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Effects of Exercise on Sleep
Abstract
Historically, perhaps no daytime behavior has been more closely associated with better sleep than exercise. The assumption that exercise promotes sleep has also been central to various hypotheses about the functions of sleep. Hypotheses that sleep serves an energy conservation function, a body tissue restitution function, or a temperature down-regulation function all have predicted a uniquely potent effect of exercise on sleep because no other stimulus elicits greater depletion of energy stores, tissue breakdown, or elevation of body temperature, respectively. Exercise offers a potentially attractive alternative or adjuvant treatment for insomnia. Sleeping pills have a number of adverse side effects and are not recommended for long-term use, partly on the basis of a significant epidemiologic association of chronic hypnotic use with mortality. Other behavioral/cognitive treatments are more effective for chronic insomnia treatment, but difficult and costly to deliver. By contrast, exercise could be a healthy, safe, inexpensive, and simple means of improving sleep.
... Since the 1990s, the effects of exercise on insomnia have been investigated. [18][19][20][21][22][23][24][25] The first review articles suggesting insomnia as the best model to study the effects of exercise on sleep were published in the 2000s, 26,27 but only after 10 years were the first clinical trials published. 23,25 Chronic 18,[20][21][22]25 and acute 23,28 exercise have elicited improvements or no impairment 19 on sleep in patients with chronic insomnia. ...
... Exercise could be particularly helpful for individuals with insomnia and short sleep duration (<6 h) that shown a poor response to CBT-I. Exercise increases sleep pressure, as evidenced by increased sleep duration (on the subsequent night-acute effect 22 and sustained for long-term exercise training 20,25 ) and deep sleep (reported previously for good sleepers after acute and chronic exercise 26,41 ). In addition, both moderate acute and chronic exercise elicit decreases in fatigue. ...
... 47 In addition, a previous study has observed no effects on delta, sigma and beta power during NREM sleep at post-treatment with CBT-I. 49 Exercise is effective in reducing psychophysiological arousal 19,26,50,51 and added to CBT-I could improve its effects. ...
The question that guided this review is whether exercise can add to the improvements in insomnia in patients treated with cognitive behavioral therapy for insomnia (CBT-I). CBT-I has long been recommended as the first-line treatment of chronic insomnia. However, CBT-I is not effective for as many as 30% to 40% of patients with insomnia. There is accumulating evidence for positive effects on insomnia following acute and chronic exercise. However, to the best of our knowledge, the effects of CBT-I combined with exercise have not been explored in clinical trials. In this article, we develop a rationale for combining CBT-I with exercise.
... A majority of epidemiological studies have indicated that exercise is significantly positively correlated with better sleep (43). Physical activity can increase total sleep time and slow-wave sleep duration while reducing rapid eye movement (REM) sleep and delaying the onset of the REM latency period (44). Furthermore, long-term exercise can enhance sleep efficiency, reduce sleep onset latency, increase total sleep duration, and promote slow-wave sleep (45,46). ...
... Furthermore, long-term exercise can enhance sleep efficiency, reduce sleep onset latency, increase total sleep duration, and promote slow-wave sleep (45,46). Mechanisms by which exercise improves sleep include exercise-induced inflammation reduction, alterations in core body temperature, changes in the regulation of neurotransmitters involved in sleep, increases in growth hormone and brain-derived neurotrophic factor (BDNF), as well as changes in heart rate variability and autonomic nervous function (44,45,(47)(48)(49). It is a simple, cost-effective, and non-pharmacological therapy for treating sleep disorders. ...
Sleep disorders often accompany neurological injuries, significantly impacting patient recovery and quality of life.The efficacy and adherence of traditional treatment methods have certain limitations. Exercise has been found to be a highly beneficial treatment method, capable of preventing and alleviating neurological injuries and sleep disorders. This article reviews relevant research findings from both domestic and international sources over the past few decades, systematically summarizing and analyzing the application of exercise therapy in sleep disorders,strategy of exercise intervention program and the potential molecular mechanisms by which exercise therapy improves sleep disorders. Shortcomings in current research and suggestions are presented, providing a reference for future in-depth studies on exercise interventions for sleep disorders.
... A large amount of evidence exists that supports the efficacy of chronic exercise for improving subjective sleep quality in individuals suffering from insomnia symptoms. Multiple meta-analytic reviews have investigated exercise interventions on sleep quality and demonstrated overall significant improvements, especially in subjective sleep complaints [131][132][133][134][135]. In a meta-analysis on exercise as an alternative treatment for chronic insomnia, Passos et al. found that the efficacy of chronic exercise was similar to hypnotic drug use in improving symptoms of insomnia [131]. ...
... Multiple types of chronic exercise, from aerobic exercise to Tai Chi, have been shown to improve sleep [132]. Several mechanisms that provide a rationale for the improvement in insomnia symptoms from exercise have been suggested [133,[136][137][138][139]; these include but are not limited to reducing core body temperature for sleep onset [140][141][142][143], increasing melatonin and serotonin secretion [131,144], reducing depression and anxiety, and improving autonomic regulation which may reduce hyperarousal associated with insomnia [143]. ...
The occupational requirements of full-time non-administrative firefighters include shift-work schedules and chronic exposure to alerting emergency alarms, hazardous working conditions, and psychologically traumatic events that they must attend and respond to. These compiling and enduring aspects of the career increase the firefighter’s risk for insomnia and mental health conditions compared to the general population. Poor sleep quality and mental health impairments are known to coincide with and contribute to the symptom severity of one another. Thus, it is important to determine approaches that may improve sleep and/or mental health specifically for firefighters, as their occupation varies in many aspects from any other occupation. This review will discuss symptoms of insomnia and mental health conditions such as PTSD, anxiety, depression, substance abuse, and suicide in firefighters. The influencing factors of sleep and mental health will be examined including anxiety sensitivity, emotional regulation, and distress tolerance. Current sleep and mental health interventions specific to full-time firefighters are limited in number; however, the existing experimental studies will be outlined. Lastly, this review will provide support for exploring exercise as a possible intervention that may benefit the sleep and mental health of this population.
... Poor sleep quality and sleep disturbances are prevalent complaints in people with RA [13,14], with poor sleep quality and low total sleep time (TST) noted in recent studies [15,16]. Exercise is known to help improve sleep [17,18], with some initial trials in people with inflammatory arthritis suggesting that it might help this population [19,20]. Previous qualitative research on the effects of exercise among people with RA has also examined how traditional exercise is experienced. ...
... Although there is a growing consensus that exercise will benefit sleep for those experiencing a chronic health disorder, research is lacking, in particular for those with a rheumatic condition [18,37]. Because of the multifactorial nature of RA and to help mitigate some of its symptoms, engaging in exercise has been widely researched and advised, with our study adding to the existing understanding of the impact of exercise on people with RA to help improve their sleep [38]. ...
Objective
The purpose of this study was to explore the experiences of people with RA of participating in an exercise intervention to improve their sleep.
Methods
Using a qualitative descriptive design, semi-structured face-to-face interviews were conducted with 12 people with RA who had completed an 8-week walking-based exercise intervention to improve their total sleep time, sleep quality and sleep disturbance. Data were analysed using thematic analysis.
Results
Four themes were generated: positive impact of exercise on participants’ sleep (‘I really didn’t think any type of exercise would help me sleep better, if I’m honest’); positive experiences of the exercise intervention (‘I learnt so much regarding walking that I didn’t even think about’); clear mental health benefits (‘If you don’t sleep well then it will have a knock-on effect to your mental health’); and achieving empowerment and ownership when exercising (‘I feel empowered now and confident that I’m not doing harm to myself’).
Conclusion
The findings demonstrated that participants had not expected exercise to improve their sleep. Although there is a growing consensus that exercise will benefit sleep and mitigate some disease symptoms, research is severely lacking in people with RA.
... Thus, the persistence of post-exercise psychophysiological reactions that continue to bedtime could indicate sleep start disturbance [10]. On the other hand, exercise in the evening may enhance sleep via anxiety reduction and antidepressant benefits [11,12]. ...
... The positive impact of exercise on sleep has been the subject of several studies, but the connection between exercise intensity in the evening and restful sleep has not been specifically studied [11]. Even though it is still debatable, a number of aspects of physical activity have been reported to enhance sleep, including an increase in body temperature before tonight, modifications in cortisol and growth hormone release, and enhanced mood [5,12]. According to our search results, fewer studies were conducted regarding the same subjects, while a sedentary lifestyle in Saudi Arabia is associated with poor exercise, sleep, and quality of life [13]. ...
Introduction Engaging in physical activity has been proven to have health benefits, with a positive impact on sleep quality. While the timing of exercise plays a significant role in determining its effect on sleep, nighttime exercise still needs to be explored, especially in Saudi Arabia. This study assessed the effect of nighttime exercise on sleep quality among the general population in Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted on people performing physical exercises in the gym, training, and walking places using a self-administered questionnaire evaluating exercising behaviors and sleep quality. Comparisons were performed using the Chi-square test and ANOVA, and p<0.05 was considered for significance. Results We enrolled 385 participants, among whom 53.8% were male, and 47.2% were female. The mean age was 28.2±7.85 years, and mostly aged 25-29 years (24.7%), followed by 20-24 years old (21.3%). Most had university degrees (61.3%) and were also employed (60%). Of all participants, the majority were overweight and obese (61.3%). Most (n=225) participants practiced vigorous physical exercise, and the mean Pittsburgh Sleep Quality Index (PSQI) global score was 7.37±3.49 points. Evening vigorous (r= 0.25, p=0.038) and moderate (r=0.30, p=0.025) physical exercise sessions lasting > 90 min had a significant positive correlation with poor sleep quality (high PSQL score). There was no statistically significant correlation between sleep quality and other variables (p>0.05). Conclusion This study found that participants had poor sleep quality, and lengthy, intense evening exercises had a negative effect on sleep. Incorporating regular exercise tailored to individual preferences and encouraging people to widen the time interval between exercise and bedtime could improve sleep quality.
... Pharmacological interventions for improving sleep and cognition have limited effectiveness [13,14]. Cognitive behavioral therapies, although effective for treating insomnia, can be expensive and difficult to access [15,16]. Alternatively, accumulating evidence suggests that acute cardiovascular or aerobic exercise is a promising, non-pharmacological approach for improving brain health and memory functions [17]. ...
... Nonetheless, our participants' average RPE (~18) during the HIIT was within the RPE range (i.e. [15][16][17][18][19] corresponding to 85-95% of their age-predicted HR max . Further analysis showed that RPE was not a significant covariate for the difference in memory performance between the HIIT groups (HIITS 5 and HIITS 8 ). ...
Recent evidence shows that a nap and acute exercise synergistically enhanced memory. Additionally, human-based cross-sectional studies and animal experiments suggest that physical exercise may mitigate the cognitive impairments of poor sleep quality and sleep restriction, respectively. We evaluated whether acute exercise may offset sleep restriction’s impairment of long-term declarative memory compared to average sleep alone. A total of 92 (82% females) healthy young adults (24.6 ±4.2 years) were randomly allocated to one of four evening groups: sleep restriction only (S5, 5-6 hours/night), average sleep only (S8, 8-9 hours/night), high-intensity interval training (HIIT) before restricted sleep (HIITS5) or HIIT before average sleep (HIITS8). Groups either followed a 15-minute remote HIIT video or rest period in the evening (7:00 p.m.) prior to encoding 80 face-name pairs. Participants completed an immediate retrieval task the same evening and a delayed retrieval task the next morning, after their respective sleep opportunities (documented subjectively). Long-term declarative memory performance was assessed with the discriminability index (d') during the recall tasks. We found that the d' of S8 (0.58 ±1.37) was not significantly different from those of HIITS5 (-0.03 ±1.64, p = 0.176) and HIITS8 (-0.20 ±1.28, p = 0.092), except the S5 (-0.35 ±1.64, p = 0.038) at the delayed retrieval. Similarly, the d' of HIITS5 was not significantly different from those of HIITS8 (p = 0.716) and S5 (p = 0.469). These results suggest that the acute evening HIIT partially reduced the detrimental effects of partial sleep restriction on long-term declarative memory.
... Several hypotheses have tried to explain how physical activity improves sleep. First, physiological processes (e. g., better thermoregulation) would promote an easier sleep onset, an earlier circadian phase and an increase in the slow-wave stage of sleep (Brand et al., 2010a;Youngstedt, 2005). Second, physical activity seems to have psychological benefits such as the reduction of depression and anxiety, and improvements in self-steem and well-being (Biddle, Ciaccioni, Thomas & Vergeer, 2019;McMahon et al., 2017). ...
... This fact goes against previous evidence that found physical activity physiological benefits. For instance, physical activity contributes to a greater slow-wave sleep intensity (Brand et al., 2010a), reduces sleep onset (e. g., via better body temperature adjustment) (Youngstedt, 2005) and stabilizes the circadian rhythm (Youngstedt & Freelove-Charton, 2005). Once again, previous literature results are contradictory: Philbrook and El-Sheikh (2016) did not found a positive relation between physical activity levels and sleep quality whereas in another study a better sleep quality was associated with those who were more active (Lang et al., 2013). ...
The purpose of this study was to assess the temporal day-today associations between physical activity and sleep in adolescents during a complete week. A total of 236 secondary education students (127 males, 109 females), age range 12-15 years, enrolled in 10 different high schools agreed to participate. They were asked to wear a GT3x accelerometer and complete a diary for a full week (24 hours / seven days). Participants' Body Mass Index and socioeconomic status were assessed. Multilevel models were used to test the associations of nighttime sleep (onset, offset , duration and efficiency) and wakefulness movement variables (MVPA, sedentary behavior). MVPA was a significant predictor of sleep duration (B = .004, p < .001) and sleep offset (B = .006, p <.001). Adolescents who were more sedentary during the day fell asleep later (B = .005, p < .001) and woke up later (B = .002, p < .001). Sedentary behavior during the day was inversely related to sleep duration that night (B =-.003, p < .001). Sleep offset was inversely related to MVPA (B =-.064, p < .001) and sedentary behavior (B =-.120, p < .001). Sleep duration was inversely associated with MVPA (B =-.27, p < .05) and sedentary behavior (B =-.41 p < .001) the following day. It seems physical activity could improve adolescents' sleep, while sedentary time could have a negative impact on it. The predictive role of sleep in physical activity is even less conclusive, indicating that the physiological relationship could be influenced by other factors such as time conflicts between individuals' daily activities. More research in this field is needed.
... When comparing the sleep quality of physical-education students and other disciplines, it was found that the physical-education students have better sleep quality (fig 1), while no difference was found when comparing both groups' well-being. Physical activity is known to be one of the factors that helps reduce many health-related consequences such as physical disabilities, mental problems, and poor sleep quality (Sherrill et al., 1998;World Health Organization, 2010;Youngstedt, 2005). Unfortunately, it has been shown that 40-50% of college students are physically inactive (Keating et al., 2005), and they are a population with poorer well-being compared to people of the same age that do not attend college. ...
... Moreover, it was shown that one of the first symptoms of student's stress is a reduction in their sleep quality (Jensen, 2003). The results here, are in line with previous studies showing that physical activity can improve sleep quality and that students that do more exercise will benefit from better sleep quality (Reid et al., 2010;Wang & Boros, 2019;Youngstedt, 2005). The fact that all the tested students achieved the same score of well-being, reinforces the positive effect of physical activity on sleep quality. ...
This study aims to examine sleep quality and well-being of college students according to their amount of exercise, field of study and academic school year. 367 college students from different academic disciplines submitted a questionnaire via Google Forms relating to the amount of exercise they engage in, sleep quality and well-being. Physical-education students exercise more than other disciplines (4.8 compared to 2.7; p<0.001). Their sleep quality is better compared to students from other disciplines (5.72 compared to 5.05, p<0.05). Moreover, sleep quality of freshmen students who exercise more is better (5.33 compared to 4.85, p=0.002). To ensure adequate quality of life and a better well-being of College students, it is recommended to enhance the level of the students' weekly physical activity, as well as implement an educational program for physical activity in their curriculum, and as early as their first year of study.
... The general consensus in comprehensive reviews (e.g. Gupta et al., 2017;Youngstedt, 2005) is that physical exercise positively influences sleep, and this is expressed as longer sleep durations, reduced sleep onset latencies, reductions in WASO, fewer sleep stage disruptions and an increase in consistency in rapid eye movement (REM) to non-REM transitions. However, there is also strong evidence that shows the training demands of athletes and individuals who partake in regular physical exercise can negatively impact sleep (Gupta et al., 2017). ...
Subjective sleep and stress are strongly associated, at multiple levels, and the current body of evidence highlights a bi-directional association. Previous research has highlighted that issues with sleep can impact on several stress responses. On the other side of this relationship, research has shown that stress-inducing factors can significantly impact sleep. The present study examined this association in a sample of recreational athletes, a population that has received little to no research focus to date Recreational athletes are defined as individuals who exercise >4 hours per week for health, fitness, or unofficial competitions. Recreational athletes (n = 34) completed online measures of subjective sleep, subjective stress, subjective anxiety/depression and training load (PSQI, PSS, HADS and DALDA). Pearson correlations were carried out to examine associations between variables. There was a significant positive correlation between subjective sleep quality and subjective stress. There was a significant positive correlation between subjective stress and training load. There was a significant positive correlation between subjective sleep quality and training load. The positive associations between sleep, stress and training load are consistent with previous research, but the present study adds to the literature by highlighting the associations in recreational athletes. Recreational athletes should proactively manage their sleep and stress, as due to the bi-directional relationship, improving sleep may benefit stress, and improving stress may benefit sleep quality. This is also likely to benefit overall mood and reduce the likelihood of overtraining in recreational athletes.
... Studies show that moderate aerobic exercise can lower pre-sleep anxiety in chronic insomniacs, improving sleep quality. [47] Additionally, exercise boosts serotonin levels, crucial for sleep regulation. By increasing serum free tryptophan, exercise enhances brain serotonin synthesis, potentially alleviating chronic insomnia related to serotonin deficits. ...
Introduction and purpose This article explores the impact of physical activity on insomnia and sleep quality. It reviews existing research to clarify how exercise affects sleep patterns, identifies mechanisms through which exercise improves sleep, and evaluates practical recommendations for integrating physical activity into insomnia treatment. The goal is to offer valuable insights for individuals and healthcare professionals on using exercise as a non-pharmacological method to manage insomnia. State of knowledge The article reviews the literature on sleep, with a particular focus on the issue of insomnia. By understanding the causes of sleep disorders, it is possible to implement targeted diagnostics and subsequent treatment. The impact of physical activity on the overall problem of insomnia is also highlighted. Material and Methods A review of literature from 2004 to 2024 was conducted using databases such as PubMed, Science Direct, and Google Scholar. Keywords included "insomnia," "sleep disorder," and "sleep impairment." The review focused on English-language primary research articles from peer-reviewed journals. Summary The review highlights the role of physical activity in managing insomnia, emphasizing its positive effects. Evidence indicates that regular exercise significantly reduces the risk and severity of insomnia and improves sleep quality. This underscores the effectiveness of physical activity as a valuable non-pharmacological approach to enhancing sleep and overall well-being. Keywords Insomnia; physical activity; sleep disorders; quality of sleep; sport
... According to our findings, 3 weeks of circuit training also brought significant differences in the are congruent with earlier studies that showed that exercise has the biggest impact on spatial memory, and executive function (11) . ...
... Our review findings further underscore the enormous benefits of PE for those with AD, notably in terms of improving sleep quality and reducing anxiety. These results support previous findings, notably Youngstedt (2005), that identified PE as a vital factor in improving sleep quality. The observed increase in sleep is mostly due to a reduction in anxiety, underscoring the relevance of PE in promoting good sleep. ...
Background: Anxiety is characterized by excessive worry, fear, or apprehension, often leading to significant impairments in daily functioning, including difficulties maintaining physical health and psychological well-being (PWB). There is a lack of conclusive research regarding the efficacy of physical exercise (PE) as a treatment for anxiety in primary care settings, as well as uncertainty about the specific degree of activity required to produce therapeutic benefits. The goal of this systematic review is to investigate the effects of PE on the PWB of people suffering from anxiety disorders (AD), as well as to compare the benefits of different PE regimens. Method: A systematic literature search was carried out utilizing seven databases (PUBMED, PsycINFO, Science Direct Engine, Semantic Scholar, Google Scholar, Online Library, and other sources such as periodicals). Inclusion and exclusion criteria were based on the PICOS framework, and the risk of bias (ROB) was utilized to assess the quality of eligible research. Result: Aerobic exercise (AE) is the most effective PE modality in reducing anxiety symptoms, while the benefits of resistance exercise (RE) are also notable. Moreover, research suggests that moderate intensity PE (MI-PE) tends to yield superior results over other PE regimens in managing anxiety symptoms. These findings underscore the importance of PE intensity in achieving therapeutic benefits for anxiety management. PE is acknowledged as an effective intervention for lowering anxiety symptoms, making it an attractive therapeutic choice for those with AD. Conclusion: PE is a safe, efficient, and effective therapeutic method for treating anxiety symptoms. However, the majority of published studies contain substantial methodological flaws, necessitating additional research to determine the suitable PE modalities, frequency, duration, and intensity for maximizing the therapeutic effects of PE on AD.
... The mechanisms by which yoga training alleviates sleep problems are not fully understood, but our findings demonstrate that yoga training may improve sleep quality. This may be attributable to the components of yoga, namely (i) meditation, which helps an individual to achieve a deep state of psychological rest by harmonizing the body and mind, which could modulate physiological and biomedical functions and thereby mediate sleep [47], and (ii) yoga postures, which help to activate exercise-induced body temperature regulation function and energy consumption [48], and melatonin secretion [49]. ...
Purpose
Upper limb dysfunction and sleep disturbance are common and serious health problems in women with breast cancer. Yoga is a mind-body intervention which is shown to improve physical and psychological health. The aim of this study is to evaluate the effectiveness of a tailor-made yoga program on upper limb function and sleep quality in women with breast cancer.
Methods
A pilot randomized controlled trial (RCT) study design was used. Participants were randomly allocated to either the yoga intervention group (YG; eight weekly 60-min group-based yoga sessions) or the wait-list control group (CG). The primary outcome measures were upper limb function and sleep quality, which were assessed by the self-reported questionnaires – the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and the Pittsburgh Sleep Quality Index (PSQI), respectively. The secondary outcome measures were upper limb muscle strength and mobility, heart rate variability (HRV), anxiety and depression, fatigue, and health-related quality of life. All participants underwent assessment at four time-points (baseline, mid-intervention, post-intervention, and 1-month follow-up). The effectiveness of the intervention was tested by two-way mixed-design repeated-measures analysis of covariance.
Results
For the primary outcomes, there was no significant between-group difference in the upper limb function. The YG demonstrated significantly shorter sleep latency and higher HRV, and less sleep disturbance than the CG at post-intervention, and 1-month follow-up, respectively. For the secondary outcomes, the YG demonstrated significantly improved shoulder muscle strength and arm symptoms compared to the CG from mid-intervention until the 1-month follow-up.
Conclusion
This pilot trial revealed that the yoga program was feasible to be implemented for women with primary stage breast cancer. Although yoga was not found to be effective in improving the upper limb function, it improved sleep latency, HRV, shoulder muscle strength and arm symptoms of women with breast cancer.
... Another point that emphasizes the relationship between anxiety and sleep is that sleep disorder is a diagnostic symptom for some anxiety disorders, such as generalized anxiety disorder and post-traumatic stress disorder [11]. Sports activities are a healthy, safe, simple, and inexpensive way to improve sleep [12]. People, especially athletes, use a variety of physical activities as a tool to reduce anxiety and increase sleep quality since regular exercise improves healthy sleep cycles and is believed to have antidepressant and antianxiety effects while acknowledging that it protects the person from the disadvantages of stress [13]. ...
... Studies have demonstrated that exercise can improve sleep onset latency (falling asleep time), sleep efficiency (percentage of time spent asleep in bed), and subjective sleep quality reports (5,6). Notably, exercise may alleviate symptoms of insomnia, a prevalent sleep disorder characterized by difficulty falling or staying asleep (7). However, the impact of exercise on sleep quality might be influenced by factors like type, intensity, and timing. ...
Objective: This narrative review aims to bridge the knowledge gap regarding the influence of exercise on sleep quality, exploring how various types, intensities, and timings of exercise impact sleep across different populations. Materials and Methods: A systematic search for relevant literature was conducted in scholarly databases such as Google Scholar, PubMed, MEDLINE, SPORTDiscus, CINAHL, and Web of Science. The search included terms related to physical activity and sleep, focusing on studies published in English from the past 10 years (2014-2024). Studies involving human participants and employing randomized controlled trials (RCTs) or observational study designs were prioritized. Results: Regular moderate-intensity aerobic exercise, such as brisk walking or cycling, significantly reduces sleep onset latency, improves sleep efficiency, and enhances subjective sleep quality across various populations. Potential mechanisms include stress hormone reduction, neurotransmitter regulation, and body temperature control. Emerging evidence suggests that resistance training can improve sleep onset latency and subjective sleep quality, particularly in older adults and individuals with chronic conditions. The benefits may be linked to muscle repair processes and stress reduction. The effects of High-Intensity Interval Training (HIIT) on sleep are mixed, with moderate-intensity programs showing potential benefits while excessive intensity or duration may disrupt sleep. Timing also plays a crucial role, with late-night HIIT potentially having negative impacts on sleep quality. Conclusion: Regular exercise, especially moderate-intensity aerobic exercise, is a powerful tool for improving sleep quality. Resistance training also holds promise, particularly for specific populations. The impact of HIIT on sleep requires further research to determine optimal training parameters. Healthcare professionals should guide patients in tailoring exercise programs to optimize sleep benefits.
... These results are in line with Saidi et al. (2019), who also observed a decrease in SL among young Rugby players after an intensified training session. This reduction in SL is likely attributed to the fact that the training sessions in this study were conducted in the afternoon (2 p.m.), as it is known that physical exercise performed in the late afternoon can lead to shorter latencies for the onset of sleep (Youngstedt, 2005). This can be explained, from a physiological point of view, by the thermoregulatory hypothesis, which is based on the evidence that the onset of sleep is triggered by the reduction in body temperature that occurs circadianly at the beginning of the night (Murphy & Campbell, 1997). ...
Purpose: The aim of this study was to examine how intensifying training loads over a week affects the sleep patterns of young soccer players on the nights immediately following the intensified training sessions. Methods: Quasi-experimental study. Fifteen young athletes participants of a team engaged in national level competition, underwent two weeks of training with varying load magnitudes—Week 1: low accumulated training load and Week 2: intensified training loads [40% increase in external training load(ETL)]. To characterize the intensification of the workload, the methods PlayerLoad and RPE-Session were employed to measure ETL and internal training load(ITL), respectively. Total sleep time(TST), total time in bed(TTB), sleep efficiency(SE), sleep latency(SL), and wake after sleep onset(WASO) were obtained using actigraphy and daily sleep log. The variables were compared among the days of week (e.g. Monday of week 1 with Monday of week 2, and so forth). Results: Acute training intensification in week 2 led to significant increases in ETL and ITL on Monday and on Wednesday(p < .05), and ETL(p < .05) on Friday on the second week. Improvements in sleep were observed (Tuesday—TST:+80 min, WASO:-29.3 min, SL:-8 min, SE:+9%; Thursday—TST:+86 min, SL:-4 min, SE:+4%; Saturday—TST:+40 min, SL:+1 min) compared to the same day of the previous week. Correlations between ETL and ITL(r = 0.637), ITL and TST(r = 0.572), ITL and SE(r = 0.548) were found. Conclusion: Intensification of training loads results in alterations in sleep variables, notably an elevated TST and SE in the days subsequent to the acute load increment.
... Hence, exercise serves as a non-pharmacological intervention for sleep-related issues, being easily accessible and more cost-effective than alternative non-pharmacological treatments (Youngstedt et al. 1997;Driver and Taylor 2000;Youngstedt 2005). Recent randomized controlled trials have substantiated the beneficial impact of physical exercise on various aspects of sleep, including sleep quality, sleep latency, the total duration of sleep, sleep efficiency, and insomnia severity (Passos et al. 2012;Reid et al. 2010;Hartescu et al. 2015). ...
Purpose
The widespread and health-detrimental sleep disorders have resulted in stretching exercises being investigated as a non-drug solution for enhanced sleep quality. However, a comprehensive understanding of the impact of stretching exercises on individuals with sleep disorders is lacking.
Methods
This scoping review systematically maps the existing literature and identifies research gaps on the impact of stretching exercises on sleep quality in individuals with sleep disorders.
Results
Sixteen eligible studies were included, where the weighted mean changes indicate a positive trend in sleep quality improvement, ranging from trivial to very large magnitudes. However, concerning the individual study results only 5 out of 16 studies reported significant improvements. Notable enhancements include a small 1.22% overall sleep quality improvement, a large 6.51% reduction in insomnia severity, a large 8.88% increase in sleep efficiency, a moderate 4.36% decrease in sleep onset latency, a large 8.27% decrease in wake after sleep onset, and a very large 14.70% improvement in total sleep time. Trivial changes are noted in sleep duration (0.58%), sleep disturbance reduction (0.07%), and daytime dysfunction reduction (0.19%). Likely mechanisms for the improvement of sleep include autonomic nervous system modulation, muscle tension relief, cortisol regulation, enhanced blood circulation, and psychological benefits such as stress reduction and mood enhancement.
Conclusion
There is little evidence that stretching exercises positively impact sleep quality in individuals with sleep disorders. Additionally, further research is vital for designing optimal protocols, understanding of the long-term effects, and clarification of the mechanisms.
... Given the beneficial effects of exercise on sleep in other patient populations (e.g., neurodegenerative disorders) [69,70], future studies examining the effects of exercise on seizures are needed. Studies should include both subjective and objective measures of sleep over multiple time points and considering multiple dimensions of sleep during and after the intervention. ...
Exercise interventions in epilepsy have been shown to improve seizure frequency, physical capacity, quality of life, mood, and cognitive functioning. However, the effectiveness of exercise in improving sleep in epilepsy is less clear. The purpose of this report is to identify the published literature regarding exercise interventions in people with epilepsy to determine 1) what proportion of published clinical trials assess sleep as an outcome, and 2) what benefits of exercise interventions on sleep have been observed. We searched the PubMed, PsycINFO, and SCOPUS electronic databases using the search terms “epilepsy AND [exercise OR physical activity]” and identified 23 articles reporting on 18 unique clinical trials. Nine studies were conducted in adults, five in children, and four in adults and children with active seizures, controlled seizures, or both. Exercise modalities included aerobic exercise, strength training, walking, and yoga, among others, and some also included educational and motivational components. Exercise effects on sleep were tested in four studies, two of which only included indirect measures of sleep- and rest-related fatigue, with mixed results. Of the two reports assessing sleep directly, one reported marginal non-significant improvements in subjective sleep quality and no improvements in objective sleep quality in children after twelve weeks of walking, and the other reported no benefits in subjective sleep quality after twelve weeks of combined aerobic, strength, and flexibility training in adults. Given the health benefits of sleep and detrimental effects of sleep deprivation in epilepsy, epilepsy researchers need to assess the effects of exercise interventions on sleep.
... Exercise is a safe and inexpensive option for improving sleep quality [12]. Past studies have revealed that the intensity [13], duration [14], and frequency [15] of exercise and exercise forms, especially among sedentary workers [16,17], are associated with sleep quality. ...
BACKGROUND: The optimal exercise combination for improving sleep quality among sedentary workers is unclear. OBJECTIVE: To reveal what combination of exercises contributes to good sleep quality. METHODS: In this cross-sectional study, we enrolled 5,201 sedentary workers who underwent health examinations in 2019. Data on sleep quality, basic attributes, energy expenditure, and lifestyle aspects such as exercise and physical activity, supper time close to bedtime, and alcohol intake were obtained. The subjects reported their exercise habits by selecting up to three forms of exercise from a list of 182 options, which were classified into three types: endurance (e.g., jogging), muscle strength (e.g., bench pressing), and balanced types which combined both endurance and muscle strength characteristics. (e.g., walking). These forms were then categorized into eight combination patterns: endurance only; muscle strength only; balanced only; endurance and muscle strength; endurance and balanced; muscle strength and balanced; all types; and absence of any exercise habits. Binary logistic regression analysis was used to examine the associations between the exercise combination patterns and sleep quality. RESULTS: Good sleep quality was significantly associated with “endurance” (OR = 1.419; 95% CI 1.110–1.814), “balanced only” (OR = 1.474; 95% CI 1.248–1.741), and “endurance and balance” (OR = 1.782; 95% CI 1.085–2.926) exercise patterns. No significant associations were found between the combinations that included muscle strength exercises and sleep quality. CONCLUSION: The endurance or balanced-type exercises, or a combination of both, may help to improve the sleep quality of sedentary workers as part of occupational health management.
... At the same time, appropriate physical exercise can also increase the duration of deep sleep and reduce the duration of light sleep. In addition, exercise can also reduce anxiety, depression and other negative emotions, promote physical and mental health, and further improve sleep quality [17]. The type of exercise can be walking, jogging, swimming, yoga, etc., but it should be noted that the exercise time should not be too late, so as not to affect sleep. ...
Parasomnia is a neurological disorder that refers to abnormal behavior during sleep. This disease has received increasing attention and research over the past few decades. In the 1950s, the symptoms of parasomnia were first described and further studied. This paper describes the three classifications of parasomnias, and details the symptoms and treatment options for these three classifications. By reading and analyzing the previous literature, it can be concluded that the types of parasomnia can be roughly divided into circadian dysrhythmia sleep disorder, sleep apnea syndrome, and restless leg syndrome. Circadian dysrhythmia sleep disorder is characterized by late sleep, insufficient or excessive sleep duration, resulting in daytime fatigue, a lack of concentration, and other symptoms. The treatment method is light therapy. The main symptom of sleep apnea is that breathing stops during sleep, resulting in a lack of oxygen supply. The treatment is to improve the maxillofacial structure through surgery to reduce the problem of dyspnea. The most obvious symptom of restless leg syndrome is discomfort and unbearable numbness in the lower legs and feet while sleeping. There are three ways to treat this condition. A more non-pharmacological treatment is to do some exercise to reduce the discomfort of the leg muscles, a medical treatment is to give the patient levodopa, and if the syndrome is caused by a lack of iron in the body, iron supplementation is sufficient.
... Specifically, sleeping for 7-8 h has been associated with better diet quality (15), higher intake of protein, vegetables, and fruits, and lower total fat (16). Furthermore, high levels of physical activity can decrease the risk of developing MS (17) or alteration in its related parameters (18) and produce beneficial effects on night-time sleep (19). In addition to physical activity, a more active daily routine and an increment in daily activity levels have been associated with better sleep quality (20). ...
Impaired sleep and low daily activity levels increase the risk of developing metabolic syndrome (MS). Metformin (MET), an insulin sensitizer drug, is effective in regressing MS and has been recently studied as an adjuvant agent for managing sleep disorders. The present study aimed to assess whether 1,700 mg/day of MET treatment modifies sleep and daily activity levels in people with MS evaluated by Rest-Activity circadian Rhythm (RAR), which is the expression of 24 h of spontaneous activity parameters. A total of 133 subjects with MS, randomized into the MET (n = 65) or placebo (PLA, n = 68) group, underwent a clinical/anthropometric examination and carried out a continuous 7-day actigraphic monitoring to investigate sleep and RAR parameters at baseline and after 1 year of intervention. After 1 year of intervention, 105 subjects were analyzed. The MET group showed greater anthropometric and metabolic improvements compared with placebo, with a significant reduction in weight (p = 0.01), body mass index (p = 0.01), waist circumference (p = 0.03), and glucose (p < 0.001). With regard to sleep parameters, the MET group showed a significant increase in actual sleep time (p = 0.01) and sleep efficiency (p = 0.04) compared with placebo. There were no significant changes reported in the RAR parameters. Our study suggests that MET might be used as an adjuvant treatment for sleep disorders in people with MS.
... To our knowledge there are no studies that examine how body awareness is affected by physical exercise in adults with ADHD or whether there is a relationship between emotion regulation, self-efficacy and body awareness in adults with ADHD. There is moderately strong scientific evidence that physical exercise can affect sleep quality and fatigue, regardless of etiology, and that energy levels increase in individuals who are physically active [16,25]. However, there are no studies examining whether physical exercise improves sleep quality and perceived fatigue in adults with ADHD. ...
Background
Core symptoms in attention deficit hyperactivity disorder (ADHD) are inattention, impulsivity and hyperactivity. Many individuals with this disorder also have a sedentary lifestyle, co-morbid mental illness such as depressive and anxiety disorders, and reduced quality of life. People with ADHD often have impaired executive function, which among other things may include difficulty in time management and structuring of everyday life. Pharmacological treatment is often the first-line option, but non-pharmacological treatment is also available and is used in clinical settings. In children and adolescents with ADHD, physical exercise is used as a non-pharmacological treatment. However, the evidence for the effectiveness of exercise in adults is sparse.
Objective
To implement the START intervention (START = Stöd i Aktivitet, Rörelse och Träning [Support in activity, movement and exercise]) consisting of a 12-week, structured mixed exercise programme with or without a cognitive intervention, in adults with ADHD, and study whether it has an effect on core symptoms of ADHD as well as physical, cognitive, mental and everyday functioning compared with usual treatment. A secondary aim is to investigate the participants’ experiences of the intervention and its possible benefits, and to evaluate the cost-effectiveness of START compared with usual treatment.
Methods
This is a randomized controlled trial planned to be conducted in 120 adults with ADHD, aged 18–65. The intervention will be given as an add-on to standard care. Participants will be randomized to three groups. Group 1 will be given a physiotherapist-led mixed exercise programme for 12 weeks. Group 2 will receive the same intervention as group 1 with the addition of occupational therapist-led cognitive skills training. Group 3 will be the control group who will receive standard care only. The primary outcome will be reduction of ADHD symptoms measured using the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS-v1.1), Clinical Global Impression-Severity scale (CGI-S) and CGI-Improvement scale (CGI-I). The effect will be measured within 1 week after the end of the intervention and 6 and 12 months later.
Discussion
Data collection began in March 2021. The final 12-month follow-up is anticipated to be completed by autumn 2024.
Trial registration
ClinicalTrials.gov (Identifier: NCT05049239). Registered on 20 September 2021 (last verified: May 2021).
... Some epidemiological and experimental studies carry evidence that exercise has a sleep-promoting effect. Additionally, some herbs, such as chamomile, appear to be a relatively safe option for improving sleep quality in the short term [9,10]. Pharmacological interventions also play an essential role in the management of sleep disorders. ...
A negative attitude toward sleep has greatly affected sleep habits. In addition to contributing to physical and metabolic disorders, poor sleep quality may cause emotional disturbances. This study aimed to measure sleep behavior and factors contributing to poor sleep quality in the Madinah region, Saudi Arabia. We also assessed whether the use of sleeping aids improved peoples sleep. Three hundred and ninety-nine adults in the Madinah region of Saudi Arabia participated in this cross-sectional study. Three data domains were collected using an online questionnaire between 30 January and 26 April 2022. In the first domain, the characteristics of participants were discussed. In the second domain, questions about sleep behavior were asked. In the third domain, we examined the types, frequency, and impact of sleep aid use. Out of the 399 participants, 154 (38.59%) reported sleep problems. A total of 64.94% of the 154 participants blamed stress as the leading cause of their sleep disorders, and 74.68% of those with sleep problems reported reduced productivity. Among those who reported having sleep problems, 46.10% used sleep aids, with Panadol night (antihistamine) being the most used, 49.30%, followed by Melatonin at 39.44%. Sleep quality improved by 67.6% among those who used sleep aids. A total of 71.8% of the participants think it is not safe to use sleep aids in the long term. Our findings suggest that sleep problems are a prevalent concern in Madinah, Saudi Arabia, and even though the use of sleep aids improved sleep quality, it should be considered an emerging and important public health objective in Saudi Arabia. Further studies are needed to evaluate sleep quality and the level of sleep aid usage among other Saudi Arabian regions.
... (27) Por otra parte, diferentes estudios señalan que la actividad física y el ejercicio físico están asociados con un mejor sueño y menos alteraciones de este entre los adultos sanos, por lo cual el ejercicio resulta un medio saludable, seguro, económico y sencillo para mejorar el sueño. (28,29) Se ha afirmado que el ejercicio físico es una de las posibles alternativas no farmacológicas que tiene un impacto positivo para mejorar la calidad del sueño, el insomnio y la ansiedad. (30,31,32,33) Aunque el sueño y el ejercicio físico pueden parecer que están mediados por mecanismos fisiológicos completamente diferentes, existe una evidencia creciente de las relaciones importantes entre ambos. ...
Los trastornos del sueño tienen una gran prevalencia en las embarazadas
y se han correlacionado con un mayor riesgo de resultados adversos del embarazo. Debido a los efectos secundarios del tratamiento farmacológico para los citados trastornos, se ha planteado que el ejercicio físico pudiera mejorar el sueño de las gestantes y, por ende, los resultados de embarazo.El objetivo de este artículo fue realizar una revisión de la literatura para analizar los efectos del ejercicio físico sobre la calidad y duración del sueño de la embarazada, así como en el insomnio de la gestante.
Abstract
Sleep disorders are highly prevalent in pregnant women and have been correlated with an increased risk of adverse pregnancy outcomes. Due to the secondary effects of the pharmacological treatment for the aforementioned disorders, it has been proposed that physical exercise could improve the sleep of pregnant women and, therefore, pregnancy outcomes. The objective of this article was to review the literature to analyze the effects of physical exercise on the quality and duration of sleep in pregnant women, as well as on insomnia in pregnant women.
... Poor mood during pregnancy is also associated with compromised sleep quality [38,39]. In turn, poor sleep quality and depressed mood may hinder the physical activity patterns that have been shown to significantly reduce depressive symptomatology and improve sleep quality during pregnancy [40,41]. ...
Background
Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG.
Methods
Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 and Spring of 2021. Eligible pregnant women were randomized to either the MBMM + intervention or the control group. Each group met over Zoom for 16 sessions (twice weekly for 60 min over 8 weeks) to learn either behavioral change and wellbeing knowledge and skills (MBMM +) or knowledge and skills related to parenting (control group). Multiple methods of evaluation to better understand the feasibility of the intervention were conducted.
Results
A total of 49 women (25 MBMM + intervention, 24 control) completed both pre- and post-survey assessments and were included in the analyses. A subsample of 19 (39%) intervention participants completed a combination of semi-structured interviews/surveys to assess acceptability, demand, implementation, and practicality. Participants expressed positive feedback regarding acceptability (satisfaction and intent to continue use) and were extremely likely or likely to recommend the program to a friend (demand). Implementation metrics were assessed by observation and feedback forms completed by peer leaders and demonstrated high-quality control. Findings suggest that the intervention was practical due to remote sessions and cost-effectiveness.
Conclusion
The MBMM + intervention was deemed to be a feasible intervention with high acceptability, demand, implementation, and practicality. These findings can be used to inform the scalability of the intervention and implementation of a larger efficacy trial.
Trial registration
19–1366, initial date is on January 23, 2020.
... This relationship is illustrated by a district leader who, when asked about impacts of stress at home, shared that "lack of energy prevents working out." That said, the inverse may also be true as increased physical exercise can help with physical health issues like sleep (Youngstedt, 2005). ...
Purpose: The purpose of this mixed-methods research is to understand leader stressors, the impacts of stress, self-care strategies used to mitigate stress, and gender-related differences. Research Methods: School and district leaders in a suburban school district in the northeastern United States ( n = 33) completed a mixed-methods survey. Quantitative and qualitative data were analyzed separately. Data were compared and integrated, then interpreted to understand educational leaders’ experiences. Findings: Leaders reported high levels of role-related stress from external pressures, responsibilities related to managing others, interactions with families, and job-related concerns. Impacts of this stress were multifaceted and found to spill over to home. Female leaders were more likely to report stress from concern for the well-being of others and from interactions with teachers and staff. To mitigate effects of stress, leaders engaged in cognitive, emotional, occupational, spiritual, and physical self-care. Female leaders were more likely to report occupational self-care and social support seeking. Implications for Research and Practice: This research suggests that districts should invest in providing mentorship, professional learning communities, and professional development focused on well-being to support educational leaders. More research is needed on individual and school-level characteristics that may influence leader experiences of stress and engagement in self-care.
... Martínez et al. (2014) showed the usefulness of CBT-I in the multidisciplinary management of FM, in which women with insomnia after CBT-I showed greater improvements in several outcomes, such as sleep quality, pain intensity, general fatigue, and daily functioning, than another group with sleep hygiene. The recommendation for exercise is due to its ability to increase slow-wave sleep, which helps thermoregulation (Youngstedt, 2005), alters the circadian cycle and alters levels of neuropeptides and neurotransmitters in the brain that play important roles in sleep (Buman and King, 2010). Furthermore, exercise has shown to improve general health, symptoms of the disease and physical function (Busch et al., 2011) and in general, the recommendations are aimed at aerobic exercise and resistance training (RT) (Albuquerque et al., 2022;Macfarlane et al., 2017). ...
This study investigated the effects of resistance training (RT) on the sleep quality of patients with fibromyalgia (FM), through a systematic review. The search was carried out in the PubMed, Embase, Scopus, and Web of Science databases. Initially, 148 studies were found, of which six were included for qualitative analysis. Four studies showed significant improvement in sleep after RT. Compared to other exercise modalities, RT proved to be superior to flexibility training and equivalent to aerobic exercise. Interventions lasted from 4 to 21 weeks, the weekly frequency ranged from two to three times, and the intensity ranged from 40% to 80% 1RM, with exercises for the major muscle groups. RT is an intervention that can be used to treat FM, however, more studies are needed to verify its effectiveness in improving sleep.
... 22 Speculatively, reducing training loads (intensity, volume, and frequency) on the players could have reduced their sleep drive (ie, sleep pressure), potentially resulting in longer SOL and lower sleep quality. 33 Also, recent evidence suggests that maintaining training intensity (despite reducing training frequency and volume) could be protective against the loss of physiological and psychological adaptations associated with detraining. 10 Thus, in cases of limited access to training facilities, maintaining training intensity should be prioritized, at least to mitigate the lockdown-induced sleep disruption. ...
Background:
The effect of the 2020 COVID-19 lockdown on athlete sleep and training behavior is documented, albeit without a worldwide soccer-specific focus.
Method:
Soccer (football) players (N = 1639; 30 countries; age 22.5 [5.7] y; 81% ≤25 y; 56% male; 30% elite; 66% Muslim) answered a retrospective, cross-sectional questionnaire related to their behavioral habits before and during COVID-19 lockdown (survey period July to September 2020), including (1) Pittsburgh Sleep Quality Index PSQI, (2) Insomnia Severity Index (ISI), (3) bespoke questions about training behaviors, and (4) Muslim player focused sleep and training behavior questions.
Results:
During lockdown (compared to prelockdown), PSQI (P < .001; moderate effect size [ES]) and ISI (P < .001; moderate ES) scores were higher in the overall sample and in elite versus nonelite (PSQI: P < .05; small ES and ISI: P < .001; small ES), >25 years versus ≤25 years (PSQI: P < .01; small ES and ISI: P < .001; moderate ES), females versus males (PSQI: P < .001; small ES), <1 month versus >1 month lockdown (PSQI: P < .05; small ES and ISI: P < .05; small ES), and players maintaining versus reducing training intensity (PSQI: P < .001; moderate ES and ISI: P < .001; small ES). Muslim players (41%) reported unfavorable sleep and/or training behaviors during Ramadan in lockdown compared to lockdown outside of Ramadan.
Conclusions:
Specific subgroups appear more vulnerable to lockdown effects, with training-intensity maintenance moderating negative effects relative to sleep. Policy and support (respectful of subgroup nuances) during lockdown-like challenges that facilitate training (including intensity) appear prudent, given their favorable relationship with sleep, mental health, and physical health, in the present data and elsewhere.
... Penurunan ini dapat lebih mudah terjadi dengan olahraga. 66 Aktivitas fisik secara teratur (1 jam 3 kali seminggu) dapat menurunkan suhu tubuh yang lebih teratur dan meningkatkan kualitas tidur. 67,68 Meningkatnya kualitas tidur ini diikuti dengan menurunnya kejadian sindrom makan malam secara signifikan yang ditunjukkan dengan nilai p = 0,003 pada kelompok perlakuan dan tidak tergolong signifikan pada kelompok kontrol dengan nilai p = 0,301. ...
The prevalence of obesity is high in women aged 18 years which is 21.8 percent. Twenty-two-year-old female students are one of the populations at risk of poor sleep quality and night-eating syndrome. Regular aerobic exercise can have a positive effect on sleep quality followed by a reduction in night eating syndrome. This study aims to analyze the effect of aerobic exercise on sleep quality and dinner syndrome in obese female students. The study was a quasi-experimental design with a pre-post test control group design conducted on 22 subjects. Inclusion criteria were female students aged 19-24 years determined by consecutive sampling. Subjects were divided into 2 treatment and control groups. The treatment was given aerobic exercise intervention for 4 weeks. As well as obesity management education and balanced nutrition using leaflets for both groups. Sleep quality data using the Pittsburgh Sleep Quality Index and night eating syndrome using the Night Eating Questionnaire and food recall 3x24 hours. Statistical analysis using Independent T-Test, and Mann-Whitney test. There was a change before and after the aerobic exercise intervention in sleep quality (-1-(-3)) and night eating syndrome (-3-(-10)), treatment group (p0.001 and p=0.003). Meanwhile, the control group did not experience significant changes. Giving aerobic exercise for 4 weeks can improve sleep quality and reduce night eating syndrome significantly
Aim
The aim of this study was to examine the characteristics of habitual hypnotic users in Japan.
Methods
This nationwide, cross‐sectional survey used self‐administered questionnaires. Data were collected from four national surveys conducted every 2 years between 2015 and 2021. The participants were Japanese individuals who had taken prescription hypnotics in the past year or had never taken them. We divided 13,396 participants into three groups to compare the social background and status of taking medication and controlled drugs, drinking, and smoking among the three groups: people who use hypnotics habitually daily (habitual hypnotic users [HUs]), people who use them only occasionally (occasional hypnotic users [OUs]), and people who do not use them (hypnotic non‐users [NUs]). We compared the perception of using hypnotics between the HU and OU groups.
Results
HUs were more likely to be older, unemployed, and to habitually use anxiolytics and analgesics than NUs. The main reasons for taking anxiolytics in HUs were alleviating insomnia and reducing anxiety, whereas the main reason for taking analgesics was improving joint pain. Additionally, the HU group had a higher proportion of habitual smokers than the OU group. There was no difference in drinking status or taking of controlled drugs among the three groups. HUs were more likely to use hypnotics and to have concerns about their side‐effects than OUs.
Conclusion
HUs were more likely to be unemployed, habitually use anxiolytics and analgesics, smoke heavily, and take hypnotic drugs with concerns regarding side‐effects. These results may help encourage the appropriate use of hypnotics.
Introduction: During the sports training process, there is different training load orientation that can cause an increased need for sleep to athletes. Therefore, the goal of this study was to verify if the acute load of soccer training, in young athletes, carried out during a week of intensification are enough to modify the sleep pattern of young football players.
Materials and Methods: Fifteen young football players (age: 15.90 ± 0.63 years; body mass: 67.82 ± 6.34 kg; weight: 1.73 ± 0.08 m; body mass index: 22.62 ± 1.16) were evaluated during a two-week of training period with different workloads. External training load (ETL) measurements were performed using the PlayerLoad method, while the rating of perceived exertion (using the CR-10 scale) value was multiplied by the match duration to measure the internal training load (ITL) Sleep variables included total time in bed (TTB), total sleep time (TST), sleep latency (SL), wake after sleep onset (WASO), and sleep efficiency (SE), and all variables were assessed daily, using wrist actigraphy (GT3-X). The CET, ITL, and Sleep data were analyzed in a paired manner, comparing the data between corresponding days of each week. For example, the data from Monday of week 1 was compared with Monday of week 2, and so forth.
Results: Regarding ETL, significant differences were found on Mondays (p = 0.036), Wednesdays (p = 0.001), and Fridays (p = 0.018). There were significant differences in ITL were observed on Mondays (p = 0.003) and Wednesdays (p = 0.001), consistently with higher loads in the second week for both variables. In relation to sleep variables, there were significant differences in SE between Tuesdays (p = 0.002) and Thursdays (p = 0.046). Similar results were found for TST, with differences between Tuesdays (p = 0.034), with the increasement of 80 minutes, and Thursdays (p = 0.004), there was an increase of 86 minutes. The results showed a higher SE and TST in the second week of training, in subsequent days of training loads intensification.
Conclusions: Increase in the workload was sufficient to promote a bigger necessity to sleep, resulting in an increase of TST and SE in subsequent days of training intensification.
Acknowledgements: Federal University of Rio Grande do Norte
This chapter aims to explain the sleep-promoting effect of physical activity on the quality of sleep. It provides an overview of the effects of single or regular physical activity on sleep—of healthy individuals or even those with sleep disorders. Previous studies with individuals suffering from insomnia show good effects of regular physical activity on sleep. Physical activity also has a positive effect on other sleep disorders such as sleep-related breathing disorder (SBAS) and Restless Legs Syndrome (RLS), although there may not be direct influences. Training science offers differentiated knowledge about training methods and allows future studies to optimize the load norms (e.g., type of training, intensity, duration) for sports therapeutic interventions in the field of sleep medicine.
https://link.springer.com/chapter/10.1007/978-3-662-64615-1_4
INTRODUCTION: Young athletes are exposed to successive periods of changes in training loads, which can affect their sleep-related health and mood states. OBJECTIVE: To analyze the effect of different training load magnitudes on sleep patterns and mood states in young soccer players. METHODS: 13 young soccer players (15.93 ±0.59 years; 68.70 ±6.12 kg; 1.75 ±0.07 m; 22.30 ±0.97 kg/m²), were evaluated by 3 weeks of training during a pre-season. The external training load (ETL) was verified by the PlayerLoad method, while the internal training load (ITL) was determined by the Subjective Perceived Effort of session (sRPE) method. Pulse actigraphy was used to monitor sleep. Sleep variables, including time in bed (TIB), total sleep time (TST), sleep latency (SL), wake after sleep onset (WASO) and sleep efficiency (SE) were evaluated on every night. Mood state was assessed using the Brunel Mood Scale (BRUMS). Repeated measures ANOVA was used to verify the effect of time. Friedman's test was used for data that did not meet normality assumptions (sleep latency and mood states). Bonferroni's post-hoc was used to verify point differences. RESULTS: Week 2 showed higher ETL and ITL compared to weeks 1 and 3 (p < 0.001). There was a significant improvement in sleep during week 2 (TIB: +35 min, p = 0.044; TST: +46 min, p = 0.003; SL: -5 min, p = 0.001; SE: +3%, p = 0.019). There was no difference in the BRUMS scale component: tension (p = 0.378), depression (p = 0.311), anger (p = 0.148), vigor (p = 0.178), fatigue (p = 0.063) and confusion (p = 0.630 ) during the three weeks analyzed. CONCLUSION: During a microcycle with higher training loads there was no change in the mood state of athletes and possibly the longer total sleep time may, at least in part, explain this finding.
Keywords: Actigraphy; Physical training; workload; Football.
The prevalence of insomnia, characterized by persistent inability to fall asleep or maintain sleep, increases with age. The aim of this study was to investigate the effect of "green exercise" on improving the sleep quality of inactive female elderly in Arak city. Participants were 45 female elderly, aging over 60 years with poor sleep quality residing in Arak city who voluntarily participated in the research in 2 experiment and control groups. The experiment group participated in the exercise trainings for 10 weeks, 3 sessions per week, and each session 60 minutes. Data was collected using Pittsburgh Sleep Quality Inventory (PSQI) and analyzed by dependent and independent t-test with SPSS software (version 16), with significant level 0.05. Results showed that experimental group had significant increase in mean score of sleep quality of post-test than pre-test (p≤0.05).The experimental group had significant increase in overall sleep quality, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction scores than the control group (p≤0.05). However, there were no significant differences between the groups’ sleep disturbance and use of hypnotics mean scores. These results support the effect of green exercises on sleep quality of female elderly with sleep problems.
Objectives:
Only one-third of U.S. Army Soldiers meet the recommended sleep guideline of 7 or more hours per night. Soldiers meeting the recommended sleep guideline are more likely to perform better on cognitive and physical tasks. The purpose of this analysis was to compare the physical and behavioral characteristics of Soldiers who met and did not meet the sleep recommendation guideline and determine associations between physical and behavioral characteristics and the acquisition of recommended amounts of sleep per night.
Methods:
A survey was administered to U.S. Army Soldiers. Adjusted odds ratios and corresponding 95% confidence intervals were calculated to determine associations between achieving the recommended number of hours of sleep per night and age, physical characteristics, health behaviors, physical training, and physical performance.
Results:
A survey was completed by 4229 men and 969 women. Male Soldiers who met the recommended sleep requirement had lower estimated body fat [20.3 ± 4.2% vs. 21.1 ± 4.4%], were less likely to use tobacco [11.5% vs. 16.2%] and exercised more [259 ± 226 vs. 244 ± 224 min/wk] compared with those who did not obtain 7 hours of sleep per night. Female Soldiers who met the recommended sleep requirement had lower estimated body fat [31.4 ± 4% vs. 32.1 ± 4.6%] and exercised more [258 ± 206 vs. 241 ± 216 min/wk] compared with those who did not obtain 7 hours of sleep per night.
Conclusion:
Soldiers who choose to adopt healthy lifestyle characteristics may be more likely to meet the recommended sleep duration guideline.
Background:
Insomnia affects the daily activities of the sufferers and reduces attention and memory. Cognitive behavioral therapy is an expensive treatment and is not applicable to all patients, and long-term treatment with sleep medication can have side effects such as drug dependency. As an alternative form of non-pharmacological treatments, the effect of exercise therapy on improving the symptoms of insomnia is addressed in the current study.
Methods:
A total of 32 patients diagnosed with insomnia participated in the study, from which 16 received combined resistance-aerobic exercise therapy. The rest of the patients comprised the control group. The intervention group went through a 12-week intervention in the form of aerobic exercise for 3 days a week and resistance training for another 3 days a week. Patients' sleep quality was assessed by the Pittsburgh test before and after the intervention.
Results:
The results showed that combined aerobic-resistance exercise can improve sleep quality in patients with insomnia as well as increase subjective sleep quality and actual sleep duration, and decrease daytime dysfunction due to sleeping problems.
Conclusions:
This study shows that, along with other insomnia treatments, exercise can improve the sleep quality of patients.
Whether an exercise intervention has significant effects on improving the sleep quality in perimenopausal women is controversial. This review explores different ways of exercise interventions (intervention item, intervention period, intervention frequency, and intervention duration of each time) on the improvement of sleep in perimenopausal women. Based on the PICOS method, two researchers independently searched the PubMed database, Excerpta Medica database (EMBASE), Cochrane Library database, Web of Science (WoS) database, Chinese National Knowledge Infrastructure (CNKI) database, Wanfang database and VIP database, evaluated the literature quality using the Cochrane system evaluation manual, and performed a meta-analysis of the included literature. A total of 12 randomized controlled trials involving 1493 subjects were included in the study. Exercise intervention items included yoga, walking, fitness Qigong, and aerobic exercise. The meta-analysis showed that exercise could effectively improve sleep in perimenopausal women (SMD = -0.44, 95%CI (-0.66, -0.22), P < 0.00001), and had significant effects on the sleep quality and insomnia symptoms in perimenopausal women. Subgroup analysis showed that fitness Qigong with a period of 10 to 12 weeks, a frequency of more than 3 times a week, and a duration of each time of 30 to 60 min was the most effective in improving sleep.
Ferreira, ABdM, Ribeiro, BLL, Batista, EdS, Dantas, MP, and Mortatti, AL. The influence of different training load magnitudes on sleep pattern, perceived recovery, and stress tolerance in young soccer players. J Strength Cond Res 37(2): 351–357, 2023—The aim of this study was to analyze the influence of 3 weeks on sleep parameters, perceived recovery, and stress tolerance in young soccer players using different training load magnitudes. A total of 13 young male soccer athletes (15.9 ± 0.5 years; 68.7 ± 6.1 kg; 170 ± 7 cm) who performed 3 typical training weeks with different workloads were analyzed. The external training load (ETL) was verified by the PlayerLoad method, and the internal training load (ITL) was determined using the session rating of perceived exertion method. Sleep was monitored using a wrist-actigraphy monitor. Sleep variables, including total time in bed (TTB), total sleep time (TST), sleep latency (SL), wake after sleep onset (WASO), and sleep efficiency (SE), were evaluated across all nights of sleep. The recovery status was assessed with the perceived recovery status (PRS) scale, and the stress tolerance was monitored using the “daily analysis of life demands of athletes” questionnaire. There was an increase in sleep time during the week with the highest training load (week 2) (TTB: +35 minutes, TST: +46 minutes, SL: −5 minutes, SE: +3%). There was no difference in the PRS or in the stress tolerance during the evaluation weeks. A very large within-individual correlation was observed between ITL and ETL (r = 0.78) and moderate within-individual correlation between ETL and TST (r = 0.34), between ITL and TST (r = 0.45), and between ITL and SE (r = 0.359). These results showed that there was an increase in TST during a microcycle with intensified loads, without impairing bedtime and resulting in maintenance of the perceived recovery or stress tolerance values.
Objectives:
Shift workers routinely obtain inadequate sleep, which has major health and well-being consequences. Sleep hygiene describes a range of behaviors, lifestyle and environmental factors that can support optimal sleep. To date, limited research has examined sleep hygiene in shift workers. This study aimed to 1) assess the knowledge and understanding of sleep hygiene amongst shift working paramedics, as well as the perceived impact on sleep, and 2) investigate paramedics engagement with sleep hygiene practices.
Study design:
Participants completed an online, cross-sectional survey.
Participants:
Queensland Ambulance Service paramedics (n = 184) who work shift work.
Measures:
The online survey included questions from the Standard Shiftwork Index and Sleep Hygiene Index.
Results:
Most participants reported little or no understanding or knowledge of "sleep hygiene" as a concept. Participants reported that sleep scheduling and bedroom environment (temperature, light, and noise) were the most impactful on sleep. Few participants reported nicotine and alcohol consumption, or daytime napping, whereas caffeine consumption and mentally-stimulating bedtime activities were more common. Participants who were young, single, and worked all shift types (day, afternoon, and night) as part of their regular rosters, demonstrated less knowledge regarding sleep hygiene, and were more likely to be exhibiting poor sleep hygiene engagement.
Conclusions:
Paramedics demonstrated a limited level of understanding of sleep hygiene as a concept, and varied knowledge about the impacts of individual sleep hygiene factors. Further, paramedics demonstrated varied engagement with individual sleep hygiene practices. Future research should focus on the development of sleep hygiene interventions to optimize sleep in paramedics.
Hipertensi suatu kondisi dimana adanya peningkatan kontraksi pembuluh darah arteri dan peningkatan tekanan darah terhadap dinding pembuluh darah. Salah satu terapi non-farmakologi yang dapat memberikan pengaruh terhadap frekuensi denyut jantung, tekanan darah, relaksasi serta kualitas tidur adalah senam jantung sehat. Tujuan: Penelitian ini bertujuan mengetahui pengaruh senam jantung sehat, terhadap tekanan darah dan kualitas tidur warga gunung kupang dengan hipertensi. Metode: Desain penelitian ini menggunakan rancangan pre eksperimen dengan One Grup Pre-test Post-test. Sampel berjumlah 20 responden yang dipilih secara purposive sampling sesuai dengan kriteria inklusi yang telah ditentukan sebelumnya. Instrumen yang digunakan yaitu sphygmomanometer dan kuesioner Pittsburgh Sleep Quality Index (PSQI). Data dianalisis menggunakan Univariat dan Bivariat, Hasil: Hasil analisa data dengan uji Paired Sample t-Test menunjukan hasil nilai signifikansi 0,000 (p-value<0,05), yang artinya ada pengaruh senam jantung sehat terhadap penurunan tekanan darah dan peningkatan kualitas tidur pada lansia hipertensi, Kesimpulan: didapatkan hasil penelitian ini adalah ada pengaruh senam jantung sehat terhadap penurunan tekanan darah dan peningkatan kualitas tidur pada lansia hipertensi dan Saran: Berdasarkan hasil penelitian ini diharapkan senam jantung sehat dapat diterapkan baik pada layanan kesehatan tingkat pertama maupun dapat dilakukan di rumah secara rutin pada lansia yang terkena hipertensi.
The purpose of this paper is to present a selective overview of recent research concerning physical activity, anxiety disorders. Introductory information about anxiety and anxiety disorders is presented in the first section. Background information about neurobiology has been emphasized in the first section because of the recent growth in knowledge about neurobiology of anxiety, its potential heuristic value for learning about the extent to which physical activity influences anxiety, and the fact that psychobiology contructs such as anxiety ultimately reflect functioning of the brain. The second section reviews and attempts to integrate into the extant literature selected, recently published investigations concerning the influence of physical activity on anxiety and anxiety disorders. Major conclusions include: (1) that most of the research concerning physical activity and clinical anxiety disordres has involved patients with panic disorder; accordingly, it is recommended that future studies be conducted examining the effects of exercise training on other anxiety disorders such as generalized anxiety disorder, (2) that not all panic disorder patients phobically avoid physical activity; however, methodological weakness of this work lead to the recommendation that large scale studies with better methods be conducted to provide a conclusive answer as to whether individuals with panic disorder are more sedentary than normal, (3) that acute and chronic exercise is safe for panic disorder patients, (4) that exercise training is associated with a reduction of anxiety symptoms in patients with panic disorder, and (5) that when groups without a clinical anxiety disorder perform an acute exercise bout, post-exercise anxiety reductions are larger than usual if methods are used to minimize the problem of low pre-exercise anxiety scores.
We investigated the effect of a 12-week physical training programme on the sleep of nine unfit women. Data were collected at 0, 4, 8 and 12 weeks of the training programme. Changes in fitness were assessed by changes in maximal oxygen consumption (VO2max) and onset of blood lactate turn point (LTP). Lean body mass (LBM) was calculated from total body potassium measurements. The all-night sleep recordings were made following days during which the subjects carried out their normal daily routines and did no extra exercise. Although cardiorespiratory fitness improved significantly as indicated by an increase in both VO2max and LTP, there was no change in LBM. The improvement in cardiorespiratory fitness did not result in any changes in the sleep parameters measured. Other workers have reported an improvement in sleep quality in eight army recruits during their basic training. The male recruits showed improved cardiorespiratory fitness and an increase in muscle bulk. These results suggest that increased fitness only facilitates sleep when there is an associated increase in LBM. Alternatively it may be that the response of sleep to improved fitness is sex-linked.
We studied the sleep patterns of nine young women when sedentary (untrained) and following a 12 week physical fitness training programme. A comparison of baseline sleep patterns and of sleep patterns following one hour of submaximal exercise performed in the evening was carried out at 0 and 12 weeks. The submaximal exercise task was for each subject to cycle for one hour at 70% of her maximal oxygen consumption (VO2 max) as measured when untrained and on completion of the training programme respectively. Changes in fitness were assessed by changes in VO2 max and anaerobic threshold (AT). On the day leading to the all night baseline sleep recordings the subjects carried out their normal daily routines and did no specific exercise. Lean body mass (LBM) was calculated from total body potassium measurements before and after training. A significant improvement in cardiorespiratory fitness did not result in any changes in baseline sleep parameters. The response to the submaximal exercise was an increase in stage 2 NREM sleep and a decrease in slow-wave sleep (SWS, stages 3 & 4) which is possibly indicative of a stress effect. However, in the trained compared to the untrained state, SWS was significantly higher after an exercise load.
PHYSIOLOGICAL, PERSONALITY, AND EEG SLEEP PATTERNS OF 16 POOR-SLEEP GROUP (PSG) SS WERE COMPARED WITH 16 GOOD-SLEEP GROUP (GSG) SS. COMPARED WITH GOOD SLEEPERS, POOR SLEEPERS HAD LESS SLEEP TIME, A HIGHER PROPORTION OF STAGE 2 SLEEP, MARKEDLY LESS REM SLEEP DESPITE A SIMILAR NUMBER OF REM PERIODS, MORE AWAKENINGS, AND REQUIRED MORE TIME TO FALL ASLEEP. SIGNIFICANT PHYSIOLOGICAL DIFFERENCES BETWEEN THE GROUPS WERE OBSERVED DURING ALL STAGES OF SLEEP AND DURING A PRESLEEP PERIOD. PERSONALITY TEST RESULTS CLEARLY INDICATED A MUCH HIGHER PROBABILITY OF SYMPTOMATIC COMPLAINTS AMONG POOR SLEEPERS AS WELL AS A STRONG POTITIVE RELATIONSHIP BETWEEN DREAMING AND INDEXES OF PSYCHOPATHOLOGY. THIS STUDY DID NOT RESOLVE CAUSE AND EFFECT RELATIONSHIPS AMONG PHYSIOLOGICAL VARIABLES, PERSONALITY MEASURES, AMOUNT OF DREAMING, AND GOOD AND POOR SLEEP; HOWEVER, SIGNIFICANT EEG, PHYSIOLOGICAL, AND PSYCHOLOGICAL DIFFERENCES WERE DEMONSTRATED. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Eight physically trained subjects underwent three experimental conditions on separate occasions between 1400 and 1800 h. Two conditions acted as controls for a high-intensity exercise (HI) condition of treadmill running at 80% VO2 max for a total of 80 min. The rate of body heating was modelled in a no-exercise passive heating condition (PH), and the total exercise load was replicated in a low-intensity condition (LI) at 40% VO2 max for 160 min. LI produced no slow-wave sleep (SWS--stages 3 + 4 sleep) changes, but was the only condition to produce significant increases in sleep length and in non-rapid eye movement (REM) sleep (stages 1 + 2 + 3 + 4), and a significant decrease in sleep onset time. Although HI and PH produced similar SWS increases, these consisted of significant increases in stage 3 sleep for HI and in stage 4 sleep for PH. No REM sleep parameter was affected under any condition. Self-estimates of presleep tiredness produced no significant findings. It was concluded that a high and sustained rate of body heating for 1-2 h, particularly the inherent rapid rates of core temperature increase and of body dehydration, may trigger a SWS response, and that exercise may simply be a vehicle for these effects.
To determine whether exercise duration effects the recovery sleep following exercise, eight fit male endurance athletes, ages 23-42 yr, had their sleep electrophysiologically studied. This was done on four separate occasions: after a day on which no specific exercise was performed; after a day of a 15-km run; after a 42.2-km run day; after a day in which the athletes participated in a strenuous ultra-triathlon. Sleep patterns following the no exercise day and the 15-km and the 42.2-km run days were similar. The sleep pattern of the ultra-triathlon day when compared with the other three days showed significantly increased wakefulness and delayed and decreased rapid eye movement (REM) sleep. The duration of slow wave sleep (SWS) in the first 6 h after lights out, however, was no different. The increased wakefulness and decreased REM clearly indicate increased stress after the ultra-triathlon. REM sleep appears to be a more sensitive index of exercise induced stress than SWS.
The purpose of the present study was to evaluate sleep patterns and complaints, and Periodic Limb Movement (PLM) and the Restless Legs Syndrome (RLS) in subjects with complete spinal cord injury. Volunteers were submitted to two polysomnograms (Oxford Medilog SAC system--EEG, EMG, EOC): (1) basal night, when the volunteer arrived at the Sleep Center, and (2) after a maximal physical test (Cybex Met 300/increase of 12.5 watts/2 min until exhaustion). Eleven volunteers with complete spinal cord injury between T7-T12 were evaluated. Data were analyzed by the paired Student's test (total sleeping time) and by the Wilcoxon matched paired test (change of sleep states, number of awakenings during sleep, latency to REM sleep and leg movements--PLM + RLS). Comparison of sleep recordings from the night before with that from the night after (12 h) practice of physical activity, showed a significant reduction in all of the sleep parameters. The results indicate that physical activity improves the sleep patterns of spinal cord injured volunteers. In particular, we noticed that PLM and RLS after physical activity were inhibited during sleep.
To determine the effects of moderate-intensity exercise training on self-rated (subjective) sleep quality among healthy, sedentary older adults reporting moderate sleep complaints.
Randomized controlled trial of 16 weeks' duration.
General community.
Volunteer sample of 29 women and 14 men (of 67 eligible subjects) aged 50 to 76 years who were sedentary, free of cardiovascular disease, and reported moderate sleep complaints. No participant was withdrawn for adverse effects.
Randomized to 16 weeks of community-based, moderate-intensity exercise training or to a wait-listed control condition. Exercise consisted primarily of four 30- to 40-minute endurance training sessions (low-impact aerobics; brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate.
Pittsburgh Sleep Quality Index (PSQI).
Compared with controls (C), subjects in the exercise training condition (E) showed significant improvement in the PSQI global sleep score at 16 weeks (baseline and posttest values in mean [SD] for C=8.93 [3.1] and 8.8 [2.6]; baseline and posttest values for E=8.7 [3.0] and 5.4 [2.8]; mean posttest difference between conditions=3.4; P<.001; 95% confidence interval, 1.9-5.4), as well as in the sleep parameters of rated sleep quality, sleep-onset latency (baseline and posttest values for C=26.1 [20.0] and 23.8 [15.3]; for E=28.4 [20.2] and 14.6 [13.0]; net improvement=11.5 minutes), and sleep duration baseline and posttest scores for C=5.8 [1.1] and 6.0 [1.0]; for E=6.0 [1.1] and 6.8 [1.2]; net improvement=42 minutes) assessed via PSQI and sleep diaries (P=.05).
Older adults with moderate sleep complaints can improve self-rated sleep quality by initiating a regular moderate-intensity exercise program.
We used meta-analytic methods to examine the influence of acute exercise on sleep. Thirty-eight studies were reviewed yielding 211 effects on 401 subjects. Mean effect sizes were calculated for sleep onset latency (SOL), stage 2, slow-wave sleep (SWS), rapid eye movement (REM) sleep, REM latency (REM-L), total sleep time (TST), and wakefulness after sleep onset (WASO). Moderating influences of subject fitness, heat load, exercise duration, time of day, associated light environment (i.e. indoor or outdoor), sleep schedule, and the scientific quality of the studies were examined.
Effect sizes for SWS, REM, REM-L, and TST were moderate [0.18–0.52 standard deviation (SD)] and their associated 95% confidence intervals did not include zero. Exercise duration and time of day were the most consistent moderator variables. In contrast with previous hypotheses, heat load had little influence on sleep.
The results of our quantitative synthesis of the literature are inconsistent with previous narrative reviews (1,2) which suggested that exercise elicits larger changes in sleep than those quantified in this meta-analysis. A major delimitation of published studies on the effects of acute exercise has been an exclusive focus on good sleepers. Hence, the effects we report herein may be underestimates of the efficacy of exercise for enhancing sleep among people with sleep disturbances.
Relationships between changes in the slope of the body temperature (BT) and the initiation of sleep were examined in 44 subjects ranging from 19 to 82 years of age. Following an adaptation night, subjects remained in the laboratory for a baseline night and 72 hours in temporal and social isolation, with strictly limited behavioral options ("disentrainment") during which continuous electroencephalograph (EEG) and BT were recorded. Polysomnographic sleep variables (e.g. sleep onset, percentage of each sleep stage) were determined for nighttime sleep periods at baseline and during the disentrainment period. Periods of the BT curve surrounding these sleep bouts were examined for minute to minute changes, and the time at which the maximum rate of decline (MROD) in temperature occurred was compared with the time of sleep onset (SO) and sleep quality parameters. On the baseline night, the MROD occurred, on average, 60 minutes prior to SO. During disentrainment, the MROD occurred, on average, 44 minutes prior to SO. The proximity of MROD to SO did not affect subsequent sleep quality on the baseline night, but during disentrainment, there were significant correlations between the interval from MROD to sleep onset and the amount of slow-wave sleep (SWS) obtained during the sleep bout. There were no significant age differences on variables related to MROD on baseline night, but the timing of both MROD and SO were significantly advanced in older, relative to younger, subjects during the disentrainment period. It is suggested that a rapid decline in core body temperature increases the likelihood of sleep initiation and may facilitate an entry into the deeper stages of sleep.
This article reports the development of the functional outcomes of sleep questionnaire (FOSQ). This is the first self-report measure designed to assess the impact of disorders of excessive sleepiness (DOES) on multiple activities of everyday living. Three samples were used in the development and psychometric analyses of the FOSQ: Sample 1 (n = 153) consisted of individuals seeking medical attention for a sleep problem and persons of similar age and gender having no sleep disorder; samples 2 (n = 24) and 3 (n = 51) were composed of patients from two medical centers diagnosed with obstructive sleep apnea (OSA). Factor analysis of the FOSQ yielded five factors: activity level, vigilance, intimacy and sexual relationships, general productivity, and social outcome. Internal reliability was excellent for both the subscales (alpha = 0.86 to alpha = 0.91) and the total scale (alpha = 0.95). Test-retest reliability of the FOSQ yielded coefficients ranging from r = 0.81 to r = 0.90 for the five subscales and r = 0.90 for the total measure. The FOSQ successfully discriminated between normal subjects and those seeking medical attention for a sleep problem (T157 = -5.88, p = 0.0001). This psychometric evaluation of the FOSQ demonstrated parameters acceptable for its application in research and in clinical practice to measure functional status outcomes for persons with DOES. Thus, the FOSQ can be used to determine how disorders of excessive sleepiness affect patients' abilities to conduct normal activities and the extent to which these abilities are improved by effective treatment of DOES.
Decreased levels of physical and social activity associated with aging can be particularly pronounced in residents of assisted living facilities. Reduced exposure to important behavioral and time-giving cues may contribute to the age-related changes in circadian rhythmicity and sleep. The present study was conducted to test the hypothesis that an enforced schedule of structured social and physical activity (0:900 to 10:30 and 19:00 to 20:30 daily for two weeks) can have beneficial effects on circadian rhythmicity, nocturnal sleep, daytime functioning, mood, and vigor. The subjects were 14 elderly residents of continued-care retirement facilities while a similar group of 9 elderly residents served as controls. The group exposed to structured activities had increased amounts of slow-wave sleep and demonstrated improvement in memory-oriented tasks following the intervention. Conversely, no significant changes were noted in the amplitude and phase of the body temperature rhythm or in subjective measures of vigor and mood. These results indicate that short-term exposure to structured social intervention and light physical activity can significantly improve memory performance and enhance slow-wave sleep in older adults without alterations to the circadian phase or amplitude of body temperature. This is the first report to demonstrate that low intensity activity in an elderly population can increase deep sleep and improve memory functioning. The high degree of interest in these activities paired with the simple nature of the tasks makes this a potentially practical intervention which can be adapted for both community dwelling and assisted-living elders.
The study examined the prevalence and correlates of insomnia in a representative sample (n=3030) from the general population of Japan. Using a structured questionnaire, we found that the overall prevalence of insomnia during the preceding month was 21.4%, including difficulty initiating sleep (DIS: 8.3%), difficulty maintaining sleep (DMS: 15.0%), and early morning awakening (EMA: 8.0%). Multiple logistic regression analysis showed that older age, being unemployed, lack of habitual exercise, poor perceived health, psychological stress, and being unable to cope with stress were associated with an increased prevalence of insomnia. These findings indicate that the prevalence of insomnia in the general population of Japan is comparable to that reported in Western countries, and that insomnia is associated with multiple psychosocial factors.
It has recently been shown that physiological arousal following walking increased sleep latencies during daytime naps as compared to sleep latencies following TV viewing. Patients with insomnia have been shown to have increased physiological arousal and to also have longer MSLT latencies. It was hypothesized that insomnia patients, who are at a higher state of physiological arousal, would be unable to relax while lying in bed and watching TV and therefore would have relatively longer sleep latencies in naps following TV watching (due to inability to relax) as compared to walking.
Twelve patients with psychophysiological insomnia took Multiple Sleep Latency Tests after either watching television for 15 minutes or after a 5-minute walk following baseline, sleep deprivation, and recovery sleep conditions.
Sleep Laboratory
Twelve patients with psychophysiological insomnia
Manipulation of state arousal and sleep deprivation
Sleep latencies were significantly longer following the walk as compared to watching TV (11.9 vs. 6.9 min. respectively). Sleep latencies were 13.4 and 3.8 min. following baseline and sleep deprivation conditions. Heart period, used as a measure of physiological arousal, was significantly elevated throughout naps following the walk as compared to naps following TV viewing. Heart period was also significantly correlated with nap sleep latency.
The insomnia patients in this study had significantly increased arousal, as measured by heart rate, and significantly longer sleep latencies after walking as compared to resting. The magnitude of these changes was similar to that seen in normal subjects in a previous study. These data, in concert with previous work, support the contention that measured sleep tendency is a combination of sleep drive and level of central nervous system arousal, where arousal has both state and trait components.
The neurobiological mechanisms of both sleep and circadian regulation have been unraveled partly in the last decades. A network of brain structures, rather than a single locus, is involved in arousal state regulation, whereas the suprachiasmatic nucleus (SCN) has been recognized as a key structure for the regulation of circadian rhythms. Although most models of sleep regulation include a circadian component, the actual mechanism by which the circadian timing system promotes--in addition to homeostatic pressure--transitions between sleep and wakefulness remains to be elucidated. Little more can be stated presently than a probable involvement of neuronal projections and neurohumoral factors originating in the SCN. This paper reviews the relation among body temperature, arousal state, and the circadian timing system and proposes that the circadian temperature rhythm provides an additional signaling pathway for the circadian modulation of sleep and wakefulness. A review of the literature shows that increased brain temperature is associated with a type of neuronal activation typical of sleep in some structures (hypothalamus, basal forebrain), but typical of wakefulness in others (midbrain reticular formation, thalamus). Not only local temperature, but also skin temperature are related to the activation type in these structures. Warming of the skin is associated with an activation type typical of sleep in the midbrain reticular formation, hypothalamus, and cerebral cortex (CC). The decreasing part of the circadian rhythm in core temperature is mainly determined by heat loss from the skin of the extremities, which is associated with strongly increased skin temperature. As such, alterations in core and skin temperature over the day could modulate the neuronal activation state or "preparedness for sleep" in arousal-related brain structures. Body temperature may thus provide a third signaling pathway, in addition to synaptic and neurohumoral pathways, for the circadian modulation of sleep. A proposed model for the effects of body temperature on sleep appears to fit the available data better than previous hypotheses on the relation between temperature and sleep. Moreover, when the effects of age-related thermoregulatory alterations are introduced into the model, it provides an adequate description of age-related changes in sleep, including shallow sleep and awakening closer to the nocturnal core temperature minimum. Finally, the model indicates that appropriately timed direct (passive heating) or indirect (bright light, melatonin, physical activity) manipulation of the nocturnal profile of skin and core temperature may be beneficial to disturbed sleep in the elderly. Although such procedures could be viewed by researchers as merely masking a marker for the endogenous rhythm, they may in fact be crucial for sleep improvement in elderly subjects.
To examine the relationship between lifestyle, health status factors and sleep loss.
A cross-sectional questionnaire survey conducted by the Ministry of Health and Welfare, Japan.
N/A. PATIENTS or
Approximately 30,000 subjects selected from the general population in Japan.
N/A. MEASUREMENTS and
This study indicated that approximately 28% of the general population sleep less than 6 hours nightly and approximately 65% sleep less than 7 hours. However, approximately 80% of the population reported getting sufficient sleep. Multiple logistic regression analysis showed that being females, being of younger age, living in an urban environment, being unemployed, and having an unhealthy lifestyle (i.e., lack of exercise, poor health status, and irregular eating habits) were associated with sleep loss.
In this study, sleep loss was found to be associated with having an unhealthy lifestyle and being in poor general health. These findings suggest that health education and promotion of a healthy lifestyle should be advocated.
Previous work has shown that low levels of illumination in the natural environment are significantly associated with sleep disturbance and depression l,2. Moreover, there is compelling experimental evidence for antidepressant3’4 and sleep-promoting effects of bright light 5.
Evidence obtained from anecdotal reports, clinical observations, epidemiological research and prospective studies suggests that physical activity may reduce an individual's risk for developing depression and may alleviate symptoms in persons with mild to moderate depression. However, many studies examining the antidepressant effects of exercise exhibit methodological limitations that prevent an adequate understanding of the relationship between physical activity and depression. Additional research is needed to better determine the role of physical activity in the prevention and/or treatment of depression so appropriate physical activity guidelines can be developed to promote mental as well as physical health. Thus, the purpose of this paper is to provide an overview of the research examining physical activity and depression, discuss potential mechanisms for an antidepressant effect of exercise, identify limitations in prior research, provide suggestions for future research, and offer recommendations for exercise prescription in depressed populations.
Objective.
—To determine the effects of moderate-intensity exercise training on self-rated (subjective) sleep quality among healthy, sedentary older adults reporting moderate sleep complaints.Design.
—Randomized controlled trial of 16 weeks' duration.Setting.
—General community.Participants.
—Volunteer sample of 29 women and 14 men (of 67 eligible subjects) aged 50 to 76 years who were sedentary, free of cardiovascular disease, and reported moderate sleep complaints. No participant was withdrawn for adverse effects.Intervention.
—Randomized to 16 weeks of community-based, moderate-intensity exercise training or to a wait-listed control condition. Exercise consisted primarily of four 30- to 40-minute endurance training sessions (low-impact aerobics; brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate.Main Outcome Measure.
—Pittsburgh Sleep Quality Index (PSQI).Results.
—Compared with controls (C), subjects in the exercise training condition (E) showed significant improvement in the PSQI global sleep score at 16 weeks (baseline and posttest values in mean [SD] for C=8.93 [3.1] and 8.8 [2.6]; baseline and posttest values for E=8.7 [3.0] and 5.4 [2.8]; mean posttest difference between conditions=3.4; P<.001; 95% confidence interval, 1.9-5.4), as well as in the sleep parameters of rated sleep quality, sleep-onset latency (baseline and posttest values for C=26.1 [20.0] and 23.8 [15.3]; for E=28.4 [20.2] and 14.6 [13.0]; net improvement=11.5 minutes), and sleep duration baseline and posttest scores for C=5.8 [1.1] and 6.0 [1.0]; for E=6.0 [1.1] and 6.8 [1.2]; net improvement=42 minutes) assessed via PSQI and sleep diaries (P=.05).Conclusions.
—Older adults with moderate sleep complaints can improve selfrated sleep quality by initiating a regular moderate-intensity exercise program.
Background:
Due to a variety of potential problems with long-term hypnotic use, patients and treating physicians often try to avoid drugs in the treatment of psychophysiologic insomnia and to use nondrug treatment strategies, but these treatments must bring relief within a limited amount of time to be acceptable to patients.Method:
Thirty patients participated in the study. All had, for a minimum of 6 months, the complaint of less than 6 hours total sleep time per night in conjunction with either: (1) spending more than 30 minutes in bed before falling asleep, or (2) awakening during the night within 2 hours of sleep onset with difficulty returning to sleep. All subjects had the associated complaint of daytime impairment and none had used hypnotics for at least 3 months. Patients were randomly assigned to three parallel treatment groups: structured sleep hygiene, structured sleep hygiene with late afternoon moderate exercise, and structured sleep hygiene with early morning light therapy. Patients responded to questionnaires and filled out sleep logs. In addition, they underwent clinical evaluation, structured interviews, nocturnal monitoring, and actigraphy. The analyzed variables before and at the end of treatment were those derived from sleep logs and actigraphy.Results:
All subjects showed a trend toward improvement, independent of the treatment received, but only the "structured sleep hygiene with light treatment" showed statistically significant improvement at the end of the trial.Conclusions:
Patients with chronic psychophysiologic insomnia may benefit from a nondrug treatment approach. Light therapy appears particularly promising.(Arch Intern Med. 1995;155:838-844)
The purpose of this study was to examine the influence of vigorous acute exercise on nocturnal sleep that had been disrupted by high doses (1200 mg) of caffeine throughout the daytime. Eight moderately fit, young males with a history of moderate caffeine use completed four conditions in a within-subjects, counterbalanced design: 60 min of (i) cycling at 60% V̇O2peak or (ii) quiet rest following placebo consumption, (iii) cycling, or (iv) quiet rest following the consumption of a high dose of caffeine. Each condition was performed twice from 1615–1715 h and followed by all-night polysomnographic recording. Subjects consumed two blinded 200-mg capsules of either lactose placebo or caffeine upon awakening, at 1600 h, and 2 h before bedtime. State anxiety was assessed at bedtime. Criterion scores consisted of the mean data across the two days in each condition. Sleep data were analyzed using a condition (exercise versus quiet rest) by drug (caffeine versus placebo) repeated-measures ANOVA. Caffeine-elicited sleep disturbance that was less than previously reported. Exercise attenuated selected sleep disturbances to a small degree. In general, the effects of exercise on sleep were not greater following caffeine compared to placebo. Indeed, increases in slow-wave sleep after exercise were approximately 1/3 smaller following caffeine treatment compared to placebo.
O’Connor, P. J., M. J. Breus, and S. D. Youngstedt. Exercise-induced Increase in Core Temperature Does Not Disrupt a Behavioral Measure of Sleep. PHYSIOL BEHAV 64(3) 213–217, 1998.—On separate nights 90 to 30 min before typical bedtime, eight physically active men completed three conditions: seated rest, low-intensity and moderate-intensity cycle exercise. Low-and moderate-intensity exercise had no significant effect on sleep onset latency, the number of awakenings, total sleep time or sleep efficiency as measured by the Sleep Assessment Device. Mean core body temperature was higher during sleep after moderate intensity (36.80 ± 0.02°C) exercise compared to both the low-intensity exercise (36.67 ± 0.02°C) and rest (36.51 ± 0.02°C) conditions. It is concluded that a 1-h bout of moderate-intensity exercise performed shortly before bed elevates core body temperature before and during sleep; however, this elevated temperature does not disrupt behavioral measures of sleep obtained in the home environment in physically active male college students who were somewhat sleep deprived.
The purpose of this epidemiological survey (N = 1600) was to describe the factors which middle-aged urban people in Finland perceived as promoting or disturbing sleep. The response rate was 75%. The results suggested that quality of sleep is determined by numerous factors; social and psychological factors, health status, external sleeping conditions, life style and living habits. Every third respondent felt that exercise had a positive impact on sleep. Second in importance were reading and listening to music. Furthermore, sauna, shower and bath, stability in life, psychological factors, positive experience in work, satisfactory sexual life and good and quiet sleeping environment were reported to have positive effects on sleep. Men considered work-related pressure and fatigue (20%) as the most important factor disturbing falling asleep or quality of sleep. In women's ranking work problems appeared no sooner than in the third place. Women reported worries, interpersonal problems, and marital and family discord as the most disturbing factors to sleep (37%). Coffee in the evening had a negative effect on falling asleep. Although a 'nightcap' was considered to improve relaxation on falling sleep, men ranked alcohol as the fourth disturbing factor. Other disturbing factors were stress, irregularities in everyday life because of social events, travelling or atypical catnaps. Eating and exercising too heavily or too late in the evening were found to disturb sleep. On the other hand, temporary lack of exercise seemed to impair the quality of sleep. As external factors disturbing sleep the subjects considered noise light, too high room temperature, tight clothing, unfamiliar sleeping environment and restless children.(ABSTRACT TRUNCATED AT 250 WORDS)
Current evidence supports a hypothesis that slow-wave sleep (SWS) in mammals and birds is controlled by thermoregulatory mechanisms, and provides brain and body cooling as a primary homeostatic feedback process. Recent work has identified a medial preoptic area anterior hypothalamic and basal forebrain neuronal network which integrates thermoregulatory and hypnogenic controls. This network induces EEG and behavioral deactivation, in part, through suppression of the reticular activating system. Studies have shown that SWS, like other heat loss processes, is facilitated when brain temperature exceeds a threshold level. This threshold is hypothesized to be determined by responses of POAH thermosensitive neurons and to be regulated by both circadian and homeostatic processes. Many known chemomodulators of SWS appear to act on this hypnogenic thermoregulatory system. At a functional level, SWS-induced brain and body cooling would provide several adaptations including lower energy utilization, reduced cerebral metabolism, protection of the brain against the sustained high temperatures of wakefulness, facilitation of immune defense processes and regulation of the timing of behavioral activity relative to the circadian light-dark cycle. This concept provides a comprehensive model for analysis of sleep homeostasis.
Appropriately timed exercise can phase shift the circadian rhythms of rodents. The purpose of this study was to determine whether exercise during the night shift could phase delay the temperature rhythm of humans to align with a daytime sleep schedule. Exercise subjects (N = 8) rode a stationary cycle ergometer for 15 min every h during the first 3 of 8 consecutive night shifts, whereas control subjects (N = 8) remained sedentary. All subjects wore dark welder's goggles when outside after the night shift until bedtime, and then slept in dark bedrooms. Sleep was delayed 9 h from baseline. Rectal temperature was continuously measured. There were fewer evening-types and more morning-types in the exercise group than in the control group, which should have made phase delay shifts more difficult for the exercise group. Nevertheless, a majority of the exercise subjects (63%) had large temperature rhythm phase delay shifts (> 6 h in the last 4 days relative to baseline), whereas only 38% of the control subjects had large shifts. An ANCOVA showed that, when morningness-eveningness was accounted for (as the covariate), the exercise group had a significantly larger temperature rhythm phase shift than the control group. As expected, there was a correlation between the temperature rhythm phase shift and morningness-eveningness in the control group, with greater eveningness resulting in larger phase shifts. However, there was no such relationship in the exercise group; exercise facilitated temperature rhythm phase shifts regardless of circadian type. These results suggest that exercise might be used to promote circadian adaptation to night shift work.
Three-hour pulses of novelty-induced wheel running in the early to middle subjective day of golden hamsters produced phase advances of 2-3 hr. This phase shifting could be almost totally abolished by a light pulse following within 3 hr of the exercise pulse. When light pulses occurred about 8 hr after the exercise pulses, the phase-advancing effects of the latter were enhanced. Consideration of the amplitude of the phase response curve (PRC) for light pulses alone, in the test paradigms used here, showed that nonphotic and photic phase shifts did not combine additively. Antagonistic and synergistic interactions between photic and nonphotic shifts may have to be taken into account if it transpires that exercise in people can be used to assist adjustment to new schedules after crossing time zones, or in shiftwork.
In earlier work REM sleep deprivation (RSD) by arousals improved endogenous depression. This suggested that drugs producing a similar RSD would have antidepressant activity. The arousal RSD was large, persisted for weeks, and was followed by a REM rebound. We call RSD with these properties arousal-type RSD. The present study reviewed literature from 1962 to 1989 on drug REM sleep effects to examine the hypothesis that drugs producing arousal-type RSD improve endogenous depression. The literature reviewed concerned the REM sleep effects of amine precursors, antidepressants, antihistamines, antipsychotics, barbiturates, benzodiazepines, other hypnotics, drugs affecting cholinergic and noradrenergic neurotransmission, ethanol, lithium and narcotics. Four hundred and sixty-eight relevant papers were read and 215 contributed information that could be used in the review. The findings indicated that all drugs producing arousal-type RSD improved endogenous depression. Four drugs that improved endogenous depression did not produce arousal-type RSD.
The aim of the study was to help clarify the equivocal findings with slow wave sleep (SWS) stages 3 and 4, following running in physically trained individuals. Six females (22-24 years) ran at 75% of their VO2max for 2 X 40 min periods on two separate occasions, 14.30-17.30 h: once under hot conditions, causing a rectal temperature (Tr) increase averaging 2.3 degrees C, and once with additional cooling, reducing the Tr rise to an average of 1.0 degree C. Compared with baseline nights, no significant sleep effects were found on the cool run. However, after the hot run, SWS, particularly stage 4 sleep, showed significant increases, and REM sleep was decreased. It was concluded that body heating effects during running may play a key role in SWS changes, and that additional cooling seems to eliminate any potential SWS increase.
It has recently been proposed that alterations in central dopamine (DA) functional activity may, in part, account for certain behavioral changes observed in seasonal affective disorder (SAD) during the winter. To explore this possibility, a preliminary study of thermoregulatory heat loss to an endogenous heat challenge--a strongly DA-dependent process--was undertaken in groups of four SAD woman and four nonpsychiatric control women across three conditions (winter, after successful phototherapy, and summer). Homeostatic heat loss during recovery from heat challenge in SAD, but not in control, subjects was found to be a significant function of light condition and of clinical state. Thermoregulatory heat loss in SAD subjects was significantly blunted in winter during depression, was similar in efficiency to control subjects after a successful antidepressant response to phototherapy, and tended to be more efficient than controls in summer during a euthymic state. Results raise the possibility that a common effect of phototherapy and summer light conditions is a facilitation of central DA activity in SAD.
Comparative studies of energy metabolism, thermoregulation and sleep indicate that down-regulation of hypothalamic thermosensitivity and metabolic rate is initiated at sleep onset and extended as animals enter circadian torpor or shallow hibernation, which are characterised by predominant patterns of electrophysiological slow wave sleep (SWS). Body weight, hibernation and euthermic sleep propensity are all endogenous circannual rhythms. Circadian torpor is also an endogenous rhythm, during which body temperature (Tb) and metabolic rate (MR) in small-to-medium sized birds are regulated at levels proportional to preceding diurnal energy reserves. In large birds total sleep and SWS increase during fasting without change in Tb or MR. In humans SWS is also increased by fasting and raised brain temperature (as indexed by tympanic temperature). The increased propensity for SWS with elevation of Tb, the reduction in MR and Tb during SWS, and the thermoregulatory and electrophysiological continuities between SWS, circadian torpor and hibernation are consistent with energy conservation theories of SWS function, and with the hypothesis that the induction of sleep by moderate peripheral and central heating is an active homeothermic response preventing hyperthermia (Obal, 1984). Therefore, changes in thermal and energy balance should be taken into consideration in studies of sleep and exercise.
Previous studies have found enhanced delta sleep following body heating. This study assessed the influence of body heating as a function of its proximity to sleep. Electroencephalogram (EEG) sleep patterns were compared following body heating (1 h immersion in water at 41 degrees C) at each of four times of day: morning (MO), afternoon (AF), early evening (EE), and late evening (LE), ending just prior to sleep. A delta filter/integrator system provided objective measures of delta content. Relative to baseline nights, whole-night delta sleep was increased by the two evening heating sessions only, particularly LE heating. Following LE, the increased delta occurred primarily in the first sleep cycle, whereas EE heating elicited increased delta distributed across the later sleep cycles (cycles 2-4). Effects on manually staged indices of slow wave sleep (SWS) were confined to increases in Stage 4 in the first sleep cycle following LE heating. Heating just prior to sleep also resulted in a substantial reduction in the duration of the first rapid eye movement sleep period. Sleep onset time was reduced by heating, particularly EE heating. The results indicate that body heating induces temporary changes that affect sleep propensity and both the quantity and temporal distribution of delta activity in the sleep EEG.
The temperature rhythms of 9 drug-free patients with primary affective disorder were measured during depression and after recovery and compared with those of 12 normal controls. The patients had higher nocturnal temperatures and decreased 24-hour amplitudes when depressed than when they had recovered and compared to the controls. There was no evidence that the temperature minimum occurred earlier in the night in depression compared to controls. However, in 4 of 7 patients the temperature minimum occurred earlier in the night during depression compared to recovery.
Restoration or repair must, like growth, depend on protein synthesis. This chapter presents evidence to support this proposition from nearly 60 reports showing that rates of protein synthesis or of mitotic division are higher at the time of rest and sleep. In addition, the chapter presents a theory, based on fundamental principles, to explain why this should be so. Oscillations about a mean are inherent in any system subject to feedback control, and this is true of all living systems. In the simplest organisms there are oscillations between food-engulfing activity on the one hand and inactivity with assimilation on the other. There will also be oscillations between a state in which degradative chemical processes are accelerated and one in which synthetic processes are enhanced. It is proposed in this chapter that it is the differing energy demands of the activity/inactivity rhythm that chiefly determine the degradative/synthetic rhythm, such that the synthetic period inevitably coincides with the inactive or rest period, and that this is equally true in higher organisms in which a central nervous system ensures rest's integrity through positive unresponsiveness during sleep, and that such relationships, present throughout the animal kingdom, rely upon a fundamental metabolic co-coordinator, the “cellular energy charge”. The energy charge is a measure of the available free energy in the form of adenosine triphosphate (ATP).
Due to a variety of potential problems with long-term hypnotic use, patients and treating physicians often try to avoid drugs in the treatment of psychophysiologic insomnia and to use nondrug treatment strategies, but these treatments must bring relief within a limited amount of time to be acceptable to patients.
Thirty patients participated in the study. All had, for a minimum of 6 months, the complaint of less than 6 hours total sleep time per night in conjunction with either: (1) spending more than 30 minutes in bed before falling asleep, or (2) awakening during the night within 2 hours of sleep onset with difficulty returning to sleep. All subjects had the associated complaint of daytime impairment and none had used hypnotics for at least 3 months. Patients were randomly assigned to three parallel treatment groups: structured sleep hygiene, structured sleep hygiene with late afternoon moderate exercise, and structured sleep hygiene with early morning light therapy. Patients responded to questionnaires and filled out sleep logs. In addition, they underwent clinical evaluation, structured interviews, nocturnal monitoring, and actigraphy. The analyzed variables before and at the end of treatment were those derived from sleep logs and actigraphy.
All subjects showed a trend toward improvement, independent of the treatment received, but only the "structured sleep hygiene with light treatment" showed statistically significant improvement at the end of the trial.
Patients with chronic psychophysiologic insomnia may benefit from a nondrug treatment approach. Light therapy appears particularly promising.
To determine whether a single episode of physical activity is capable of inducing rapid phase shifts in human circadian rhythms, 17 subjects were studied two times under constant routine conditions, once in the absence of stimulus and once with a 3-h nighttime pulse of exercise interrupting the constant routine conditions. The profiles of plasma cortisol, thyrotropin (TSH), and melatonin and of body temperature were monitored continuously to derive estimations of circadian phase position. The phase shifts were measured on the 1st day after exercise exposure. The timing of the exercise period ranged from -5 h to +4 h around the time of the minimum body temperature rhythm. Nighttime exercise was associated with 1- to 2-h phase delays of both the melatonin and TSH rhythms, with the size of the delays tending to be smaller when the exercise was presented in the latter part of the nighttime period and in the early morning. These data demonstrate that nonphotic stimuli may exert phase-shifting effects on the human circadian pacemaker.
Some of the main themes in this review are as follows. 1. The notion that non-photic zeitgebers are weak needs re-examining. Phase-shifts to some non-photic manipulations can be as large as those to light pulses. 2. As well as being able to phase-shift and entrain free-running rhythms, non-photic events have a number of other effects: these include after-effects of entrainment, period changes, and promotion of splitting. 3. The critical variable for non-photic shifting is unknown. Locomotor activity is more likely to be an index of some other necessary state rather than being causal itself. This index may be better when tendencies to move are channelled into easily measured behaviours like wheel-running. 4. Given ignorance about the critical variable, quantification of activity may be the best presently available measure of zeitgeber intensity. Therefore, the behaviour during non-photic manipulations must be examined as carefully as the shifts themselves. When no phase-shifting follows manipulations such as IGL lesions or serotonin depletion, if the animals are inactive, then little can be inferred. 5. Lack of information on the critical variable(s) for non-photic shifting makes it problematic to compare data from studies using different non-photic manipulations. However, the presence of locomotor activity (or its correlate) does appear to be necessary for triazolam to produce shifts. 6. Novelty-induced wheel-running in hamsters depends on the NPY projection from the IGL to SCN. It remains to be determined how important NPY is in other species or in clock-resetting by other manipulations, but methods are now available to study this. 7. Interactions between photic and non-photic zeitgebers remain virtually unexplored, but it is evident that photic and non-photic stimuli can attenuate the phase-shifting effects of each other. Interactions are not purely additive or predictable from PRCs. 8. The circadian system does more than synchronize free-running rhythms to the solar day. Its non-photic functions and their interactions with photic inputs probably account for some of the anatomical complexity of circadian circuitry.