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Sari F, Oskay D, Tufan A. Effects of a telerehabilitation-based exercise program in patients with systemic sclerosis. Z Rheumatol 2024; 83:167-174. [PMID: 37097308 PMCID: PMC10127957 DOI: 10.1007/s00393-023-01346-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND This study aimed to evaluate the effect of telerehabilitation-based exercise programs in systemic sclerosis (SSc) patients. METHODS Forty-six SSc patients were randomly separated into two groups as telerehabilitation and control. Videos comprising clinical Pilates-based exercises were designed and uploaded to YouTube™ for the telerehabilitation group by physiotherapists. A video interview was conducted with the SSc patients once a week and an exercise program was performed twice daily for 8 weeks in the telerehabilitation group. The same exercise programs were printed on paper brochures and patients were instructed on their application in the form of a home exercise program to be continued for 8 weeks in the control group. Pain, fatigue, quality of life, sleep, physical activity, anxiety, and depression were assessed in all patients at the beginning and end of the study. RESULTS The clinical and demographic characteristics were similar in both groups (p > 0.05). Fatigue, pain, anxiety, and depression decreased in both groups, while quality of life and sleep quality increased after the exercise program (p < 0.05). However, the improvements in the telerehabilitation group were statistically more significant than in the control group for all studied parameters (p < 0.05). CONCLUSION The results of our study demonstrate the superior efficacy of telerehabilitation-based treatment programs over home exercise programs, hence, we suggest widespread use of this innovative treatment program in SSc patients.
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Affiliation(s)
- Fulden Sari
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bingol University, 12000, Bingol, Turkey.
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Abdurrahman Tufan
- Inflamatuar Disease Section, National Human Genome Research Institute, Rockville Pike, USA
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2
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Zhao M, Sun M, Zhao R, Chen P, Li S. Effects of exercise on sleep in perimenopausal women: A meta-analysis of randomized controlled trials. Explore (NY) 2023; 19:636-645. [PMID: 36781319 DOI: 10.1016/j.explore.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
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.
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Affiliation(s)
- Mengnan Zhao
- College of P.E and Sports, Beijing Normal University, Beijing 100875, China
| | - Mingyu Sun
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Rutong Zhao
- Tianjin Experiment High School, Tianjin 300074, China
| | - Pan Chen
- Beijing No. 80 High School, Beijing 100102, China
| | - Sunnan Li
- College of P.E and Sports, Beijing Normal University, Beijing 100875, China.
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3
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Benham JL, Booth JE, Goldfield G, Friedenreich CM, Rabi DM, Sigal RJ. Self-reported sleep quality and exercise in polycystic ovary syndrome: A secondary analysis of a pilot randomized controlled trial. Clin Endocrinol (Oxf) 2023; 98:700-708. [PMID: 36843192 DOI: 10.1111/cen.14900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 02/23/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVE To examine the proportion of participants with poor sleep quality, evaluate the associations between sleep quality and anthropometric and cardiometabolic health markers, and evaluate the effect of high intensity interval training (HIIT) and continuous aerobic exercise training (CAET) on sleep quality in polycystic ovary syndrome (PCOS). DESIGN Secondary analysis of a pilot randomized controlled trial. PATIENTS Women with PCOS aged 18-40 years. MEASUREMENTS The Pittsburgh Sleep Quality Index (PSQI) was measured at baseline and following a 6-month exercise intervention. A PSQI score >5 indicates poor sleep. Linear regression was used to evaluate the associations between PSQI score and anthropometric and cardiometabolic health markers, and the effect of exercise training on these associations. RESULTS Thirty-four participants completed the PSQI at baseline, and 29 postintervention: no-exercise control (n = 9), HIIT (n = 12) and CAET (n = 8). At baseline, 79% had poor sleep quality. Baseline PSQI score was positively correlated with body mass index, waist circumference, body weight, haemoglobin A1c and insulin resistance. Mean PSQI score changes were -0.4 (SD 1.1), -0.7 (SD 0.6) and -0.5 (SD 0.9) for control, HIIT and CAET, respectively. For HIIT participants, change in PSQI score was associated with changes in body weight (B = .27, 95% CI 0.10-0.45) and waist circumference (B = .09, 95% CI 0.02-0.17). CONCLUSION Most participants had poor sleep quality which was associated with poorer anthropometric and cardiometabolic health markers. There were no statistically significant changes in PSQI score with exercise training. With HIIT training, decreases in the sleep efficiency score were associated with reductions in body weight and waist circumference. Further studies are needed to determine the effect of exercise training on sleep quality.
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Affiliation(s)
- Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jane E Booth
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gary Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Christine M Friedenreich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Doreen M Rabi
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ronald J Sigal
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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4
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Zhao H, Lu C, Yi C. Physical Activity and Sleep Quality Association in Different Populations: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1864. [PMID: 36767229 PMCID: PMC9914680 DOI: 10.3390/ijerph20031864] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The meta-analysis statistical methodology was used to test the effect of physical activity intervention on sleep quality. According to the preliminary results of the meta-analysis, moderating variables (age stage and physical activity intensity) were included for further study. On this basis, measures and schemes to improve sleep quality through physical activity were put forward. A preliminary Endnote X9 search of relevant literature from six electronic databases (Web of Science, Medline, PubMed, CNKI, PsycINFO and Wanfang) was performed. The results showed the following: (1) The overall test effect of physical activity intervention on sleep quality was not significant (p = 0.15). (2) Moderate- and low-intensity physical activity had significant effects on sleep quality (moderate intensity d = 2.56, p = 0.015; low-intensity d = 1.38, p = 0.03), while high-intensity physical activity had no obvious effect on sleep quality (d = 1.12, p = 0.32). (3) There were differences in the effect of physical activity on sleep quality at different ages. The effect of physical activity on sleep quality was more obvious in children and middle-aged and elderly people (children d = 1.24, p = 0.03; middle-aged and elderly people d = 1.98, p = 0.037), but not in young people (d = 1.32, p = 0.11). Conclusion: The overall effect of physical activity on sleep quality was not significant. Physical activity had an obvious effect on the sleep quality of children and middle-aged and elderly people but had no obvious effect on young people. Moderate-intensity physical activity had a certain effect on sleep quality, but high-intensity physical activity had no obvious effect on sleep quality. Future studies need to confirm these findings with a good large sample and moderating variables.
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Affiliation(s)
- Haitao Zhao
- Department of Sociology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China
- College of Physical Education, ShanXi Normal University, Taiyuan 030031, China
| | - Chuntian Lu
- Department of Sociology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China
| | - Cuixia Yi
- Department of Sociology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China
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5
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Tokdemir G. Software professionals during the COVID-19 pandemic in Turkey: Factors affecting their mental well-being and work engagement in the home-based work setting. THE JOURNAL OF SYSTEMS AND SOFTWARE 2022; 188:111286. [PMID: 35250124 PMCID: PMC8885087 DOI: 10.1016/j.jss.2022.111286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 02/09/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
With the COVID-19 pandemic, strict measures have been taken to slow down the spread of the virus, and consequently, software professionals have been forced to work from home. However, home-based working entails many challenges, as the home environment is shared by the whole family simultaneously under pandemic conditions. The aim of this study is to explore software professionals' mental well-being and work engagement and the relationships of these variables with job strain and resource-related factors in the forced home-based work setting during the COVID-19 pandemic. An online cross-sectional survey based on primarily well-known, validated scales was conducted with software professionals in Turkey. The analysis of the results was performed through hierarchical multivariate regression. The results suggest that despite the negative effect of job strain, the resource-related protective factors, namely, sleep quality, decision latitude, work-life balance, exercise predict mental well-being. Additionally, work engagement is predicted by job strain, sleep quality, and decision latitude. The results of the study will provide valuable insights to management of the software companies and professionals about the precautions that can be taken to have a better home-based working experience such as allowing greater autonomy and enhancing the quality of sleep and hence mitigating the negative effects of pandemic emergency situations on software professionals' mental well-being and work engagement.
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Affiliation(s)
- Gul Tokdemir
- Cankaya University, Computer Engineering Department, Eskisehir Yolu 29.km. Mimar Sinan Cad. No:4, 06790, Ankara, Turkey
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6
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Sella E, Toffalini E, Canini L, Borella E. Non-pharmacological interventions targeting sleep quality in older adults: a systematic review and meta-analysis. Aging Ment Health 2022; 27:847-861. [PMID: 35352595 DOI: 10.1080/13607863.2022.2056879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: This review aimed to examine the available evidence about non-pharmacological interventions (NPIs) aimed at improving sleep quality in older adults without insomnia or dementia.Methods: Studies on NPIs targeting older adults' sleep were searched in the PsycInfo, PubMed and Scopus databases, with no restriction on publication year up to September 2021. Studies on NPIs for older adults with no diagnosed sleep disorders were included, while those on pharmacological therapies and/or concerning pathological samples were excluded. The risk of bias was assessed using tools based on Joanna Briggs' criteria. The data extracted were meta-analyzed using random effects models for subgroups of NPIs.Results: Of the 1,893 records identified, 31 studies on NPIs (N = 2,224; range of mean ages: 60-78 years) were analyzed. All NPIs improved self-reported sleep quality, albeit to a different extent (physical activity: d=.97 - 95% CI=.62, 1.32-; psychological/psychoeducational, or NPIs that combined more than one sleep-targeting activity: d range: .21 to .97). Only the NPIs based on physical activity improved objectively-measured sleep, d=.31 (.04, .57). The methodological quality of most studies was limited.Conclusion: The most often used NPIs targeting sleep rely on physical activity and sensory stimulation with promising results on sleep quality for the former. More data are needed on psychological/psychoeducational NPIs and combined interventions in order to test their effectiveness. The methodological weaknesses of the available studies suggest they their findings should be interpreted with caution.
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Affiliation(s)
- Enrico Sella
- Department of General Psychology, University of Padova, Padova, Italy
| | - Enrico Toffalini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Luca Canini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
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7
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Li L, Sheehan CM, Petrov ME, Mattingly JL. Prospective associations between sedentary behavior and physical activity in adolescence and sleep duration in adulthood. Prev Med 2021; 153:106812. [PMID: 34560096 PMCID: PMC8638459 DOI: 10.1016/j.ypmed.2021.106812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 08/18/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
The purpose of this prospective study was to investigate whether sedentary screen time (SST) and physical activity in adolescence were related to sleep duration in adulthood and whether these associations varied by sex. We analyzed data from 9279 adolescents who participated in Waves I and V of the National Longitudinal Study of Adolescent Health (Add Health) in the United States. SST was measured by reported hours spent watching television/videos or playing video/computer games per week. Physical activity was measured with participation in school team club sports and frequency (times/week) of moderate to vigorous physical activity (MVPA). Results from multinomial regression models indicated that adolescents with more SST, particularly 15-21 h (Relative Risk Ratio [RRR] = 1.18, 95% CI: 1.02-1.36) or 22 or more hours (RRR = 1.19, 95% CI: 1.06-1.35) compared to 0-7 h per week SST, had significantly higher relative risk of short sleep (six or fewer hours) in adulthood, after controlling for demographic characteristics, socioeconomic status and health behaviors at Waves I and V, sleep duration at Wave I, and SST and MVPA at Wave V. The association between 22 or more hours per week SST in adolescence and later short sleep varied by sex (RRR = 0.75, 95% CI: 0.58-0.95) and was significantly stronger among males. Measures of physical activity in adolescence did not predict sleep duration. Decreasing adolescents' SST to prevent suboptimal sleep later in development may be a target for further investigation, particularly for males.
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Affiliation(s)
- Longfeng Li
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, United States of America
| | - Connor M Sheehan
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, United States of America; Global Sport Institute, Arizona State University, Tempe, AZ, United States of America.
| | - Megan E Petrov
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States of America
| | - Jennifer L Mattingly
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States of America
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8
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Seol J, Lee J, Nagata K, Fujii Y, Joho K, Tateoka K, Inoue T, Liu J, Okura T. Combined effect of daily physical activity and social relationships on sleep disorder among older adults: cross-sectional and longitudinal study based on data from the Kasama study. BMC Geriatr 2021; 21:623. [PMID: 34732144 PMCID: PMC8565015 DOI: 10.1186/s12877-021-02589-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background This study investigated whether daily physical activity of older adults, combined with social relationships, is associated with the risk of sleep disorder. Further, it determined whether a high level of one variable with a low level of the other, leads to a significantly lower risk of sleep disorder than low levels of both. Methods The sample comprised 1339 community-dwelling older Japanese adults: 988 in Study 1 and 351 in Study 2. The level of daily physical activity and range of social relationships were assessed using the Physical Activity Scale for the Elderly and the Lubben Social Network Scale, respectively. The Pittsburgh Sleep Quality Index was used to assess sleep disorder. To test the combined relationships and effects in Studies 1 and 2, the medians for the respective scores of each of the following four groups that the participants were categorized into, were calculated: (1) low activity group with low social relationships, (2) low activity group with high social relationships, (3) high activity group with low social relationships, and (4) high activity group with high social relationships. After adjusting for potential confounders, a logistic regression analysis was conducted in Study 1. After adjusting for potential confounders, a Cox proportional hazards regression analysis was conducted in Study 2. Results Study 1 revealed that the high activity group with high social relationships showed a significantly lower risk of sleep disorder (ORs: 0.585, 95% CI: 0.404–0.847) than the low activity group with low social relationships. Study 2 also revealed that the high activity group with high social relationships showed a significantly lower prevalence of sleep disorder (HRs: 0.564, 95% CI: 0.327–0.974) than the low activity group with low social relationships. Conclusions Our findings suggest that for older adults with high social relationships, being physically active is favorably associated with sleep quality. However, a high level of one variable with a low level of the other has not been confirmed in improving sleep quality among older adults.
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Affiliation(s)
- Jaehoon Seol
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan. .,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. .,Japan Society for the Promotion of Sciences, 5-3-1 Kojimachi, Chiyoda, Tokyo, 102-0083, Japan.
| | - Jaehee Lee
- Master's Program in Physical Education, Health and Sports Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Koki Nagata
- Doctoral Program in Public Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Yuya Fujii
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobukimachi, Hachioji, Tokyo, 192-0001, Japan
| | - Kaya Joho
- Doctoral Program in Human Care Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,J-Stretch Association, 1132-1-504 Ochikawa, Hino-city, Tokyo, 191-0034, Japan
| | - Korin Tateoka
- Doctoral Program in Physical Education, Health and Sports Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Taiki Inoue
- Doctoral Program in Human Care Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Jue Liu
- Doctoral Program in Physical Education, Health and Sports Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,R&D Center for Tailor-Made QOL, University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
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9
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Brupbacher G, Zander-Schellenberg T, Straus D, Porschke H, Infanger D, Gerber M, von Känel R, Schmidt-Trucksäss A. The Acute Effects of Aerobic Exercise on Nocturnal and Pre-Sleep Arousal in Patients with Unipolar Depression: Preplanned Secondary Analysis of a Randomized Controlled Trial. J Clin Med 2021; 10:jcm10174028. [PMID: 34501476 PMCID: PMC8432550 DOI: 10.3390/jcm10174028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/03/2021] [Accepted: 09/03/2021] [Indexed: 12/28/2022] Open
Abstract
Unipolar depression is associated with insomnia and autonomic arousal. The aim of this study was to quantify the effect of a single bout of aerobic exercise on nocturnal heart rate variability and pre-sleep arousal in patients with depression. This study was designed as a two-arm, parallel-group, randomized, outcome assessor-blinded, controlled, superiority trial. Patients with a primary diagnosis of unipolar depression aged 18-65 years were included. The intervention consisted of a single 30 min moderate-intensity aerobic exercise bout. The control group sat and read for 30 min. The primary outcome of interest was RMSSD during the sleep period assessed with polysomnography. Secondary outcomes were additional heart rate variability outcomes during the sleep and pre-sleep period as well as subjective pre-sleep arousal. A total of 92 patients were randomized to either the exercise (N = 46) or the control (N = 46) group. Intent-to-treat analysis ANCOVA of follow-up sleep period RMSSD, adjusted for baseline levels and minimization factors, did not detect a significant effect of the allocation (β = 0.12, p = 0.94). There was no evidence for significant differences between both groups in any other heart rate variability measure nor in measures of cognitive or somatic pre-sleep arousal. As this is the first trial of its kind in this population, the findings need to be confirmed in further studies. Patients with depression should be encouraged to exercise regularly in order to profit from the known benefits on sleep and depressive symptoms, which are supported by extensive literature.
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Affiliation(s)
- Gavin Brupbacher
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (D.I.); (A.S.-T.)
- OBERWAID AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland; (D.S.); (H.P.)
- Correspondence:
| | - Thea Zander-Schellenberg
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, 4055 Basel, Switzerland;
| | - Doris Straus
- OBERWAID AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland; (D.S.); (H.P.)
| | - Hildburg Porschke
- OBERWAID AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland; (D.S.); (H.P.)
| | - Denis Infanger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (D.I.); (A.S.-T.)
| | - Markus Gerber
- Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland;
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Culmannstrasse 8, 8091 Zurich, Switzerland;
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (D.I.); (A.S.-T.)
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10
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King AC, Campero MI, Garcia D, Blanco-Velazquez I, Banchoff A, Fierros F, Escobar M, Cortes AL, Sheats JL, Hua J, Chazaro A, Done M, Espinosa PR, Vuong D, Ahn DK. Testing the effectiveness of community-engaged citizen science to promote physical activity, foster healthier neighborhood environments, and advance health equity in vulnerable communities: The Steps for Change randomized controlled trial design and methods. Contemp Clin Trials 2021; 108:106526. [PMID: 34371162 PMCID: PMC8453124 DOI: 10.1016/j.cct.2021.106526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/18/2022]
Abstract
While low-income midlife and older adults are disproportionately affected by non-communicable diseases that can be alleviated by regular physical activity, few physical activity programs have been developed specifically with their needs in mind. Those programs that are available typically do not address the recognized local environmental factors that can impact physical activity. The specific aim of the Steps for Change cluster-randomized controlled trial is to compare systematically the initial (one-year) and sustained (two-year) multi-level impacts of an evidence-based person-level physical activity intervention (Active Living Every Day [ALED] and age-relevant health education information), versus the ALED program in combination with a novel neighborhood-level citizen science intervention called Our Voice. The study sample (N = 300) consists of insufficiently active adults ages 40 years and over living in or around affordable senior public housing settings. Major study assessments occur at baseline, 12, and 24 months. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of physical activity, assessed via validated self-report measures supported by accelerometry, and physical function and well-being variables. Additional intervention impacts are assessed at 24 months. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. TRIAL REGISTRATION: clinicaltrial.gov Identifier = NCT03041415.
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Affiliation(s)
- Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Maria I Campero
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Dulce Garcia
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Isela Blanco-Velazquez
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Ann Banchoff
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Fernando Fierros
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Michele Escobar
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Ana L Cortes
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Jylana L Sheats
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Jenna Hua
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Aldo Chazaro
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Monica Done
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America
| | - Patricia Rodriguez Espinosa
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Daniel Vuong
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - David K Ahn
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
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Hidde MC, Leach HJ, Marker RJ, Peters JC, Purcell WT. Effects of a Clinic-Based Exercise Program on Sleep Disturbance Among Cancer Survivors. Integr Cancer Ther 2021; 19:1534735420975852. [PMID: 33243013 PMCID: PMC7705805 DOI: 10.1177/1534735420975852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Sleep disturbance is the second leading negative side effect reported by cancer survivors, and evidence exists to suggest that exercise may improve sleep for cancer survivors. This study examined changes in sleep following a 3-month, clinic-based exercise program among a diverse group of cancer survivors. Methods Single group, pre-post study design. Participants were enrolled in a supervised exercise program which consisted of moderate intensity aerobic and resistance training, twice per week for 3-months. To be eligible, individuals had to be diagnosed with cancer, and undergoing, or within 6-months of completing chemo and/or radiation therapy. Sleep was assessed at pre-and post-program using 3 self-report questions as part of a standard wellness assessment conducted at the program’s facility. Changes in categorical outcomes were evaluated using McNemar and Wilcoxon Signed-Rank Tests. Results Participants (N = 94) were mostly female (68.1%, N = 64), mean age = 54.26 ± 14.26 (20-78), and diagnosed with more than 8 different cancer types. Half (N = 48, 51.1%) of participants improved on 1 or more of the questions assessing sleep. At post-program, 39% of participants reported that they did not awaken feeling rested versus 48% at pre-program (P = .08). At post-program, 47% reported awakening ≥1 time per night versus 46% at pre-program (P = .97), and 17% reported poor or very poor sleep quality at post-program versus 24% at pre-program (P = .16). There were no differences in demographic, cancer-related, psychosocial, and physical fitness variables between participants who improved on any of the questions assessing sleep versus those who did not. Conclusions A clinically implemented exercise program may help some cancer survivors improve sleep, however more studies utilizing validated, objective measures of sleep are needed to confirm effectiveness.
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Affiliation(s)
- Mary C Hidde
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA.,Department of Community and Behavioral Health, Colorado School of Public Health at Colorado State University, Fort Collins, CO, USA
| | - Ryan J Marker
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John C Peters
- Anchutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W Thomas Purcell
- School of Medicine, University of Colorado, Aurora, CO, USA.,University of Colorado Cancer Center, Aurora, CO, USA
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12
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Kline CE, Hillman CH, Bloodgood Sheppard B, Tennant B, Conroy DE, Macko RF, Marquez DX, Petruzzello SJ, Powell KE, Erickson KI. Physical activity and sleep: An updated umbrella review of the 2018 Physical Activity Guidelines Advisory Committee report. Sleep Med Rev 2021; 58:101489. [PMID: 33934046 PMCID: PMC8338757 DOI: 10.1016/j.smrv.2021.101489] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/21/2022]
Abstract
Physical activity (PA) is widely considered to improve sleep, but a comprehensive review of the research on this topic has not been performed. In this umbrella review, conducted initially for the 2018 Physical Activity Guidelines for Americans Advisory Committee and updated to reflect more recent research, we examined whether PA enhances sleep outcomes across the lifespan as well as among individuals with sleep disorders. Systematic reviews and meta-analyses were utilized to assess the evidence. We also examined dose-response considerations and whether the association between PA and sleep was moderated by various factors (e.g., timing, sociodemographic characteristics). We found strong evidence that both acute bouts of PA and regular PA improved sleep outcomes. Moderate evidence indicated that longer bouts of PA (both acute and regular) improved sleep, and that the effects of PA on sleep outcomes were generally preserved across adult age groups and sex. Finally, moderate evidence demonstrated that PA improved sleep in adults with insomnia symptoms or obstructive sleep apnea. Several important areas in need of future research were also identified. Overall, the review supported the claim that PA improves sleep, but highlighted gaps that need to be addressed to facilitate more widespread utilization of PA for improving sleep.
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Affiliation(s)
- Christopher E Kline
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, MA, USA; Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | | | | | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Richard F Macko
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - David X Marquez
- Department of Kinesiology and Nutrition, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, USA
| | - Steven J Petruzzello
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kenneth E Powell
- Centers for Disease Control and Prevention (Retired), Atlanta, GA, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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13
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Zhang Q, Liu Y, Liang Y, Yang D, Zhang W, Zou L, Wan Z. Exercise intervention for sleep disorders after stroke: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25730. [PMID: 33907166 PMCID: PMC8084092 DOI: 10.1097/md.0000000000025730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sleep disorders after stroke is one of the most common neuropsychiatric complications and is associated with increased risk of death and poor functional outcomes. Some evidence shows that patients with sleep disorders after stroke benefit from exercise intervention. However, this result is still conflicting. This study aims to explore the effects of exercise on sleep disorders after stroke and to establish safe and effective exercise prescriptions. METHODS AND ANALYSIS The databases including Google Scholar, Pubmed, Embase, and Cochrane library will be searched using pre-specified search strategies. Randomized controlled trials and non-randomized prospective controlled cohort studies regarding exercise for sleep disorders after stroke will be included. The primary outcome is the Pittsburgh Sleep Quality Index (PSQI) scale. The secondary outcomes are adverse events associated with exercise and all deaths. The methodological quality of each study will be evaluated by the physiotherapy evidence database scale. The heterogeneity will be evaluated using the I2 test. If I2 > 50%, random effects models will be used in the analysis; otherwise, fixed effects models will be used to pool the data. RESULTS This study will assess the efficacy and safety of exercise for sleep disorders after stroke. CONCLUSIONS Our findings will be helpful for clinicians to examine the clinical decision-making in the treatment of sleep disorders after stroke using exercise intervention. ETHICS AND DISSEMINATION Ethical approval is not required because this study is a secondary analysis. The results of this study will be disseminated through journals and academic exchanges. SYSTEMATIC REVIEW REGISTRATION NUMBER INPLASY202130106.
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Affiliation(s)
- Qin Zhang
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
- School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Liu
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
- School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Liang
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
- School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Yang
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
- School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhang
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
- School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Liqun Zou
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
- School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Wan
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Disaster Medical Center
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Shaheen AM, Alkaid Albqoor M. Prevalence and Correlates of Sleep Quality Among Jordanian University Students: A Cross-Sectional National Study. Eval Health Prof 2020; 45:176-182. [PMID: 33356501 DOI: 10.1177/0163278720983415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Poor sleep quality affects university students' life and increases their risk of long-term health consequences. This study aimed to describe the quality of sleep among Jordanian university students, examine differences in sleep quality according to selected variables, and identify predictors of sleep quality. A cross-sectional correlational design and a multi-strategic sampling technique were used to select a sample of 1,308 university students. The Pittsburgh Sleep Quality Index, the Perceived Stress Scale, and the Sleep Hygiene Instrument were administered to the subjects. T-test, ANOVA, and multiple regressions were used to analyze the data. The results showed that most students were classified as poor sleepers (87.1%), and only (12.8%) reported having a good sleep quality. Among the components of sleep quality, subjective sleep quality (m = 1.90, SD = 0.89) and daytime dysfunction (m = 1.72, SD = 0.67) had the highest mean scores, while sleep efficiency (m = 0.50, SD = 0.91) and the use of sleep medications (m = 0.23, SD = 0.73) had the lowest mean scores. There were statistically significant differences in sleep quality in relation to residency, academic level, academic achievement, and family income. Significant predictors of sleep quality were gender, marital status, employment status, sleep hygiene, and stress.
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15
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M Abd El-Kader S, H Al-Jiffri O. Aerobic exercise affects sleep, psychological wellbeing and immune system parameters among subjects with chronic primary insomnia. Afr Health Sci 2020; 20:1761-1769. [PMID: 34394237 PMCID: PMC8351861 DOI: 10.4314/ahs.v20i4.29] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic primary insomnia is characterized by long-term difficulties in maintaining and initiating sleep, too early waking up, poor mood, fatigue, impaired concentration and poor quality of life. Exercise training is recommended to prevent and alleviate sleep disorders. OBJECTIVE The aim of the study was to investigate the influence of aerobic exercise training on quality of sleep, psychological wellbeing and immune system among subjects with chronic primary insomnia. MATERIAL AND METHODS Eighty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 35-56 years. All participants were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or control group (group B, n=40). Polysomnographic recordings for sleep quality assessment, Beck Depression Inventory (BDI), Profile of Mood States(POMS), Rosenberg Self-Esteem Scale (RSES), number of CD3+, CD4+, CD8+ T cells count and CD4/CD8 ratio were measured before and at the end of the study after six months. RESULTS There was a significant increase in the total sleep duration, sleep efficiency and sleep onset latency in group(A) after six months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after six months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of BDI, POMS, CD3 count, CD4 count and CD8 count decreased significantly and the mean value of RSES significantly increased in group (A) after the aerobic exercise training, while the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. CONCLUSION Exercise training can be considered as a non-pharmacological modalty for modifying sleep quality, psychological wellbeing and immune system among subjects with chronic primary insomnia.
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Li Z, Li J, Yu G, Yu F, Li K, Szanton S. The effect of resistance training on sleep in Chinese older adults: A randomized controlled trial. Geriatr Nurs 2020; 42:289-294. [PMID: 32977992 DOI: 10.1016/j.gerinurse.2020.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
Sleep disturbances affect approximately half of the older adult population and add additional risks of developing Alzheimer's disease. This study is to test the effects of a 12-week resistance training (RT) program on sleep in older adults residing in an assisted living facility in China. A total of 62 eligible participants were randomly assigned to RT (n = 31) or control group (n = 31). Participants in RT group participated in three 1-hour moderate intensity RT sessions per week for 12 weeks (at least 48 h between sessions). In the overall sample, sleep efficiency increased (P < 0.01), wake after sleep onset (P < 0.01) decreased in participants in RT group at post-intervention, compared to control group. Similar results were found in participants with mild cognitive impairment (MCI). The findings support that RT improves sleep efficiency and decreases sleep fragmentation in older adults in general and in those with MCI.
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Affiliation(s)
- Zhihui Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun 130021, China; Nursing department, Qingdao Women and Children's Hospital, No.6 Tongfu Road, Shibei District, Qingdao 266011, China
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Guiling Yu
- Nursing department, Qingdao Women and Children's Hospital, No.6 Tongfu Road, Shibei District, Qingdao 266011, China
| | - Fang Yu
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall 308 Harvard Street SE Minneapolis, MN 55455, United States
| | - Kun Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun 130021, China.
| | - Sarah Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
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17
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King AC, Campero I, Sheats JL, Castro Sweet CM, Espinosa PR, Garcia D, Hauser M, Done M, Patel ML, Parikh NM, Corral C, Ahn DK. Testing the effectiveness of physical activity advice delivered via text messaging vs. human phone advisors in a Latino population: The On The Move randomized controlled trial design and methods. Contemp Clin Trials 2020; 95:106084. [PMID: 32659437 PMCID: PMC7351675 DOI: 10.1016/j.cct.2020.106084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022]
Abstract
Physical inactivity is a key risk factor for a range of chronic diseases and conditions, yet, approximately 50% of U.S. adults fall below recommended levels of regular aerobic physical activity (PA). This is particularly true for ethnic minority populations such as Latino adults for whom few culturally adapted programs have been developed and tested. Text messaging (SMS) represents a convenient and accessible communication channel for delivering targeted PA information and support, but has not been rigorously evaluated against standard telehealth advising programs. The objective of the On The Move randomized controlled trial is to test the effectiveness of a linguistically and culturally targeted SMS PA intervention (SMS PA Advisor) versus two comparison conditions: a) a standard, staff-delivered phone PA intervention (Telephone PA Advisor) and b) an attention-control arm consisting of a culturally targeted SMS intervention to promote a healthy diet (SMS Nutrition Advisor). The study sample (N = 350) consists of generally healthy, insufficiently active Latino adults ages 35 years and older living in five northern California counties. Study assessments occur at baseline, 6, and 12 months, with a subset of participants completing 18-month assessments. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of PA, assessed via validated self-report measures and supported by accelerometry, and physical function and well-being variables. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. Trial Registration: clinicaltrial.gov Identifier = NCT02385591.
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Affiliation(s)
- Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Ines Campero
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Jylana L Sheats
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Cynthia M Castro Sweet
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Patricia Rodriguez Espinosa
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Dulce Garcia
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Michelle Hauser
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Monica Done
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Michele L Patel
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Nina M Parikh
- CareMessage, Inc., San Francisco, California 94115, United States of America.
| | - Cecilia Corral
- CareMessage, Inc., San Francisco, California 94115, United States of America.
| | - David K Ahn
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
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Sonnega A, Leggett A, Pepin R, Assari S. Physical Activity and Insomnia Symptoms Over 10 Years in a U.S. National Sample of Late-Middle-Age and Older Adults: Age Matters. J Aging Phys Act 2020; 28:613-622. [PMID: 31896077 PMCID: PMC7326645 DOI: 10.1123/japa.2018-0337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/30/2019] [Accepted: 11/14/2019] [Indexed: 01/04/2023]
Abstract
Research suggests that physical activity may influence sleep, yet more research is needed before it can be considered a frontline treatment for insomnia. Less is known about how this relationship is moderated by age. Using multilevel modeling, we examined self-reported physical activity and insomnia symptoms in 18,078 respondents from the U.S. nationally representative Health and Retirement Study (2004-2014). The mean baseline age was 64.7 years, with 53.9% female. Individuals who reported more physical activity (B = -0.005, p < .001) had fewer insomnia symptoms. Over 10 years, the respondents reported fewer insomnia symptoms at times when they reported more physical activity than was average for them (B = -0.003, p < .001). Age moderated this relationship (B = 0.0002, p < .01). Although modest, these findings concur with the literature, suggesting moderate benefits of physical activity for sleep in older adults. Future research should aim to further elucidate this relationship among adults at advanced ages.
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Bernstein JPK, DeVito A, Calamia M. Subjectively and Objectively Measured Sleep Predict Differing Aspects of Cognitive Functioning in Adults. Arch Clin Neuropsychol 2020; 34:1127-1137. [PMID: 31250888 DOI: 10.1093/arclin/acz017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/06/2019] [Accepted: 03/13/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine associations between subjectively-reported sleep and objectively-measured sleep (i.e., actigraphy) with different domains of cognitive functioning, and determine whether age may moderate these associations. METHOD In this cross-sectional study, a total of 489 participants (mean age = 45.4 years; SD = 18.8) completed a self-reported sleep measure and one week of actigraphy. Participants also completed a battery of cognitive tests measuring episodic memory, social cognition, executive functioning, and complex cognition (i.e., reasoning, visuospatial, and language abilities). RESULTS Multiple regression analyses revealed that greater objective sleep quality and longer onset latencies were both associated with better performance on measures of conceptual flexibility. In contrast, subjective sleep quality was not associated with performance in any cognitive domain after accounting for objective sleep variables. Age moderated sleep-cognition relationships in differing ways based on cognitive domain and facet of sleep assessed. For example, whereas poorer subjective sleep quality was associated with poorer complex cognition in younger, but not older adults, poorer objective sleep quality was associated with poorer conceptual flexibility in older, but not younger adults. CONCLUSIONS Objectively-measured and self-reported sleep are associated with differing aspects of executive functioning, with the latter related to executive functioning broadly and the former associated with conceptual flexibility in particular. Age moderates sleep-cognition relationships differentially depending on the method by which sleep quality and quantity are measured.
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Affiliation(s)
- John P K Bernstein
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
| | - Alyssa DeVito
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
| | - Matthew Calamia
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
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Hawkins M, Marcus B, Pekow P, Rosal MC, Tucker KL, Spencer RMC, Chasan-Taber L. Physical Activity and Sleep Quality and Duration During Pregnancy Among Hispanic Women: Estudio PARTO. Behav Sleep Med 2019; 17:804-817. [PMID: 30252507 DOI: 10.1080/15402002.2018.1518225] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective/Background: Poor sleep during pregnancy is common and is associated with pregnancy complications. Physical activity (PA) is associated with better sleep in nonpregnant populations. However, studies among pregnant women are sparse, conflicting, and none have been conducted among Hispanic women, who face a disproportionate burden of poor sleep and pregnancy complications. Therefore, our objective was to examine the relationship between intensity- and domain-specific PA, respectively, on sleep quality and duration among Hispanic pregnant women. Participants: We evaluated these associations among participants (n = 251) in Estudio PARTO, an ongoing randomized controlled trial aimed at reducing type 2 diabetes among women at high risk. Methods: We assessed the cross-sectional relationship between PA (via Pregnancy PA Questionnaire) and sleep quality and duration (via Pittsburgh Sleep Quality Index) using baseline data (26.5 ± 6.9 weeks gestation). Results: In multivariable logistic models, household and caregiving activities were associated with higher odds of very poor sleep quality (OR = 2.69; 95% CI = 1.04 to 7.04) and with short (vs. medium) sleep duration (OR = 2.85; 95% CI = 1.07 to 7.56). In contrast, occupational PA was associated with lower odds of very poor sleep quality (OR = 0.39; 95% CI = 0.17 to 0.89). Light-intensity PA was associated with lower odds of long (vs. medium) sleep duration (OR = 0.13; 95% CI = 0.03 to 0.52). There were no statistically significant relationships between PA in any other domain and sleep. Conclusions: Prospective studies will be critical in evaluating the potential adverse impact of household and caregiving activities on poor sleep quality.
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Affiliation(s)
- Marquis Hawkins
- Department of Biostatistics and Epidemiology, University of Massachusetts , Amherst , Massachusetts, USA
| | - Bess Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health , Providence , Rhode Island, USA
| | - Penelope Pekow
- Department of Biostatistics and Epidemiology, University of Massachusetts , Amherst , Massachusetts, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School , Worcester , Massachusetts, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell , Lowell , Massachusetts, USA
| | - Rebecca M C Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts , Amherst , Massachusetts, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, University of Massachusetts , Amherst , Massachusetts, USA
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Hung Y, Wijnhoven HAH, Visser M, Verbeke W. Appetite and Protein Intake Strata of Older Adults in the European Union: Socio-Demographic and Health Characteristics, Diet-Related and Physical Activity Behaviours. Nutrients 2019; 11:nu11040777. [PMID: 30987278 PMCID: PMC6521269 DOI: 10.3390/nu11040777] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/24/2019] [Accepted: 03/28/2019] [Indexed: 12/25/2022] Open
Abstract
Considerable efforts have been directed towards stimulating healthy ageing regarding protein intake and malnutrition, yet large-scale consumer studies are scarce and fragmented. This study aims to profile older adults in the European Union (EU) according to appetite (poor/good) and protein intake (lower/higher) strata, and to identify dietary and physical activity behaviours. A survey with older (aged 65 years or above) adults (n = 1825) in five EU countries (Netherlands, United Kingdom, Finland, Spain and Poland) was conducted in June 2017. Four appetite and protein intake strata were identified based on simplified nutritional appetite questionnaire (SNAQ) scores (≤14 versus >14) and the probability of a protein intake below 1.0 g/kg adjusted BW/day (≥0.3 versus <0.3) based on the 14-item Pro55+ screener: "appi"-Poor appetite and lower level of protein intake (12.2%); "APpi"-Good appetite but lower level of protein intake (25.5%); "apPI"-Poor appetite but higher level of protein intake (14.8%); and "APPI"-Good appetite and higher level of protein intake (47.5%). The stratum of older adults with a poor appetite and lower level of protein intake (12.2%) is characterized by a larger share of people aged 70 years or above, living in the UK or Finland, having an education below tertiary level, who reported some or severe financial difficulties, having less knowledge about dietary protein and being fussier about food. This stratum also tends to have a higher risk of malnutrition in general, oral-health related problems, experience more difficulties in mobility and meal preparation, lower confidence in their ability to engage in physical activities in difficult situations, and a lower readiness to follow dietary advice. Two multivariate linear regression models were used to identify the behavioural determinants that might explain the probability of lower protein intake, stratified by appetite status. This study provides an overview and highlights the similarities and differences in the strata profiles. Recommendations for optimal dietary and physical activity strategies to prevent protein malnutrition were derived, discussed and tailored according to older adults' profiles.
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Affiliation(s)
- Yung Hung
- Department of Agricultural Economics, Ghent University, Coupure links 653, 9000 Ghent, Belgium.
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Wim Verbeke
- Department of Agricultural Economics, Ghent University, Coupure links 653, 9000 Ghent, Belgium.
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22
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The psychological wellbeing outcomes of nonpharmacological interventions for older persons with insomnia symptoms: A systematic review and meta-analysis. Sleep Med Rev 2019; 43:1-13. [DOI: 10.1016/j.smrv.2018.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 12/20/2022]
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23
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Yeung T, Martin JL, Fung CH, Fiorentino L, Dzierzewski JM, Rodriguez Tapia JC, Song Y, Josephson K, Jouldjian S, Mitchell MN, Alessi C. Sleep Outcomes With Cognitive Behavioral Therapy for Insomnia Are Similar Between Older Adults With Low vs. High Self-Reported Physical Activity. Front Aging Neurosci 2018; 10:274. [PMID: 30271340 PMCID: PMC6146107 DOI: 10.3389/fnagi.2018.00274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/27/2018] [Indexed: 11/13/2022] Open
Abstract
We examined whether baseline self-reported physical activity is associated with the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in older veterans. Community-dwelling veterans aged 60 years and older with insomnia received CBT-I in a randomized controlled trial. Participants who received active treatment were divided into low and high physical activity based on self-report. Sleep outcomes were measured by sleep diary, questionnaire and wrist actigraphy; collected at baseline, post-treatment, 6-month and 12-month follow-up. Mixed-effects models compared differences between physical activity groups in change in sleep outcome from baseline to each follow-up, and equivalence tests examined if physical activity groups were clinically equal. There were no significant differences in sleep outcomes between physical activity groups. Equivalence tests suggested possible equality in physical activity groups for five of seven sleep outcomes. Efficacy of CBT-I in older veterans was not associated with self-reported physical activity at baseline. Older adults with insomnia who report low levels of physical activity can benefit from CBT-I.
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Affiliation(s)
- Timothy Yeung
- Washington & Jefferson College, Washington, PA, United States
| | - Jennifer L Martin
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States.,Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Constance H Fung
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States.,Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lavinia Fiorentino
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Juan C Rodriguez Tapia
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Yeonsu Song
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States.,Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Karen Josephson
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States
| | - Stella Jouldjian
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States
| | - Michael N Mitchell
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States
| | - Cathy Alessi
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA, United States.,Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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24
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Khou CS, Rendzia B, Watts A. Evaluation of waist-worn actigraphy monitors for the assessment of sleep in older adults with and without Alzheimer's disease. J Rehabil Assist Technol Eng 2018; 5:2055668318777989. [PMID: 31191943 PMCID: PMC6453051 DOI: 10.1177/2055668318777989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/18/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives Evaluate differences in sleep characteristics between older adults with and without mild Alzheimer's disease using waist-worn actigraphy monitors. Methods Actigraph GT3X+ monitors and self-reported sleep and activity logs were used for one week and compared between older adults (N = 85) with (n = 35) and without Alzheimer's disease (n = 51). Results Participants with Alzheimer's disease had greater total sleep time and spent more time in bed than nonimpaired older adults. Estimates for sleep efficiency and total sleep time for the total sample were elevated compared to previous studies of wrist-worn devices in similar populations, while estimates of sleep onset latency and wake after sleep onset for the total sample were lower. Conclusions Actigraphy-based sleep studies in older adults with Alzheimer's disease should consider discrepancies between objective and subjective estimates of sleep and monitor placement to maximize the ability to measure both activity and sleep.
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Affiliation(s)
| | - Brady Rendzia
- Department of Psychology, University of Kansas, Lawrence, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, USA
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25
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Nijs J, Mairesse O, Neu D, Leysen L, Danneels L, Cagnie B, Meeus M, Moens M, Ickmans K, Goubert D. Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice. Phys Ther 2018; 98:325-335. [PMID: 29425327 DOI: 10.1093/ptj/pzy020] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 02/05/2018] [Indexed: 02/09/2023]
Abstract
Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review article applies the current understanding of insomnia to clinical practice, including assessment and conservative treatment of insomnia in people with chronic pain. Cognitive-behavioral therapy for insomnia can be efficacious for improvements in sleep initiation, sleep maintenance, perceived sleep quality, and pain interference with daily functioning in people with chronic pain. A recent systematic review concluded that with additional training, physical therapist-led cognitive-behavioral interventions are efficacious for low back pain, allowing their implementation within the field. Cognitive-behavioral therapy for insomnia, as provided to people with chronic pain, typically includes education, sleep restriction measures, stimulus control instructions, sleep hygiene, and cognitive therapy.
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Affiliation(s)
- Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, the Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium, and Vrije Universiteit Brussel, Building F-Kima, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Olivier Mairesse
- Brugmann University Hospital, Sleep Laboratory and Unit for Chronobiology U78, Université Libre de Bruxelles - Vrije Universiteit Brussel, Brussels, Belgium, and the Department of Experimental and Applied Psychology (EXTO), Vrije Universiteit Brussel
| | - Daniel Neu
- Brugmann University Hospital, Sleep Laboratory and Unit for Chronobiology U78, Université Libre de Bruxelles - Vrije Universiteit Brussel, and UNI Neuroscience Institute, ULB312 Faculty of Medicine, and ULB388 Faculty of Motor Sciences, Université Libre de Bruxelles
| | - Laurence Leysen
- Pain in Motion International Research Group, and the Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University
| | - Mira Meeus
- Pain in Motion International Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University
| | - Maarten Moens
- Department of Neurosurgery and Radiology, University Hospital, and the Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel
| | - Kelly Ickmans
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, and the Department of Physical Medicine and Physiotherapy, University Hospital Brussels
| | - Dorien Goubert
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, and Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University
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26
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Norton MC, Eleuteri S, Cerolini S, Ballesio A, Conte SC, Falaschi P, Lucidi F. Is poor sleep associated with obesity in older adults? A narrative review of the literature. Eat Weight Disord 2018; 23:23-38. [PMID: 29080950 DOI: 10.1007/s40519-017-0453-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 10/15/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION To address the worldwide epidemic of obesity, a sizable literature implicates sleep problems in the onset of obesity in younger populations. However, less is known about how this process may operate among older adults, which is of concern, given demographic shifts that have resulted in a much higher proportion of developed nations around the world reaching late life. METHODS We offer a current review of the literature studying older adults and examining associations between sleep quality and obesity in this population. We consider both subjective and objectively measured sleep as well as both cross-sectional and longitudinal studies offering stronger causal inference. RESULTS We discuss seemingly contradictory literature showing that shorter sleep duration as well as longer sleep duration are associated with obesity risk, then review studies that tested for non-linear relationships and reported a U-shape pattern, suggesting that too much or too little sleep is detrimental. Besides sleep duration, we discuss evidence showing that other forms of sleep dysfunction related to night-time awakenings, REM sleep, slow-wave sleep, and daytime sleepiness, which are indicators of sleep quality, are also linked to obesity. Specific psychological and physiological mediators and moderators, suggesting possible mechanisms whereby sleep problems may affect obesity in older adults, are described. CONCLUSION We conclude by discussing areas, where additional research could help clarify this association, considering such factors as medical comorbidities common in late life, and health-related behaviors that may stem from poor sleep (such as disordered eating behavior). Such insights will have great value for clinical practice. LEVEL OF EVIDENCE Level V, narrative review.
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Affiliation(s)
- Maria C Norton
- Department of Family, Consumer and Human Development and Department of Psychology, Utah State University, Logan, UT, USA.
| | - Stefano Eleuteri
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Silvia Cerolini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Falaschi
- Geriatric Unit, Faculty of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy
| | - Fabio Lucidi
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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27
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Baker JH, Rothenberger SD, Kline CE, Okun ML. Exercise during early pregnancy is associated with greater sleep continuity. Behav Sleep Med 2018; 16:482-493. [PMID: 27739877 PMCID: PMC6124311 DOI: 10.1080/15402002.2016.1228649] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES/BACKGROUND Pregnant women report disturbed sleep beginning in early pregnancy. Among nonpregnant populations, exercise has been associated with improved sleep; however, research in pregnant samples has been equivocal. We examined whether varying degrees of exercise were associated with better nocturnal sleep among pregnant women during early gestation. PARTICIPANTS 172 pregnant women. METHODS Self-reported sleep and exercise and objective sleep were collected during early gestation: T1 (10-12 weeks), T2 (14-16 weeks), and T3 (18-20 weeks) from 172 pregnant women. Exercise was categorized into three time-varying groups: 0 metabolic equivalent minutes per week (MET-min/week), 1 to < 500 MET-min/week, or ≥ 500 MET-min/week. Linear mixed-effects models were employed to test hypotheses. RESULTS A significant main effect for Time (F[2,254] = 9.77, p < 0.0001) and Time*Exercise group interaction were observed for actigraphic sleep efficiency (aSE) (F[4,569] = 2.73, p = 0.0285). At T2, women who reported ≥ 500 MET-min/week had higher aSE than those who reported 0 MET-min/week. Significant main effects for Exercise Group and Time were observed for actigraphic wake after sleep onset (aWASO; F[2,694] = 3.04, p = 0.0483 and F[2,260] = 3.21, p = 0.0419). aWASO was lowest for those reporting 1 to < 500 MET-min/week (t[701] = 2.35, adjusted p = .0489) and aWASO decreased from T1 to T3 (t[258] = 2.53, adjusted p value = 0.036). Lastly, there was a main effect for Time for the PSQI (F[2,689] = 52.11, p < 0.0001), indicating that sleep quality improved over time. CONCLUSIONS Some level of exercise among pregnant women appears to be more advantageous than no exercise at all. Moderate exercise, while still unclearly defined, may be a worthwhile adjunct treatment to combat sleep disturbances during pregnancy.
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Affiliation(s)
| | | | | | - Michele L Okun
- University of Pittsburgh, Department of Psychology,University of Colorado at Colorado Springs, Biofrontiers Institute
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28
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King AC, Campero I, Sheats JL, Castro Sweet CM, Garcia D, Chazaro A, Blanco G, Hauser M, Fierros F, Ahn DK, Diaz J, Done M, Fernandez J, Bickmore T. Testing the comparative effects of physical activity advice by humans vs. computers in underserved populations: The COMPASS trial design, methods, and baseline characteristics. Contemp Clin Trials 2017; 61:115-125. [PMID: 28739541 PMCID: PMC5987528 DOI: 10.1016/j.cct.2017.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/07/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
While physical inactivity is a key risk factor for a range of chronic diseases and conditions associated with aging, a significant proportion of midlife and older adults remain insufficiently active. This is particularly true for ethnic minority populations such as Latino adults for whom few culturally adapted programs have been developed and tested. The major objective of this 12-month cluster-randomized controlled trial is to test the comparative effectiveness of two linguistically and culturally adapted, community-based physical activity interventions with the potential for broad reach and translation. Ten local community centers serving a sizable number of Latino residents were randomized to receive one of two physical activity interventions. The Virtual Advisor program employs a computer-based embodied conversational agent named "Carmen" to deliver interactive, individually tailored physical activity advice and support. A similar intervention program is delivered by trained Peer Advisors. The target population consists of generally healthy, insufficiently active Latino adults ages 50years and older living within proximity to a designated community center. The major outcomes are changes in walking and other forms of physical activity measured via self-report and accelerometry. Secondary outcomes include physical function and well-being variables. In addition to these outcome analyses, comparative cost analysis of the two programs, potential mediators of intervention success, and baseline moderators of intervention effects will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yield as well as study baseline characteristics. TRIAL REGISTRATION clinicaltrial.gov Identifier=NCT02111213.
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Affiliation(s)
- Abby C King
- Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA 94305, United States; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Ines Campero
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Jylana L Sheats
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Cynthia M Castro Sweet
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Dulce Garcia
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Aldo Chazaro
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - German Blanco
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Michelle Hauser
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Fernando Fierros
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - David K Ahn
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Jose Diaz
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Monica Done
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
| | - Juan Fernandez
- College of Computer and Information Science, Northeastern University, Boston, MA 02115, United States
| | - Timothy Bickmore
- College of Computer and Information Science, Northeastern University, Boston, MA 02115, United States.
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29
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Siengsukon CF, Al-Dughmi M, Stevens S. Sleep Health Promotion: Practical Information for Physical Therapists. Phys Ther 2017; 97:826-836. [PMID: 28789471 DOI: 10.1093/ptj/pzx057] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/17/2017] [Indexed: 11/14/2022]
Abstract
Sleep disturbances occur in one third of the US population, and the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control has deemed insufficient sleep to be a public health problem. Knowledge about sleep and skills to screen sleep disorders and to promote sleep health have been recommended for physical therapists. Furthermore, in survey studies, physical therapists overwhelmingly agree that sleep is important for health and poor sleep impairs function. Sleep is critical for the proper functioning of the body, including immune function, tissue healing, pain modulation, cardiovascular health, cognitive function, and learning and memory. Sleep disruptions occur across the life span and in individuals with various conditions that are typically treated by physical therapists. Therefore, the purpose of this perspective paper is to (1) discuss the relevance of sleep to physical therapist practice, (2) recommend tools to screen for the 3 most common sleep disorders, and (3) provide suggestions for how therapists can integrate sleep health in prevention, health promotion, and wellness interventions.
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Affiliation(s)
- Catherine F Siengsukon
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 2002, Kansas City, KS 66160 (USA)
| | - Mayis Al-Dughmi
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center
| | - Suzanne Stevens
- Department of Neurology, University of Kansas Medical Center
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30
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McKenna S, Donnelly A, Fraser A, Comber L, Kennedy N. Does exercise impact on sleep for people who have rheumatoid arthritis? A systematic review. Rheumatol Int 2017; 37:963-974. [PMID: 28251248 DOI: 10.1007/s00296-017-3681-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/14/2017] [Indexed: 11/30/2022]
Abstract
To systematically search for the availability of evidence for exercise impacting on sleep for people who have rheumatoid arthritis. Two reviewers independently searched seven electronic databases, identified and extracted relevant studies by applying eligibility criteria. Sources of bias were assessed independently by two reviewers using the Cochrane bias assessment tool for randomized controlled trials (RCTs) and Newcastle-Ottawa Quality Assessment Scale for non-RCTs. Data were synthesized using a level of evidence approach. Meta-analyses were deemed to be inappropriate due to the heterogeneity of study designs, measurement tools and interventions. Five studies were included: one RCT; two pilot RCTs and two samples of convenience. A total of 262 people with RA were included. Interventions used were difficult to assess due to the heterogeneity of study designs and the inclusion of two using different types of yoga as an intervention. Different sleep outcome measures were used thus, it was not feasible to pool results. Studies had a high risk of bias. This review could find no consistent or conclusive evidence on whether exercise impacts on sleep in people who have rheumatoid arthritis, therefore no firm conclusions can be made. However, there is some indication that exercise may have positive benefits on sleep in people who have rheumatoid arthritis. Further studies with improved study designs, using subjective and objective measures, are needed.
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Affiliation(s)
- Sean McKenna
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
| | - Alan Donnelly
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Alexander Fraser
- Department of Rheumatology, University Hospital Limerick, Limerick, Ireland.,Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Laura Comber
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Norelee Kennedy
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
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31
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Garfield V, Llewellyn CH, Kumari M. The relationship between physical activity, sleep duration and depressive symptoms in older adults: The English Longitudinal Study of Ageing (ELSA). Prev Med Rep 2016; 4:512-516. [PMID: 27699145 PMCID: PMC5045946 DOI: 10.1016/j.pmedr.2016.09.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 09/16/2016] [Accepted: 09/19/2016] [Indexed: 11/23/2022] Open
Abstract
Research to date suggests that physical activity (PA) is associated with distinct aspects of sleep, but studies have predominantly focused on sleep quality, been carried out in younger adults, and have not accounted for many covariates. Of particular interest is also the reported relationship between physical activity and depression in older adults and as such, their associations with sleep duration. Here we examine the cross-sectional relation between physical activity and sleep duration in a community-dwelling sample of 5265 older adults from the English Longitudinal Study of Ageing. We analysed the data using multiple regression, with physical activity as a categorical exposure and sleep duration a continuous outcome, as well as testing the interaction between physical activity and depressive symptoms, which was significant (p < 0.001). We therefore stratified our analyses by depressive symptomatology. Our main finding was that, in the group with elevated depressive symptoms only, physical activity was positively associated with sleep duration in models adjusted for all covariates (age, sex, wealth, ethnicity, smoking, alcohol consumption, BMI, long-standing illness) across low [B (mean difference in sleep duration) = 25.22 min, 95% CI = (3.72; 46.72)], moderate [B = 27.92 min, 95% CI = (6.59; 49.26)] and high [B = 31.65 min, 95% CI = (7.36; 55.94)] PA groups, in comparison to the sedentary group. However, we observed no relation between physical activity and sleep duration in respondents who reported no depressive symptoms, irrespective of physical activity level (p > 0.05). Our findings suggest that a potentially effective way of improving sleep in older adults with depressive symptoms is via physical activity interventions.
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Affiliation(s)
- Victoria Garfield
- Department of Epidemiology and Public Health, University College London, UK
| | - Clare H. Llewellyn
- Department of Epidemiology and Public Health, University College London, UK
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, UK
- Institute for Social & Economic Research, University of Essex, UK
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32
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Gutierrez PM, Davidson CL, Friese AH, Forster JE. Physical Activity, Suicide Risk Factors, and Suicidal Ideation in a Veteran Sample. Suicide Life Threat Behav 2016; 46:284-92. [PMID: 26404757 DOI: 10.1111/sltb.12190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/10/2015] [Indexed: 11/28/2022]
Abstract
The association between current level of suicidal ideation and physical activity was tested in a broad sample of veterans seeking care from the Veterans Health Administration. It was hypothesized that the two variables would be significantly inversely related. It was further hypothesized that the relationship would be mediated by depressive symptoms, disturbed sleep, and a measure of heart rate variability based on existing research regarding physical activity and sleep. Due to the first hypothesis not being supported, the second could not be tested. Post hoc correlation analyses did find associations between physical activity and depressive symptoms, in expected directions, and are discussed. Possible explanations for the negative findings along with recommendations for future research to continue exploring links between suicide risk and physical activity are presented. We conclude by suggesting that physical activity may have promise as a risk reduction intervention and that prospective data are more likely to yield significant results than the cross-sectional methodology employed in the current study.
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Affiliation(s)
- Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Collin L Davidson
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA
| | - Ariel H Friese
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA
| | - Jeri E Forster
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
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33
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Sleep and physical activity as modifiable risk factors in age-associated cognitive decline. Sleep Biol Rhythms 2015. [DOI: 10.1007/s41105-015-0002-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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34
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Varrasse M, Li J, Gooneratne N. Exercise and Sleep in Community-Dwelling Older Adults. CURRENT SLEEP MEDICINE REPORTS 2015; 1:232-240. [PMID: 27088071 DOI: 10.1007/s40675-015-0028-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Insomnia and other sleep complaints are highly prevalent in community-dwelling older adults yet often go under detected. Age-related physiological changes may affect sleep, but sleep disturbances and complaints should not be considered normal in this population. Various physiological, psychological, and social consequences have been associated with insomnia and sleep complaints. Treatment options are available so it is imperative to diagnose and treat these individuals to promote healthy aging. Exercise is known to have a wide variety of health benefits, but unfortunately most older adults engage in less exercise with advancing age. This paper describes age-related changes in sleep, clinical correlates of insomnia, consequences of untreated insomnia, and nonpharmacological treatments for insomnia in older adults, with a focus on the relationship between exercise and sleep in community-dwelling older adults with insomnia or sleep complaints. Possible mechanisms explaining the relationship between exercise and sleep are discussed. While the research to date shows promising evidence for exercise as a safe and effective treatment for insomnia and sleep complaints in community-dwelling older adults, future research is needed before exercise can be a first-line treatment for insomnia and sleep complaints in this population.
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Affiliation(s)
- Miranda Varrasse
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; Center for Integrative Science in Aging, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Junxin Li
- Center for Integrative Science in Aging, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nalaka Gooneratne
- Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Geriatric Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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35
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IL-1β and BDNF are associated with improvement in hypersomnia but not insomnia following exercise in major depressive disorder. Transl Psychiatry 2015; 5:e611. [PMID: 26241349 PMCID: PMC4564559 DOI: 10.1038/tp.2015.104] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 05/04/2015] [Accepted: 06/14/2015] [Indexed: 12/15/2022] Open
Abstract
Given the role of sleep in the development and treatment of major depressive disorder (MDD), it is becoming increasingly clear that elucidation of the biological mechanisms underlying sleep disturbances in MDD is crucial to improve treatment outcomes. Sleep disturbances are varied and can present as insomnia and/or hypersomnia. Though research has examined the biological underpinnings of insomnia in MDD, little is known about the role of biomarkers in hypersomnia associated with MDD. This paper examines biomarkers associated with changes in hypersomnia and insomnia and as predictors of improvements in sleep quality following exercise augmentation in persons with MDD. Subjects with non-remitted MDD were randomized to augmentation with one of two doses of aerobic exercise: 16 kilocalories per kilogram of body weight per week (KKW) or 4 KKW for 12 weeks. The four sleep-related items on the clinician-rated Inventory of Depressive Symptomatology (sleep onset insomnia, mid-nocturnal insomnia, early morning insomnia and hypersomnia) assessed self-reported sleep quality. Inflammatory cytokines (tumor necrosis factor-alpha, interleukin (IL)-1β, IL-6) and brain-derived neurotrophic factor (BDNF) were assessed in blood samples collected before and following the 12-week intervention. Reduction in hypersomnia was correlated with reductions in BDNF (ρ = 0.26, P = 0.029) and IL-1β (ρ = 0.37, P = 0.002). Changes in these biomarkers were not associated with changes in insomnia; however, lower baseline levels of IL-1β were predictive of greater improvements in insomnia (F = 3.87, P = 0.050). In conclusion, improvement in hypersomnia is related to reductions in inflammatory markers and BDNF in persons with non-remitted MDD. Distinct biological mechanisms may explain reductions in insomnia.
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Dekker K, Benjamins JS, Van Straten A, Hofman WF, Van Someren EJW. Effectiveness of internet-supported cognitive behavioral and chronobiological interventions and effect moderation by insomnia subtype: study protocol of a randomized controlled trial. Trials 2015; 16:292. [PMID: 26141682 PMCID: PMC4490722 DOI: 10.1186/s13063-015-0790-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/01/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND DSM-V criteria for insomnia disorder are met by 6 to 10% of the adult population. Insomnia has severe consequences for health and society. One of the most common treatments provided by primary caregivers is pharmacological treatment, which is far from optimal and has not been recommended since a 2005 consensus report of the National Institutes of Health. The recommended treatment is Cognitive Behavioral Therapy for Insomnia. Effectiveness, however, is still limited. Only a few studies have evaluated the effectiveness of chronobiological treatments, including the timed application of bright light, physical activity and body warming. Another opportunity for optimization of treatment is based on the idea that the people suffering from insomnia most likely represent a heterogeneous mix of subtypes, with different underlying causes and expected treatment responses. The present study aims to evaluate the possibility for optimizing insomnia treatment along the principles of personalized and stratified medicine. It evaluates the following: 1. The relative effectiveness of internet-supported cognitive behavioral therapy, bright light, physical activity and body warming; 2. Whether the effectiveness of internet-supported cognitive behavioral therapy for insomnia can be augmented by simultaneous or prior application of bright light, physical activity and body warming; and 3. Whether the effectiveness of the interventions and their combination are moderated by the insomnia subtype. METHODS/DESIGN In a repeated measures, placebo-controlled, randomized clinical trial that included 160 people diagnosed with insomnia disorder, we are evaluating the relative effectiveness of 4 intervention weeks. Primary outcome is subjective sleep efficiency, quantified using a sleep diary. Secondary outcomes include other complaints of sleep and daytime functioning, health-related cost estimates and actigraphic objective sleep estimates. Compliance will be monitored both subjectively and objectively using activity, light and temperature sensors. Insomnia subtypes will be assessed using questionnaires. Mixed effect models will be used to evaluate intervention effects and moderation by insomnia subtype ratings. DISCUSSION The current study addresses multiple opportunities to optimize and personalize treatment of insomnia disorder. TRIAL REGISTRATION Netherlands National Trial Register NTR4010, 4 June 2013.
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Affiliation(s)
- Kim Dekker
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
| | - Jeroen S Benjamins
- Department of Clinical and Health Psychology, Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Annemieke Van Straten
- Department of Clinical Psychology, VU University Amsterdam & EMGO Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
| | - Winni F Hofman
- Department of Psychology, Brain and Cognition group, University of Amsterdamy, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands.
- Personal Health Institute International, Lobo-Braakensiekstraat 94, 1065 HP, Amsterdam, The Netherlands.
| | - Eus J W Van Someren
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
- Departments of Integrative Neurophysiology and Medical Psychology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
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Pa J, Goodson W, Bloch A, King AC, Yaffe K, Barnes DE. Effect of exercise and cognitive activity on self-reported sleep quality in community-dwelling older adults with cognitive complaints: a randomized controlled trial. J Am Geriatr Soc 2015; 62:2319-26. [PMID: 25516028 DOI: 10.1111/jgs.13158] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To compare the effects of different types of physical and mental activity on self-reported sleep quality over 12 weeks in older adults with cognitive and sleep complaints. DESIGN Randomized controlled trial. SETTING General community. PARTICIPANTS Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems (mean age 73.3 ± 6.1; 60% women). INTERVENTION Random allocation to four arms using a two-by-two factorial design: aerobic+cognitive training, aerobic+educational DVD, stretching+cognitive training, and stretching+educational DVD arms (60 min/d, 3 d/wk for physical and mental activity for 12 weeks). MEASUREMENTS Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the 2005 to 2006 National Health and Nutrition Examination Survey (range 0-28, with higher scores reflecting worse sleep quality). Analyses used intention-to-treat methods. RESULTS Sleep quality scores did not differ at baseline, but there was a significant difference between the study arms in change in sleep quality over time (P < .005). Mean sleep quality scores improved significantly more in the stretching+educational DVD arm (5.1 points) than in the stretching+cognitive training (1.2 points), aerobic+educational DVD (1.1 points), or aerobic+cognitive training (0.25 points) arms (all P < .05, corrected for multiple comparisons). Differences between arms were strongest for waking at night (P = .02) and taking sleep medications (P = .004). CONCLUSION Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate- or high-intensity activities in older adults with self-reported cognitive and sleep difficulties. Future longer-term studies with objective sleep measures are needed to corroborate these results.
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Affiliation(s)
- Judy Pa
- Department of Neurology, University of California at San Francisco, San Francisco, California; Department of Neurology, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California
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Madden KM, Ashe MC, Lockhart C, Chase JM. Sedentary behavior and sleep efficiency in active community-dwelling older adults. ACTA ACUST UNITED AC 2014; 7:82-8. [PMID: 26483908 PMCID: PMC4521656 DOI: 10.1016/j.slsci.2014.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/07/2014] [Accepted: 07/14/2014] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Previous studies have demonstrated that aerobic exercise interventions have a positive impact on sleep efficiency in older adults. However, little work has been done on the impact of sedentary behavior (sitting, watching television, etc.) on sleep efficiency. METHODS 54 Community-dwelling men and women >65 years of age living in Whistler, British Columbia (mean 71.5 years) were enrolled in this cross-sectional observational study. Measures of sleep efficiency as well as average waking sedentary (ST), light (LT), and moderate (MT) activity were recorded with Sensewear accelerometers worn continuously for 7 days. RESULTS From the univariate regression analysis, there was no association between sleep efficiency and the predictors LT and MT. There was a small negative association between ST and sleep efficiency that remained significant in our multivariate regression model containing alcohol consumption, age and gender as covariates. (standardized β correlation coefficient -0.322, p=0.019). Although significant, this effect was small (an increase in sedentary time of 3 hours per day was associated with an approximately 5% reduction in sleep efficiency). CONCLUSIONS This study found a small significant association between the time spent sedentary and sleep efficiency, despite high levels of activity in this older adult group.
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Affiliation(s)
- Kenneth M Madden
- University of British Columbia, Division of Geriatric Medicine, Gerontology and Diabetes Research Laboratory, Vancouver, Canada
| | - Maureen C Ashe
- University of British Columbia, Division of Geriatric Medicine, Gerontology and Diabetes Research Laboratory, Vancouver, Canada
| | - Chris Lockhart
- University of British Columbia, Division of Geriatric Medicine, Gerontology and Diabetes Research Laboratory, Vancouver, Canada
| | - Jocelyn M Chase
- University of British Columbia, Division of Geriatric Medicine, Gerontology and Diabetes Research Laboratory, Vancouver, Canada
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McClain JJ, Lewin DS, Laposky AD, Kahle L, Berrigan D. Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults. Prev Med 2014; 66:68-73. [PMID: 24931432 DOI: 10.1016/j.ypmed.2014.06.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 06/03/2014] [Accepted: 06/05/2014] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine the associations between objectively measured physical activity (PA) or sedentary behavior and self-reported sleep duration or daytime sleepiness in a nationally representative sample of healthy US adults (N=2128). METHODS We report analyses of four aspects of sedentary behavior and PA derived from accelerometry data (minutes of sedentary time, activity counts/minute, Minutes of Moderate and Vigorous PA [MVPA], and MVPA in 10-minute bouts) versus self-report of sleep duration and frequency of daytime sleepiness from the 2005-2006 National Health and Nutrition Examination Survey. RESULTS Age and sex dependence of associations between PA and sleep were observed. Aspects of PA were significantly lower in adults reporting more frequent daytime sleepiness in younger (20-39) and older (≥ 60) age groups, but not in middle-aged (40-59), respondents. In younger respondents, PA increased with sleep duration, but in middle aged and older respondents PA was either unrelated to sleep duration or lower in those reporting ≥ 8 h of sleep. Objectively measured sedentary time showed limited evidence of associations with sleep duration. CONCLUSIONS Further research delineating the relationships between sleep and PA is important because both activities have been implicated in diverse health outcomes as well as in the etiology of obesity.
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Affiliation(s)
- James J McClain
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA.
| | - Daniel S Lewin
- Children's National Medical Center, George Washington University School of Medicine, Washington, DC 20310, USA
| | - Aaron D Laposky
- National Center for Sleep Disorders Research, National Heart Lung and Blood Institute, Bethesda, MD 20892, USA
| | - Lisa Kahle
- Information Management Services, Inc., Calverton, MD, USA
| | - David Berrigan
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
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Durcan L, Wilson F, Cunnane G. The effect of exercise on sleep and fatigue in rheumatoid arthritis: a randomized controlled study. J Rheumatol 2014; 41:1966-73. [PMID: 25128510 DOI: 10.3899/jrheum.131282] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Sleep disturbance and chronic fatigue are common in rheumatoid arthritis (RA) and contribute to disability, symptomatology, and healthcare use. It has long been recognized in other populations that exercise can improve sleep and diminish fatigue. The effect of exercise on sleep quality and fatigue in RA has not been evaluated. METHODS Ours is a randomized controlled study in RA to determine the effect of an exercise program on sleep quality and fatigue. These were measured using the Pittsburgh Sleep Quality Index and the Fatigue Severity Scale. Patients were randomized to either a 12-week, home-based exercise intervention or usual care. The exercise program consisted of specific exercises to target individual deficiencies identified using the Health Assessment Questionnaire (HAQ) with cardiovascular work as per the guidelines. The intervention group was evaluated on a 3-week basis. Full evaluation was carried out at baseline and at 12 weeks. RESULTS Forty patients were randomized to the intervention with 38 controls. In the exercise intervention group, there was a statistically significant improvement in HAQ (p = 0.00), pain (p = 0.05), stiffness (p = 0.05), sleep quality (p = 0.04), and fatigue (p = 0.04). In our control group, there was a statistically significant improvement demonstrated in their overall perceptions of the benefits of exercise, but none of the other variables. CONCLUSION Our study demonstrates that an exercise program resulted in significant improvement in sleep quality and fatigue. This is particularly interesting given the importance of fatigue as an outcome measure in RA and gives us yet another reason to prescribe exercise in this population.
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Affiliation(s)
- Laura Durcan
- From the Department of Rheumatology, St. James's Hospital; the Department of Physiotherapy, Trinity College, Dublin, Ireland.L. Durcan, MD, MB, Bch, BAO, Specialist Registrar in Rheumatology, Department of Rheumatology, St. James's Hospital; F. Wilson, PhD, Assistant Professor and Chartered Physiotherapist, Department of Physiotherapy, Trinity College; G. Cunnane, PhD, Clinical Professor, Trinity College Dublin, Consultant Rheumatologist, St. James's Hospital.
| | - Fiona Wilson
- From the Department of Rheumatology, St. James's Hospital; the Department of Physiotherapy, Trinity College, Dublin, Ireland.L. Durcan, MD, MB, Bch, BAO, Specialist Registrar in Rheumatology, Department of Rheumatology, St. James's Hospital; F. Wilson, PhD, Assistant Professor and Chartered Physiotherapist, Department of Physiotherapy, Trinity College; G. Cunnane, PhD, Clinical Professor, Trinity College Dublin, Consultant Rheumatologist, St. James's Hospital
| | - Gaye Cunnane
- From the Department of Rheumatology, St. James's Hospital; the Department of Physiotherapy, Trinity College, Dublin, Ireland.L. Durcan, MD, MB, Bch, BAO, Specialist Registrar in Rheumatology, Department of Rheumatology, St. James's Hospital; F. Wilson, PhD, Assistant Professor and Chartered Physiotherapist, Department of Physiotherapy, Trinity College; G. Cunnane, PhD, Clinical Professor, Trinity College Dublin, Consultant Rheumatologist, St. James's Hospital
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Kline CE. The bidirectional relationship between exercise and sleep: Implications for exercise adherence and sleep improvement. Am J Lifestyle Med 2014; 8:375-379. [PMID: 25729341 DOI: 10.1177/1559827614544437] [Citation(s) in RCA: 200] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Exercise has long been associated with better sleep, and evidence is accumulating on the efficacy of exercise as a nonpharmacologic treatment option for disturbed sleep. Recent research, however, has noted that poor sleep may contribute to low physical activity levels, emphasizing a robust bidirectional relationship between exercise and sleep. This article will briefly review the evidence supporting the use of exercise as a nonpharmacologic treatment for sleep disturbance, outline future research that is needed to establish the viability of exercise as a behavioral sleep treatment, describe recent research that has emphasized the potential influence of poor sleep on daytime activity levels, and discuss whether improving sleep may facilitate adoption and/or better adherence to a physically active lifestyle. With poor sleep and physical inactivity each recognized as key public health priorities, additional research into the bidirectional relationship between exercise and sleep has significant implications for facilitating greater exercise adherence and improving sleep in society.
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Anderson D, Seib C, Rasmussen L. Can physical activity prevent physical and cognitive decline in postmenopausal women? A systematic review of the literature. Maturitas 2014; 79:14-33. [PMID: 25008420 DOI: 10.1016/j.maturitas.2014.06.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 06/13/2014] [Indexed: 12/23/2022]
Abstract
BACKGROUND Participation in regular physical activity is among the most promising and cost effective strategies to reduce physical and cognitive decline and premature death. However, confusion remains about the amount, frequency, and duration of physical activity that is likely to provide maximum benefit as well as the way in which interventions should be delivered. AIMS This paper aimed to review research on the impact of leisure-time and general physical activity levels on physical and cognitive decline in postmenopausal women. In a systematic review of the literature, empirical literature from 2009 to 2013 is reviewed to explore the potential impact of either commencing or sustaining physical activity on older women's health. RESULTS All studies found that physical activity was associated with lower rates of cognitive and physical decline and a significant reduction in all-cause mortality. In this review we found that exercise interventions (or lifestyle activities) that improved cardiorespiratory exercise capacity showed the most positive impact on physical health. CONCLUSIONS Findings suggest that programs should facilitate and support women to participate in regular exercise by embedding physical activity programs in public health initiatives, by developing home-based exercise programs that require few resources and by creating interventions that can incorporate physical activity within a healthy lifestyle. The review also suggests that clinicians should consider prescribing exercise in a tailored manner for older women to ensure that it is of a high enough intensity to obtain the positive sustained effects of exercise.
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Affiliation(s)
- Debra Anderson
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
| | - Charlotte Seib
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Laura Rasmussen
- School of Nursing, Queensland University of Technology, Australia
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Singh JK, Learman LA, Nakagawa S, Gregorich SE, Kuppermann M. Sleep problems among women with noncancerous gynecologic conditions. J Psychosom Obstet Gynaecol 2014; 35:29-35. [PMID: 24393058 DOI: 10.3109/0167482x.2013.868880] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of and identify factors associated with poor sleep quality and short sleep duration among women with noncancerous gynecologic conditions. STUDY DESIGN We conducted a cross-sectional analysis of 838 pre-menopausal women aged 31-54 who enrolled in a study of pelvic problems, hysterectomy and intervention alternatives in 2003/2004. Primary outcomes were poor sleep quality and short sleep duration (six or less hours on average) in the four weeks preceding the interview; hypothesized correlates included sociodemographic characteristics, pelvic problem impact, measured by the Pelvic Problem Impact Questionnaire (PPIQ), and depression, measured by the Patient Health Questionnaire (PHQ). RESULTS One-third (33.7%) of the participants reported having poor sleep quality and nearly half (46.8%) reported short sleep duration. In multivariable models, women with major depressive disorder were more likely than those who were not depressed to experience poor sleep quality (adjusted odds ratio (aOR) 4.15, 95% confidence interval (CI) 2.36-7.28, p < 0.001). Women with higher PPIQ scores also were more likely to experience poor sleep quality (aOR 1.59, 95% CI 1.27-1.98, p < 0.001) and short sleep duration (aOR 1.37, 95% CI 1.11-1.69, p < 0.003). Finally, women who self-identified as African-American (aOR 2.81, 95% CI 1.83-4.32, p < 0.001) or Asian/Pacific Islander (aOR 2.32, 95% CI 1.32-4.09, p < 0.003) were more likely than White women to have short sleep duration. CONCLUSIONS Sleep problems are prevalent among women with noncancerous gynecologic conditions, and are associated with depression and high pelvic problem impact. Providers should be proactive in inquiring about and offering solutions for sleep difficulties experienced by their patients.
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Affiliation(s)
- Jaspreet K Singh
- Departments of Obstetrics, Gynecology & Reproductive Sciences, University of California , San Francisco, CA , USA
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Krampe J, Miller SJ, Echebiri C, Rantz MJ, Skubic M. Nighttime restfulness during daytime dance therapy: an exploratory study using bed sensors. West J Nurs Res 2014; 36:362-73. [PMID: 24005243 PMCID: PMC4283802 DOI: 10.1177/0193945913503716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dance-based therapy has the potential to slow the progression of functional limitations in older adults. The purpose of this study was to explore the feasibility of measuring the impact of dance-based therapy on the nighttime restfulness patterns of older adults in an aging-in-place facility using passive bed sensors. A secondary data analysis of the continuous 2-month nighttime bed sensor data was reviewed for measurable change during a dance study. A measurable variation in nighttime restfulness level was detected between the dancers and nondancers, and no high or very high restlessness was detected during this period for the dance-based therapy group. Although these exploratory variations are modest, the findings suggest that bed sensors can be used to measure nighttime restfulness following a therapeutic dance intervention. More research is needed in this emerging area.
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Affiliation(s)
- Jean Krampe
- Saint Louis University School of Nursing, MO, USA
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Abstract
Despite its pervasiveness in primary care, deficient sleep often is underappreciated as a cue to other health risks. Accordingly, this review discusses contemporary evidence-based perspectives on impaired sleep and its associations with other lifestyle medicine concerns, including obesity, cardiovascular conditions, psychological problems, and health-compromising habits. The potential clinical benefits of promoting sleep health also will be considered.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri
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46
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Ng TW, Feldman DC. How do within-person changes due to aging affect job performance? JOURNAL OF VOCATIONAL BEHAVIOR 2013. [DOI: 10.1016/j.jvb.2013.07.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wong SN, Halaki M, Chow CM. The effects of moderate to vigorous aerobic exercise on the sleep need of sedentary young adults. J Sports Sci 2012; 31:381-6. [PMID: 23075031 DOI: 10.1080/02640414.2012.733823] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exercise has been recommended for enhancing sleep; a claim linked to the belief that sleep need - defined by sleep duration and depth - is increased post-exercise to allow tissue recovery. Objective studies investigating exercise-sleep responses have produced mixed outcomes, and the disparity in results between studies may be due to differences in individual characteristics and/or exercise protocol, emphasising the importance of carefully controlled trials. We investigated the role of exercise on the sleep need of sedentary adults, after controlling for exercise mode, timing and duration. Twelve healthy volunteers (25.2 ± 4.0 years, 9 females, [Vdot]O(2)max 35.4 ± 8.8 ml· kg(-1) · min(-1)) were randomised to no-exercise or to a bout of treadmill exercise at 45%, 55%, 65% or 75% [Vdot]O(2)max in a crossover design. Sleep on no-exercise and exercise nights were assessed by polysomnography. Participants spent a greater proportion of sleep in light sleep (stage 1 + stage 2) after exercise at both 65% and 75% [Vdot]O(2)max (P < 0.05) than the no-exercise condition. There was a trend of a reduced proportion of rapid eye movement sleep with increased exercise intensity (P = 0.067). No other changes were observed in any other sleep variables. Two findings emerged: vigorous exercise did not increase sleep need; however, this level of exercise increased light sleep.
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Affiliation(s)
- Shi N Wong
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Australia.
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Passos GS, Poyares DLR, Santana MG, Tufik S, Mello MTD. Is exercise an alternative treatment for chronic insomnia? Clinics (Sao Paulo) 2012; 67:653-60. [PMID: 22760906 PMCID: PMC3370319 DOI: 10.6061/clinics/2012(06)17] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 02/13/2012] [Indexed: 11/18/2022] Open
Abstract
The purposes of this systematic/critical review are: 1) to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2) to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing the chronic effects of exercise on sleep in people with sleep complaints or chronic insomnia were considered. We used the following keywords when searching for articles: insomnia, sleep, sleep complaints, exercise and physical activity. For a critical review, studies were selected on the effects of exercise and possible mechanisms that may explain the effects of exercise on insomnia. We identified five studies that met our inclusion criteria for systematic review. Exercise training is effective at decreasing sleep complaints and insomnia. Aerobic exercise has been more extensively studied, and its effects are similar to those observed after hypnotic medication use. Mechanisms are proposed to explain the effects of exercise on insomnia. There is additional documented evidence on the antidepressant and anti-anxiety effects of exercise. Exercise is effective to decrease sleep complaints and to treat chronic insomnia. Exercise presented similar results when compared with hypnotics; however, prospective studies comparing the effects of exercise with medical and non-medical treatments are warranted before including exercise as a first-line treatment for chronic insomnia are necessary.
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Affiliation(s)
- Giselle Soares Passos
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
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Norra C, Richter N, Juckel G. Sleep disturbances and suicidality: a common association to look for in clinical practise and preventive care. EPMA J 2011; 2:295-307. [PMID: 23199165 PMCID: PMC3405392 DOI: 10.1007/s13167-011-0101-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 07/01/2011] [Indexed: 01/10/2023]
Abstract
Suicidality and suicide has been associated with many risk factors, while recent clinical and epidemiological studies increasingly point to a potential link between sleep loss or sleep disturbances and suicidality. This review on studies of sleep disturbances associated with suicidality, i.e., suicidal ideation, suicide attempt and completed suicide suggests a frequent association especially with insomnia and nightmares but also hypersomnia and sleep panic attacks. In suicidal insomniacs with comorbid psychiatric disorders, there is some evidence for an even independent predictive nature of sleep problems for suicidality. Considerations on the shared neurobiology, risk assessment and treatment options complement the overview. Thus, sleep disturbances may qualify as an individual treatable target of personalised medicine in the clinical routine as well as in suicide prevention programmes. A more detailed assessment of sleep problems and identification of specific risk domains in primary or secondary prevention of suicidality seem to be a future area of high importance.
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Affiliation(s)
- Christine Norra
- Department of Psychiatry, Ruhr University Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Nadja Richter
- Department of Psychiatry, Ruhr University Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
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