Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations

J Am Geriatr Soc. 2015 Jul;63(7):1381-90. doi: 10.1111/jgs.13509. Epub 2015 Jun 26.

Abstract

Objectives: To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations.

Design: Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30 months.

Setting: Lifestyle Interventions and Independence for Elders Study.

Participants: Community-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N = 1,635).

Measurements: Sleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30 months.

Results: The randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5 = 0.80, 95% confidence interval (CI) = 0.68-0.94), including fewer new cases (aOR for PSQI >5 = 0.70, 95% CI = 0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI ≤5 = 1.13, 95% CI = 0.90-1.43). No significant intervention effects were observed for the ISI or ESS.

Conclusion: Structured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI.

Trial registration: ClinicalTrials.gov NCT01072500.

Keywords: daytime drowsiness; insomnia; physical activity; poor sleep quality; sleep-wake behaviors.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / epidemiology
  • Exercise*
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Mobility Limitation*
  • Prevalence
  • Sedentary Behavior
  • Single-Blind Method
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / prevention & control*
  • Surveys and Questionnaires
  • United States / epidemiology

Associated data

  • ClinicalTrials.gov/NCT01072500