoregulatory mechanism
Temperature regulation is an important aspect of homeostasis. It
is the maintenance of the core body temperature within a narrow
range by controlling the dissipation and absorption of heat to and
from the body.58
Modulation in core body temperature affect the sleep
parameters59-65 .This change in core body temperature can be
brought about actively (by exercises etc.) or passively (by warm
bath, thermo suit, electrical blankets, warm footbath etc.)61-64
These methods of increasing the temperature can be implemented
at various times (before sleep61-62,64-65 or during sleep63). The
time of application also seems to play a role as reported in
various studies61-65. In a review article, Liao et al reported that
slow wave sleep can be increased and the sleep fragmentation
can be decreased with passive body heating that changes the core
temperature in the evening. Similar results were reported by
different researchers using different methods to decrease the
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temperature before sleep.38,39,46 Fletcher et al used electrical
blanket to bring about an increase in core body temperature
during sleep and they report decreased efficiency and more
number of arousals.63 further proves that there is a relationship
between core body temperature and sleep.
Neuroanatomical studies also concluded that preoptic area or
anterior hypothalamus plays a key role in thermoregulation.
Initiation of sleep can be brought about by increased firing rate
of the neurons of the preoptic area which in turn may be brought
about by warming them. These neurons can be warmed by
changes in core body temperature. Hence the hypothesis that
sleep might serve as a down regulation function can be
Horne et al has conducted studies on relationship between
exercise and sleep. They reported a positive relationship between
SWS and exercise 58,59.
3. Effects on circadian Rhythm
Circadian rhythm is the 24 hour interval clock which responds to
endogenous factors like core body temperature etc. and to
exogenous factors like light etc. A disturbance in either of these
factors leads to a disturbance in the rhythm which in turn affects
sleep. It is suggested by various studies that one of the most
important factor here is light.46Various studies have been done to
implicate exercise and sleep. Some important studies here were
the impact of time of exercise on sleep39,66 and the correlation
between effects of exercise on circadian rhythm parse.38,46
Aerobic exercises performed late in the evening has reported to
be associated with poor sleep quality as compared to exercises in
the afternoon.56
It is postulated by Driver and Taylor that exercise done in a well
lighted area may improve the sleep for individuals with altered
circadian rhythm. They also suggested further research to find
out the relation between light, exercise and sleep38.
There seems to be an agreement in the reviews regarding shift
work and its ill effects on health. Physical activity has been
suggested to decrease fatigue levels, improving the tolerance of
shifts but at the same time there is a problem of poor adherence
to exercises too52, 67. It has also been reported that exercise acts
as a zeitgeber and it brings about a shift in the phase response
curve68. There are various other additional factors which are
responsible for the effects.
4. Effects on restoration of the body
Aristotle had proposed the humoral mechanisms of sleep control
69. Although the mechanism of their control is not the same as
suggested by him but there is an existence of sleep regulatory
mechanism which has been proved 68. Some of these factors are
Growth Regulating Hormone(GHR), cytokines, interleukin-1,
prostaglandin D2, adenosine, tumour necrosis factor(TNF),
prolactin 100, corticotropin like intermediate lobe peptide
vasoactive intestinal peptide3,28,35,69,70,71,72. Acute exercises have
been shown to bring about an increase in cytokines which in turn
can be related to regulation of sleep. This may be one of the
restorative mechanisms though others like muscle repair46,73 have
also been discussed along with compensation of high energy
expenditure 46,73. All these factors work towards the restoration
In conclusion , it may be said that a number of hypothesis’ exist
regarding the mechanism underlying the effects of exercise on
sleep primarily due to complex nature and ambiguity in
mechanisms controlling it.
Sleep is an enigma even now primarily because of the huge
amount of interaction which takes place between external and
internal factors to bring about sleep. The problems with sleep
research have been discussed earlier. The general
recommendations after most of the reviews are still inconclusive.
But a few points may still be commented upon which are as
1. Exercise is a positive behavioral modification tool for
all age groups to bring about an improvement in sleep
2. Exercise can be very effective in older populations for
not only for improvement in sleep but also for other
3. Acute exercises don’t seem to be very effective in
bringing about an improvement in quality of sleep but
the number of studies done is still lesser so it is not very
conclusive either.
4. Effects of aerobic and resistance training done for long
duration may bring about improvement in sleep quality.
5. Exercises done just before bedtime seem to have
negative effect on sleep quality.
Future research may be directed towards analysis of:
1. Effect of acute exercises on poor sleepers but not
2. Effect of resistance exercises on poor sleepers but not
3. Effects of exercises on patients with different training
levels egsedentary, moderately trained and trained.
4. Effects of temperature variations on sleep quality.
5. Effect of time of intervention on sleep quality.
6. Exercise as apharmacological management of sleep.
International Journal of Scientific and Research Publications, Volume 2, Issue 8, August 2012 5
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Key results
Ferris LT et
al 28
older adults
training to
upper& lower
body strength
Mean body strength-
significant improvement
Global PSQI- significant
SD et al 45
stage 2
REM sleep
SOL-not significant
Stage2-significant increase
REM-significant reduction
REM-L-Significant delay
TST-significant increase
King CA et
50-76 yrs,
complaint at
s/wk for 16
Global score-significant
SOL- significant decrease
TST- significant
Faria AP et
men aged 20-
40 yrs, good
sleep quality
exercises with
50% of 1
No significant change
Singh NA et
(3days/wk for
10 wks)
Quality of
Improvement in both
parameters of sleep as
compared to
Significant change in total
physical activity level and
Significant improvement in
Trend towards improvement
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Table 2: Studies done to find out the effect of exercise on sleep
PSQI-Pittsburg sleep quality index, PSG-Polysomnography, RCT- randomised control trial, SOL-sleep onset latency, SWS-Slow
wave sleep, REM- repeated eye movement, REM-L- repeated eye movement latency, TST- total sleep time, WASO- wakefulness
after sleep onset, TWT- total wake time,OSA-Oguri-Shirakawa-azumi sleep inventory, KSS-Kanseigakuin sleepiness scale.
Passos GS et
High intensity
Reduction in anxiety scale
All the above in Moderate
intensity aerobic exercise
King CA et
50-76 yrs,
complaint at
wk for 52 wks)
Sleep log
Self rated-<disturbance,
SOL, >rested
PSG-<awakenings &stage-1
PSG- >stage -2
Sherrill DL et
al 75
Some form of
physical activity
done regularly
Regular exercise is
associated with lesser
incidence of disturbed sleep
Yoshida H et
male students
at diff times of
Good sleep effects with late
evening exercises
Singh NA et
al 77
older adults
exercise at 80%
&20% RM (3
days/wk for 8
PSQI global score- significant
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First Author Zubia Veqar, BPT, MPT(Osteomyology), PhD
(pursuing), Assistant professor, Centre for physiotherapy and
rehabilitation sciences, JamiaMilliaIslamia, New Delhi -110025,
Second Author - Prof M EjazHussain, Mphil, PhD, Director &
Professor, Centre foe physiotherapy and rehabilitation sciences
Jamia Millia Islamia, New Delhi -110025, India
CorrespndingAuthor - ZubiaVeqar, BPT, MPT
(Osteomyology), PhD (pursuing), Assistant professor, Centre for
physiotherapy and rehabilitation sciences, Jamia Millia Islamia,
New Delhi -110025, India
... Healthy sleep has plays important role in better health maintenance and wellbeing with improve the public health [1]. Sleep is functional state which consists of complex combination of physiological and behavioural processes [2]. The sleeping is essential for improve health and sleep disorder which affect the physical and mental health [3]. ...
... En estos trabajos se ha señalado, cuando se comparan los patrones de sueño entre indivi-duos sedentarios e individuos activos físicamente, que el ejercicio parece que influye en el sueño, entre otras cuestiones, produciendo un aumento del tiempo de sueño, un aumento en la fase N3 de sueño y una disminución del tiempo de la fase REM (Kubitz, Landers, Petruzzello & Han, 1996;Driver & Taylor, 2000;Santos et al., 2007;Lang et al., 2013;Kalak et al., 2012;Aguilar-Farias, Martino-Fuentealba & Chandia-Poblete, 2020). Veqar & Hussain (2012) recogen un importante número de trabajos en los que se señalan efectos del ejercicio físico sobre el sueño en la línea de los señalados en el párrafo anterior, planteando que sus efectos pueden ser utilizados como herramienta de modificación de la conducta para llevar una mejora en la calidad del sueño, pero siguen siendo necesarios más estudios que permitan calcular la dosimetría exacta de la intervención junto con el periodo adecuado del día para la práctica del ejercicio. ...
The purpose of this study was to find out if an increase in physical exercise could improve the level of average physical activity and sleep patterns in teenagers with autism. Physical activity and sleep pattern were monitored in three participants with autism by a triaxial accelerometer. They joint a programme to increase their physical activity thru regular walks - three times a week during a month. Results shew higher levels of physical activity during the ‘walking days’ compared the days without that activity. The difference was statistically significant and the effect large. The participants slept more time in the days with increased physical activity (including the ‘walking days’). The difference was significant, but the effect was moderate. The walking program had a clear effect on the level of physical activity in the participants getting them closer to the international recommendations, with positive influence on their quality of life, improving their daily physical activity and sleep
... Various studies reported the positive effects In agreement with the findings of the present study, Tartibian and Abdollah Zadeh reported the positive effects of exercise on sleep quality among physically active young men. [25] Other studies also found that exercise improves sleep quality through promoting mental health, alleviating anxiety, [26] stimulating the anterior hypothalamus, changing core body temperature, [27] and regulating cytokines. [28] Similarly, Ilahi et al. found that exercise was directly correlated with sleep quality and satisfaction. ...
... The new finding of this study is the analysis of the variable sleep quality of the elderly in a training program with the Pilates Method, which obtained a significant result. Whereas that exercise is a positive behavioral modification tool for all age groups to bring about an improvement in sleep quality, exercise can be very effective in older populations not only to improve sleep but also other diseases; acute exercises are not effective in improving sleep quality; effects of aerobic and resistance training can improve sleep quality; and pre-sleeping exercises seem to have a negative effect on sleep quality (Veqar & Hussain, 2012). Although it is another population, our results are in line with previous findings. ...
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The objective of this study was to determine the effect of 16 weeks of mat-based Pilates training on health perception and sleep quality among elderly women. A randomized and controlled trial was conducted in Caxias do Sul, Brazil, in 2015, in which 61 healthy older women were divided into two groups: experimental group (EG; n=31, average of 64.25 years old, SD 0.14) and control group (CG; n=30, average of 63.75 years old, SD 0.08). The EG participants performed mat-based Pilates exercises twice a week in 60-min sessions, whereas the CG did not train. All participants completed Brazilian-adapted and validated versions of the Pittsburgh Sleep Quality Index (PSQI-BR) and General Health Questionnaire (GHQ-12) at baseline and after 16 weeks. Significant time x group interaction effects were found for the GHQ-12 total score (p<0.001, η(2)=0.19), and the depression (p=0.002, η(2)=0.15) and social dysfunction subscales (p=0.001, η(2)=0.18), as well as the PSQI-BR total score (p=0.017, η(2)=0.09), and the sleep latency (p=0.023, η(2)=0.09) and use of sleeping medication subscales (p=0.019, η(2)=0.09), indicating better improvements (reductions) in these outcome variables for the Pilates EG when compared to the CG. All significant effects were classified as moderate to high. These results indicate that 16 weeks of mat-based Pilates training significantly improves the perceived health status and some sleep quality indices among elderly women. However, more studies are needed to assess the effectiveness of equipment-based Pilates exercises among this population. Full-text available at
... People who perform yoga asanas mostly declare that they have higher levels of energy, vivacity, and more balanced feelings 23 . It has also been reported that the variations in the hormonal levels caused by physical activities including Growth Hormone Receptor (GHR), melatonin, interleukin-1, prolactin, and prostaglandin D2 have desirable modulating effects on the sleep quality 28 . ...
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Objective: The aim of this study was investigating the effect of 12 weeks of yoga and aerobic exercise (running on a treadmill) on the sleep quality in women with Type 2 diabetes. MATERIALS AND Methods: 39 diabetic women were selected from Semnan city with the mean age of 46.85±3.35 years, weight of 69.79±17.18 kg, height of 155.03±5.00, BMI of 29.64±5.00 kg/m2 who had a background of diabetes for 6.46±2.69 years. They were then randomly divided into yoga exercise (n=15), aerobic exercise (n=13), and control group (n=11). The exercise program was performed for 12 weeks, three sessions per each week. In order to measure the sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. The data were analyzed by non-parametric wilcoxon and Kruskal-Wallis Test at significance level of p
Physical activity is considered an effective method to improve sleep quality in adolescents and adults. However, there is mixed evidence among children. Our objectives were to investigate this association in children and to examine potential moderating variables. Eight databases were systematically searched, and we included all study designs with a sample of healthy children ages 3-13 years-old. We identified 47 studies for meta-analysis. Overall, we found little association between physical activity and sleep (r = 0.02, 95% confidence interval = -0.03 to 0.07). There was a high amount of heterogeneity in the overall model (I2 = 93%). However, none of the examined variables significantly moderated the overall effect, including age, gender, risk of bias, study quality, measurement methodology, study direction, and publication year. Exploratory analyses showed some weak, but statistically significant associations for vigorous physical activity with sleep (r = 0.09, 95% CI = 0.01 to 0.17, I2 = 66.3%), specifically sleep duration (r = 0.07, 95% CI = 0.00 to 0.14, I2 = 41.1%). High heterogeneity and the lack of experimental research suggest our findings should be interpreted with caution. The current evidence, however, shows little support for an association between physical activity and sleep in children.
PurposeThe purpose of this study was to explore the relationship between physical activity and screen based activity with sleep patterns in adolescents.MethodsA cross-sectional study was conducted among junior high school students in August 2016. Samples were 536 respondents selected using stratified random sampling. Data were collected through interviews with a structured questionnaire, and measurements of height and waist circumference. Data analyses used chi-square, mann-whitney and logistic regression tests to explore factors associated with sleep pattern.ResultsOut off 536 respondents, poor sleep quality (34.5%) and short sleep duration (45.3%) happened among female adolescents. There was a significant correlation between screen based activity with sleep quality in adolescents. Physical activity had a significant relationship with sleep duration.Conclusion Physical activity and SBA was associated with adolescent sleep patterns. Appropriate educational promotions by the Kulon Progo education authorities should be conducted to provide information about the importance of adequate sleep.
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Insomnia is one of the most common complaints from patients with cancer and overall prevalence rate is higher than in the general population. Under the long and hard process of cancer treatment, insomnia tends to be perceived as less important problem by patients themselves as well as clinicians. However, sleeping well is a principal factor in determining quality of life and can eventually influence patients' mental health, medical condition, and treatment outcome. The cognitive-behavioral therapy for insomnia (CBT-I) is established as an effective non-pharmacological treatment which consists of sleep education, stimulus control, sleep restriction, relaxation techniques, and cognitive therapy. Especially for patients with cancer suffering from insomnia, CBT-I has been reported to reduce sleep disturbance and psychological distress and improve quality of life. This paper contains an overview of CBT-I techniques and application of CBT-I to cancer patients. We aim to customize the existing CBT-I techniques focusing on the patients' unique situations in the context of cancer trajectory.
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Background and Objectives: Studies indicated that physical activity influences sleep quality and inflammatory markers, but not have been studied much the relationship between sleep quality and inflammatory markers caused by physical activity. The aim of the present study was to investigation of the relationship between sleep quality with interleukin-1β and C - reactive protein in active and non-active men Material and Methods: The present study is a cross- sectional. Twenty-two healthy males aged 32-38 years participated voluntarily in this study, and were divided into two non-active (n=11) and active groups (n =11). The non-active group were without sports history and the active group had more than two years of moderate-intensity aerobic exercise history (moderate aerobic training 45 minutes/day, 3days/week). Fasting blood samples were taken from all subjects. Serum C-reactive protein and interleukin -1 beta was measured by ELISA method and Pittsburg Sleep Quality Index Questionnaire (PSQI) was, used to evaluate sleep quality. The research data were analyzed using the independent t test, Pearson’s correlation coefficient and Multiple Linear Regression. Results: IL-1β (p=0.015) and CRP (p=0.043) concentrations under the effect of physical activity in the active group compared to the non-active group showed a significant decrease. The Sleep Quality Index score was significantly lower in the active group compared to non-active group (p=0. 021). A Significant relationship was observed between sleep quality score, IL-1β (r=0. 571, p=0. 033) and CRP (r=0. 613, p=0. 012) concentrations in active men. Conclusion: The present study demonstrates that there is a significant relationship between sleep quality with IL-1β and CRP levels in active men so that it may improve sleep quality by reduction in inflammatory markers.
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Abstract Background: Physical activity is an effective factor in pulmonary functions and sleep quality. However information on the rate of changes in exercise-induced respiratory parameters associated with sleep quality is not available. The aim of this study was to compare the parameters of the sleep quality and respiratory function in active and none active men. Methods: The present study is a semi-experimental. Thirty healthy young men with an age range of 20-24 years were enrolled in this study. Then the participants were randomly assigned to either an active (N=15) or none active (N=15) groups. Respiratory parameters including FEV1 (forced expiratory volume in 1second %) , FEV1, MVV (maximum voluntary ventilation VC (vital capacity), FVC (forced vital capacity), MEF25% and MEF75% (maximum forced flow rates at 25and 75% of expired FVC) were measured by spirometer. Pittsburg Sleep Quality Index questionnaire (PSQI) was used to evaluate sleep quality. The research data were analyzed using the independent t test, Pearson’s correlation coefficient and Multiple Linear Regression. Results: The active group showed significant increased in FVC(p=0.023), VC(p=0.002), MVV(p=0.001), FEV1(p=0.001), %FEV1(p=0.031), MEF25%(p=0.026), EF75%(p=0.042) when compared with the none active group. Score of Sleep Quality Index was significantly lower in the active group (p= 0.002). In the active group with regarding to increasing in per unit of, FEV1, MVV, VC, FVC and MEF75 % respectively equal to 0.217, 0.127, 0.370, 0.386 and 0.194 a reduction in per unit score of sleep quality was observed(p>0.05). Conclusions: The results of this study show the beneficial effect of physical activity by increasing pulmonary volumes and capacities and as a result improving sleep quality. However, correlation analyses show no significant relationship between respiratory parameters and score of sleep quality.
Since publication of the first edition in 1994, the second edition in 1999, and the third edition in 2009, many new advances in sleep medicine have been made and warrant a fourth edition. This comprehensive text features 19 additional chapters and covers basic science, technical and laboratory aspects and clinical and therapeutic advances in sleep medicine for beginners and seasoned practitioners. With the discovery of new entities, many new techniques and therapies, and evolving basic science understanding of sleep, Sleep Disorders Medicine, Fourth Edition brings old and new knowledge about sleep medicine together succinctly in one place for a deeper understanding of the topic. Neurologists, internists, family physicians, pediatricians, psychiatrists, psychologists, otolaryngologists, dentists, neurosurgeons, neuroscientists, intensivists, as well as those interested in advancing their knowledge in sleep and its disorders, will find this edition to be an invaluable resource to this bourgeoning field. © Springer Science+Business Media New York 1994, 1999, 2009, 2017. All rights reserved.
In this review, we develop a blueprint for exercise biology research in the new millennium. The first part of our plan provides statistics to support the contention that there has been an epidemic emergence of modern chronic diseases in the latter part of the 20th century. The health care costs of these conditions were almost two-thirds of a trillion dollars and affected 90 million Americans in 1990. We estimate that these costs are now approaching $1 trillion and stand to further dramatically increase as the baby boom generation ages. We discuss the reaction of the biomedical establishment to this epidemic, which has primarily been to apply modern technologies to stabilize overt clinical problems (e.g., secondary and tertiary prevention). Because this approach has been largely unsuccessful in reversing the epidemic, we argue that more emphasis must be placed on novel approaches such as primary prevention, which requires attacking the environmental roots of these conditions. In this respect, a strong association exists between the increase in physical inactivity and the emergence of modern chronic diseases in 20th century industrialized societies. Approximately 250,000 deaths per year in the United States are premature due to physical inactivity. Epidemiological data have established that physical inactivity increases the incidence of at least 17 unhealthy conditions, almost all of which are chronic diseases or considered risk factors for chronic diseases. Therefore, as part of this review, we present the concept that the human genome evolved within an environment of high physical activity. Accordingly, we propose that exercise biologists do not study "the effect of physical activity" but in reality study the effect of reintroducing exercise into an unhealthy sedentary population that is genetically programmed to expect physical activity. On the basis of healthy gene function, exercise research should thus be viewed from a nontraditional perspective in that the "control" group should actually be taken from a physically active population and not from a sedentary population with its predisposition to modern chronic diseases. We provide exciting examples of exercise biology research that is elucidating the underlying mechanisms by which physical inactivity may predispose individuals to chronic disease conditions, such as mechanisms contributing to insulin resistance and decreased skeletal muscle lipoprotein lipase activity. Some findings have been surprising and remarkable in that novel signaling mechanisms have been discovered that vary with the type and level of physical activity/inactivity at multiple levels of gene expression. Because this area of research is underfunded despite its high impact, the final part of our blueprint for the next millennium calls for the National Institutes of Health (NIH) to establish a major initiative devoted to the study of the biology of the primary prevention of modern chronic diseases. We justify this in several ways, including the following estimate: if the percentage of all US morbidity and mortality statistics attributed to the combination of physical inactivity and inappropriate diet were applied as a percentage of the NIH's total operating budget, the resulting funds would equal the budgets of two full institutes at the NIH! Furthermore, the fiscal support of studies elucidating the scientific foundation(s) targeted by primary prevention strategies in other public health efforts has resulted in an increased efficacy of the overall prevention effort. We estimate that physical inactivity impacts 80-90% of the 24 integrated review group (IRG) topics proposed by the NIH's Panel on Scientific Boundaries for Review, which is currently directing a major restructuring of the NIH's scientific funding system. Unfortunately, the primary prevention of chronic disease and the investigation of physical activity/inactivity and/or exercise are not mentioned in the almost 200 total subtopics comprising t
Older individuals, as a group, tend to experience difficulty sleeping compared to younger adults. Improving sleep in the elderly would have beneficial public health consequences. This study utilized 8 sedentary, older adults, 78.1 ± 3.1 years of age, who participated in a six-month long resistance training (RT) program. The Pittsburgh Sleep Quality Index (PSQI) was used to examine sleep quality, and a 1 repetition max test (1-RM) was used to determine upper (bench press) and lower (leg press) body strength. Total strength, defined as the sum of the bench press and leg press 1-RM results, was also reported. The training resulted in significant improvements (p < 0.05) in total (19%) and upper body (52%) strength and in sleep quality (38%). Future studies should examine the effects of strength gain/loss and time-of-day training on sleep quality. Key PointsCompromised sleep and deterioration of skeletal muscle mass and function are commonly found among the aged.Results show that RT led to improvements in upper and total body strength in older participants who trained three times per week in the morning.The resistance training led to improvements in sleep as measured by a self-report sleep questionnaire, the Pittsburgh Sleep Quality Index.The small sample size used, lack of control group, and the fact that the participants on average were characterized as "good "sleepers at the study onset, necessitates that further investigation occur.We suggest that further research is required to explore the effects of RT performed at different times of the day as well as to determine the relationship between sleep gains or losses upon changes in sleep quality.