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Hausenblas HA, Lynch T, Hooper S, Shrestha A, Rosendale D, Gu J. Magnesium-L-threonate improves sleep quality and daytime functioning in adults with self-reported sleep problems: A randomized controlled trial. Sleep Med X 2024; 8:100121. [PMID: 39252819 PMCID: PMC11381753 DOI: 10.1016/j.sleepx.2024.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/23/2024] [Accepted: 08/14/2024] [Indexed: 09/11/2024] Open
Abstract
Objective/Background Sleep problems challenge overall wellbeing. Magnesium has been implicated to benefit sleep, although the clinical evidences varied based on the magnesium source used. Magnesium L-threonate (MgT) is a promising intervention due to its brain bioavailability and effects on cognition, memory and mood. We investigated MgT supplementation on sleep quality and daily function. Patients/methods Eighty 35-55-year-olds with self-assessed sleep problems participated in a randomized, double-blind, placebo-controlled, parallel-arm study, taking 1 g/day of MgT or placebo for 21 days. Sleep and daily behaviors were measured subjectively using standardized questionnaires including the Insomnia Severity Index, Leeds Sleep Evaluation Questionnaire, and Restorative Sleep Questionnaire, and objectively using an Oura ring. The Profile of Mood States questionnaire and a daily diary were used to evaluate mood, energy and productivity, and record any safety concerns. Results The MgT group maintained good sleep quality and daytime functioning, while placebo declined. From objective Oura ring measurements, MgT significantly (p < 0.05) improved vs placebo deep sleep score, REM sleep score, light sleep time, and activity and readiness parameters activity score, activity daily movement score, readiness score, readiness activity balance, and readiness sleep balance. From subjective questionnaires, MgT significantly (p < 0.05) improved vs placebo behavior upon awakening, energy and daytime productivity, grouchiness, mood and mental alertness. MgT was safe and well tolerated. Conclusions This showed MgT improved sleep quality, especially deep/REM sleep stages, improved mood, energy, alertness, and daily activity and productivity. These are consistent with how MgT works in neuron cells and animal models, suggesting broader positive impacts on overall brain health.
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Li X, Ye Q, Liu Q, Peng J, Li N, Deng Q, Hu J, Yong C, Li S, Wang Y, Zhu J, Zhao X, Zhou J. Longer-term Effect of Physical Activity Intervention on Sleep Quality: A Secondary Analysis of Cluster Randomized Controlled Trial. Sleep 2024:zsae165. [PMID: 39041369 DOI: 10.1093/sleep/zsae165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Indexed: 07/24/2024] Open
Abstract
STUDY OBJECTIVES To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers. METHODS This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months. RESULTS The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point. CONCLUSION The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.
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Affiliation(s)
- Xianlan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qin Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jie Peng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Nanyan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qian Deng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Julinling Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chan Yong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyi Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yufei Wang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Jingjie Zhu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Boyle JT, Nielson SA, Perlis ML, Dzierzewski JM. Move your feet and sleep: A longitudinal dynamic analysis of self-reported exercise, sedentary behavior, and insomnia symptoms. Sleep Health 2024; 10:321-326. [PMID: 38548566 PMCID: PMC11162937 DOI: 10.1016/j.sleh.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/13/2024] [Accepted: 02/24/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Insomnia symptoms are associated with poor physical and mental health. Exercise is associated with good sleep while sedentary behavior is associated with poor sleep. This study investigated the longitudinal, dynamic associations among exercise, sedentary behavior, and insomnia symptoms. METHODS Seven hundred and fifty-six adults (Mage=47.2years, 54.9% female) took part in an online longitudinal study investigating sleep and health across the lifespan. Participants reported duration of moderate-to-strenuous exercise, percentage of day spent sitting, and insomnia symptoms (Insomnia Severity Index [ISI]). The ISI was scored as a total score and two-factor scores: (1) Sleep Disturbance (items 1, 2, 3) and (2) Daytime Dysfunction (items 4, 5, 6, 7). Multilevel modeling was used to examine the typical (i.e., between-persons) and individual (i.e., within-persons) associations among sedentary behavior, exercise, and insomnia symptoms. RESULTS Sedentary behavior was significantly associated with total ISI scores at both the between-person and within-person levels (β = 0.036, t = 3.23, p = .001; β = 0.014, t = 1.99, p = .048). Both between-persons and within-person levels of sedentary behavior were associated with Daytime Dysfunction (β = 0.028, t = 3.79, p < .001; β = 0.009, t = 2.08, p = .039). Exercise was associated with total ISI and Daytime Dysfunction scores at the between-persons level but not at the within-persons level (β = 0.028, t = 2.57, p = .01; β = -0.002, t = -3.02, p = .003). CONCLUSIONS Sedentary behavior was a more consistent and robust predictor of insomnia symptoms than exercise. The association between sedentary behavior and insomnia symptoms was dynamic in that when an individual reported being more sedentary than their norm, they also reported more insomnia symptoms. Future analyses should examine potential moderator variables and comorbid conditions.
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Affiliation(s)
- Julia T Boyle
- Office of Research and Development, VA Boston Healthcare System, Massachusetts, USA; New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Spencer A Nielson
- Department of Psychology, Virginia Commonwealth University, Virginia, USA
| | - Michael L Perlis
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Chronobiology and Sleep Institute Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Stein MD, Godersky ME, Kim TW, Walley AY, Heeren TC, Winter MR, Magane KM, Saitz R. Self-medication of pain and discomfort with alcohol and other substances by people with HIV infection and substance use disorder: preliminary findings from a secondary analysis. AIDS Care 2024; 36:414-424. [PMID: 37909062 PMCID: PMC10922286 DOI: 10.1080/09540121.2023.2275047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
There is a limited literature regarding factors associated with self-medication of pain and discomfort using alcohol, non-prescription substances or overuse of prescription medications among people living with Human Immunodeficiency Virus (HIV). This cross-sectional analysis used data from the Boston ARCH Cohort among participants with HIV infection and a history of alcohol or other substance use. Among 248 participants, 37% were female, 50% Black, 25% Latinx; 36% reported fair to poor health and 89% had CD4 cell counts >200/mm3. Half reported self-medication and of those, 8.8% reported doing so only with alcohol, 48.8% only with other substances and 42.4% with both alcohol and other substances. Those reporting self-medication were significantly (p < .05) younger (mean 47 vs 50 years), less employed (11% vs 21%), and less likely to have HIV viral suppression (60% vs. 80%). Depression, anxiety, and HIV symptoms were associated with significantly greater odds of self-medicating, as were substance dependence, recent injection substance use, heavy alcohol use, cocaine use, opioid use, sedative use, and cannabis use. Self-medication, highly prevalent and associated with worse mental health symptoms, greater substance use, and lesser HIV disease control, should be explored by HIV clinicians caring for people who use substances.
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Affiliation(s)
- Michael D. Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health. 715 Albany Street, Boston, MA, USA 02118
| | - Margo E. Godersky
- SORCE, Department of Surgery, University of Washington Medical Center, 1107 NE 45th Street, Suite 502 Seattle, WA, USA 98105
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 4th Floor, Boston, MA, USA 02118
| | - Theresa W. Kim
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Grayken Center for Addiction, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, USA 02118
| | - Alexander Y. Walley
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Grayken Center for Addiction, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, USA 02118
| | - Timothy C. Heeren
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health 85 East Newton Street, 9th Floor, Boston, MA, USA 02118
| | - Michael R. Winter
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health 85 East Newton Street, 9th Floor, Boston, MA, USA 02118
| | - Kara M. Magane
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 4th Floor, Boston, MA, USA 02118
| | - Richard Saitz
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Grayken Center for Addiction, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, USA 02118
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 4th Floor, Boston, MA, USA 02118
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Kong X, Qi W, Xing F, Zhu S, Sun Y, Duan H, Wu Y. Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects. J Am Med Dir Assoc 2024; 25:368-374. [PMID: 37931896 DOI: 10.1016/j.jamda.2023.09.033] [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: 06/27/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES Sleep is associated with physical activity (PA), yet the nature and directions of this association are less understood. This study aimed to disentangle the long-term temporal sequences between sleep duration/disturbance and PA in older adults, distinguishing between- and within-person effects. DESIGN Longitudinal panel study. SETTING AND PARTICIPANTS We conducted a longitudinal study using 3 waves of data collected in 2008/09 (T1), 2012/13 (T2), and 2016/17(T3) from adults aged ≥50 years in the English Longitudinal Study of Ageing (N = 10,749 individuals). MEASURES Sleep duration, sleep disturbance, and PA were assessed by self-reported questionnaires. We used cross-lagged panel models (CLPMs) to examine between-person effects and random intercept cross-lagged panel models (RI-CLPMs) to examine within-person effects. RESULTS Our analyses revealed a reciprocal relationship between abnormal sleep duration and low PA levels at between-person level (abnormal sleep duration to PA: βT1-T2 = -0.053, βT2-T3 = -0.058, all P < .001; PA to abnormal sleep duration: βT1-T2 = -0.040, βT2-T3 = -0.045, all P < .05), with abnormal sleep duration being the driving force in the dynamic association. In addition, there was a unidirectional effect of more severe sleep disturbance on lower levels of PA at both between- and within-person levels (between-person level: βT1-T2 = -0.032, βT2-T3 = -0.028, all P < .001; within-person level: βT1-T2 and T2-T3 = -0.031, all P = .011). CONCLUSIONS AND IMPLICATIONS This study adds novel insights into the temporal directionality of sleep and PA among community-dwelling older adults and highlights poor sleep as a potential risk factor for PA. Intervention strategies should aim to improve sleep to promote PA levels and successful aging.
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Affiliation(s)
- Xiangjie Kong
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Weifeng Qi
- Zibo Centre for Disease Control and Prevention, Zibo, Shandong, China
| | - Fangjie Xing
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Shuai Zhu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Haiping Duan
- Qingdao Municipal Centre for Disease Control and Prevention/Qingdao Institute of Preventive Medicine, Qingdao, Shandong, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China.
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González-Martín AM, Aibar-Almazán A, Rivas-Campo Y, Marín-Gutiérrez A, Castellote-Caballero Y. Effects of mindfulness-based cognitive therapy on older adults with sleep disorders: a systematic review and meta-analysis. Front Public Health 2023; 11:1242868. [PMID: 38179560 PMCID: PMC10765593 DOI: 10.3389/fpubh.2023.1242868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Objective This systematic review and meta-analysis was conducted to analyze the effectiveness of a mindfulness-based program on sleep quality in healthy non-institutionalized older people. Methods This study was conducted following the PRISMA (Preferred Reporting Items For Systematic Reviews And Meta-Analyses) guidelines. The search was conducted during May and June 2023 using four databases: Pubmed, Scopus, Web of Science, and CINAHL. Different keywords combined with Boolean operators were used. Only 10 articles of the initial 177 were included. In the study, the standardized mean difference (SMD) was used along with a 95% confidence interval to measure the effect. Heterogeneity among the studies, assessed using Cochran's Q-test and the I2 statistic was found to be low, leading to the use of a fixed-effects model in the analysis. The effect size was expressed as Hedge'g. Furthermore, a subgroup analysis was conducted, taking into account the various tools used to assess sleep conditions. Results Mindfulness was found to reduce poor sleep quality in people with both long-term and short-term sleep disorders. Weighting effect model Hedge'g = -0.344 with a 95% confidence interval ranging from -0.425 to -0.263. In all cases, statistically significant results were observed, as well as moderate and negative effect sizes according to the Hedge's g index: -0.326 for Insomnia Severity Index (ISI), -0.343 for Pittsburgh Sleep Quality Index (PSQI), and -0.28 for Sleep Onset Latency (SOL). Conclusion This systematic review and meta-analysis found that mindfulness can be used to remedy poor sleep quality in older people, so it could be a viable treatment option for insomnia or other problems related to poor sleep quality in this population.
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Affiliation(s)
- Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
- Department of Psychology, Centro de Educación Superior de Enseñanza e Investigación Educativa, Madrid, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Yulieth Rivas-Campo
- Faculty of Human and Social Sciences, University of San Buenaventura-Cali, Santiago de Cali, Colombia
| | - Alejandro Marín-Gutiérrez
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
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Moura SS, Menezes Júnior LAA, Carraro JCC, Machado-Coelho GLL, Meireles AL. Poor Sleep Quality and Working From Home Influence the Prevalence of Leisure Time Physical Inactivity During the COVID-19 Pandemic: COVID-Inconfidentes Study. J Occup Environ Med 2023; 65:e640-e647. [PMID: 37505098 DOI: 10.1097/jom.0000000000002930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVE The aim of the study is to explore possible associations according to quality of sleep and work from home (WFH) with physical inactivity (PI) during the COVID-19 pandemic. METHODS This is a cross-sectional study in two Brazilian cities (>18 years), by probability sampling. Leisure-time physical activity was self-reported and classified according to guidelines. Sleep was by applying the Pittsburgh Sleep Quality Index. Work from home was classified as: total WFH or no WFH. RESULTS A total of 1750 adults were analyzed, 69.1% were physically inactive, 51.9% had poor sleep quality, and 79.8% were not in WFH. PI was associated with poor sleep quality and non-WFH. Compared with those who reported WFH and good sleep quality, those who reported non-WFH and poor sleep quality had 4 times the prevalence of PI. CONCLUSIONS Poor sleep quality, and not WFH, is associated with leisure PI. These factors combined increase the probability of PI.
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Affiliation(s)
- Samara Silva Moura
- From the Post-graduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto. Ouro Preto, Minas Gerais, Brazil (S.S.d.M., L.A.A.d.M.J., J.C.C.C., G.L.L.M.-C., A.L.M.); and Epidemiology Laboratory, Medical School, Federal University of Ouro Preto. OuroPreto, Minas Gerais, Brazil (S.S.d.M., L.A.A.d.M.J., G.L.L.M.-C.)
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Liu H, Liu F, Ji H, Dai Z, Han W. A bibliometric analysis of sleep in older adults. Front Public Health 2023; 11:1055782. [PMID: 36908435 PMCID: PMC9995908 DOI: 10.3389/fpubh.2023.1055782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Background Sleep problems severely affect the quality of life in the elderly and have gradually gained attention among scholars. As a major hot spot of current research, sleep in older adults is highly exploratory and of great significance for human health. Objective Therefore, in this study, the current state of the art of sleep research in older adults was analyzed through the visual mapping function of CiteSpace software. Using this software, we analyzed popular research questions and directions and revealed the development trends and research frontiers of this field. Methods In this paper, we searched the Web of Science database for sleep-related studies focusing on older adults and analyzed the number of publications, journals, authors, institutions, country regions, and keywords by using CiteSpace software. Results Our results revealed that the number of publications concerning sleep in older adults has gradually increased; after 2017, this field underwent rapid development. The journal Sleep has published the majority of the articles on sleep in older adults and has the highest citation frequency. The Journal of the American Geriatrics Society has the highest impact factor and CiteScore among the top 10 journals in terms of the number of published articles. The United States has the highest number of publications and most of the leading institutions in this field are located in the United States, with the University of California, Los Angeles, and the University of Pittsburgh having the highest number of publications. Dzierzewski JM is the most published author and has played an important role in guiding the development of this field. Research in this area is focused on insomnia, sleep quality, depression, and sleep duration. Conclusion The rapid development of sleep research in older adults, which shows a yearly growth trend, indicates that this field is receiving increasing attention from researchers. Insomnia in older adults is the most concerning problem in this field. At the same time, future research should continue to focus on the impact of sleep disorders on older adults to improve sleep and quality of life in older adults.
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Affiliation(s)
- Haitao Liu
- College of Physical Education, Henan University, Kaifeng, Henan, China.,Research Center of Sports Reform and Development, Henan University, Kaifeng, Henan, China.,Institute of Physical Fitness and Health, Henan University, Kaifeng, Henan, China
| | - Feiyue Liu
- College of Physical Education, Henan University, Kaifeng, Henan, China
| | - Haoyuan Ji
- College of Physical Education, Henan University, Kaifeng, Henan, China
| | - Zuanqin Dai
- College of Physical Education, Henan University, Kaifeng, Henan, China
| | - Wenxiu Han
- College of Physical Education, Henan University, Kaifeng, Henan, China
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Amoako M, Amoah-Agyei F, Mensah GO, Du C, Sergin S, Fenton JI, Tucker RM. Effects of the COVID-19 Pandemic on Health Behaviors of Higher Education Students in Ghana: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16442. [PMID: 36554322 PMCID: PMC9778950 DOI: 10.3390/ijerph192416442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
Stressful events can significantly impact health behaviors of tertiary students in various ways. Many studies reported adverse alterations in health behaviors during the COVID-19 pandemic. However, there is limited knowledge about students from sub-Saharan African countries. Therefore, this study aimed to assess effects of the COVID-19 pandemic on the health behaviors of Ghanaian tertiary students, with an emphasis on the association between sleep and other health behaviors. A cross-sectional study with eligible tertiary students from the Kwame Nkrumah University of Science and Technology in Ghana (n = 129) was conducted. An online survey assessed quality and duration of sleep, financial stress, dietary risk, alcohol misuse, and physical exercise using validated tools. Health behaviors did not differ by gender. The COVID-19 pandemic negatively affected health behaviors for many students including dietary intake (20.2%), sleep quality (20.2%) and duration (81.4%), alcohol consumption (3.1%), exercise frequency (4.1%), and exercise intensity (38%). Shorter sleep duration was linked with greater alcohol misuse scores (p < 0.05). A majority of the students (56%) had increased financial stress during the pandemic. This study contributes important insights into the effects that stressful events such as a pandemic have on the health of higher education students in sub-Saharan Africa.
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Affiliation(s)
- Mary Amoako
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Felicity Amoah-Agyei
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Gideon Okyere Mensah
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Rd., East Lansing, MI 48824, USA
| | - Selin Sergin
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Rd., East Lansing, MI 48824, USA
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Rd., East Lansing, MI 48824, USA
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Rd., East Lansing, MI 48824, USA
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Aliabadi S, Zarghami F, Farhadi A, Sharifi F, Moodi M. Effect of Physical Activity on Sleep Outcomes among Iranian Older Adults: A Cross-Sectional Study. ADVANCES IN GERONTOLOGY 2022. [DOI: 10.1134/s2079057022040038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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11
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Alfini AJ, Won J, Weiss LR, Nyhuis CC, Zipunnikov V, Spira AP, Liu-Ambrose T, Shackman AJ, Smith JC. Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition. Brain Sci 2022; 12:1360. [PMID: 36291294 PMCID: PMC9599432 DOI: 10.3390/brainsci12101360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to understand the associations of sleep and cardiorespiratory fitness with hippocampal volume and global cognition among older adults (n = 30, age = 65.8 years, female = 73.3%). Wrist actigraphy provided objective measures of nighttime sleep including sleep duration, average wake bout length (WBL; sleep disturbance), and wake-to-sleep transition probability (WTSP; sleep consolidation). Cardiorespiratory fitness was quantified via cycle exercise using a modified heart rate recovery approach. Magnetic resonance imaging was used to determine hippocampal volume and the Mini-Mental State Examination was used to assess global cognition. Fitness moderated associations of sleep with hippocampal volume and cognitive performance, whereby the association of WBL-an index of poor sleep-with hippocampal atrophy was stronger among less-fit individuals, and the association of sleep duration with cognitive performance was stronger among more-fit individuals. Across the fitness levels, a longer WBL was associated with lower cognitive performance, and a higher WTSP-an index of more consolidated sleep-was associated with greater hippocampal volume. Sleep and fitness were unrelated to the volume of an amygdala control region, suggesting a degree of neuroanatomical specificity. In conclusion, higher cardiorespiratory fitness may attenuate sleep disturbance-related hippocampal atrophy and magnify the cognitive benefits of good sleep. Prospective studies are needed to confirm these findings.
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Affiliation(s)
- Alfonso J. Alfini
- National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20817, USA
| | - Junyeon Won
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Lauren R. Weiss
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
| | - Casandra C. Nyhuis
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada
| | - Alexander J. Shackman
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA
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12
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Clark C, Rivas E, Gonzales JU. Six nights of sleep extension increases regional cerebral oxygenation without modifying cognitive performance at rest or following acute aerobic exercise. J Sleep Res 2022; 31:e13582. [PMID: 35266244 PMCID: PMC9458765 DOI: 10.1111/jsr.13582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 11/29/2022]
Abstract
Long sleep durations (≥540 min) are associated with poor cognitive performance in ageing adults, but the underlying cause is unclear. The aim of this study was to investigate the effect of extended sleep on cognitive performance and cerebral vascular function before and then after aerobic exercise. In all, 12 adults completed 6 nights of 8- (control) and 10+-h (sleep extension) time in bed in a randomised, crossover experiment. Sleep was measured using wrist actigraphy. On the last day of each time in bed protocol, participants performed three bouts of brisk walking. Sustained attention, spatial rotation ability, mental flexibility, and working memory were assessed, while prefrontal oxygen saturation index (ΔTSI) was measured using near-infrared spectroscopy. A two-way repeated-measures analysis of variance (time in bed × before/after exercise) was used for statistical analysis. Average sleep duration was longer following sleep extension as compared to control, at a mean (SD) of 551 (16) versus 428 (20) min (p < 0.001). Sleep extension did not alter cognitive performance as compared to control, but increased ΔTSI during tests of spatial rotation ability (main effect for time in bed, p = 0.03), mental flexibility (p = 0.04), and working memory (p < 0.01). Cognitive performance was improved (main effect for exercise, p < 0.05) following brisk walking for all cognitive domains except sustained attention with no interaction with time in bed. In summary, 6 nights of extended time in bed accompanied by long sleep durations does not impair cognitive performance at rest or alter the positive effect of acute aerobic exercise on cognition but may increase frontal cerebral oxygenation during cognitive functioning.
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Affiliation(s)
- Cayla Clark
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, United States of America
| | - Eric Rivas
- H-3PO Laboratory, NASA Johnson Space Center, Houston, Texas, United States of America
| | - Joaquin U. Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, United States of America
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13
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Prusynski RA, Kelly VE, Fogelberg DJ, Pradhan S. The association between sleep deficits and sedentary behavior in people with mild Parkinson disease. Disabil Rehabil 2022; 44:5585-5591. [PMID: 34218729 PMCID: PMC10659136 DOI: 10.1080/09638288.2021.1940320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
Purpose: Sleep deficits are a common nonmotor symptom of Parkinson disease (PD). People with mild PD also achieve less physical activity (PA) than healthy older adults (HOA), but the relationship between sleep and PA in PD is unclear. This study examined associations between sleep and PA in participants with PD and HOA.Materials and Methods: Secondary analysis of a prospective observational study. Participants wore a commercially available activity monitor for two weeks. Wilcoxon Rank-Sum tests compared nighttime sleep, wakenings after sleep onset, number of wakenings, naps, step count, and PA intensity between PD and HOA groups. Age-adjusted regression models calculated associations between nighttime sleep and PA.Results: Per day, participants with PD slept 75 fewer minutes (p < 0.01), took 5,792 fewer steps (p < 0.001), achieved less PA at all intensities, and had 32% more sedentary time (p < 0.001) compared to HOA. Thirty minutes more sleep was associated with 26 fewer sedentary minutes for HOA (p = 0.01) and 25 fewer sedentary minutes for the PD group (p < 0.001).Conclusions: Sleep and PA are reduced in mild PD compared to HOA. Both groups demonstrated similar associations between reduced sleep and increased sedentary behavior. Results may encourage providers to screen for sleep deficits when promoting PA.IMPLICATIONS FOR REHABILITATIONThe use of a wrist-worn commercial activity and sleep monitor was well tolerated by both healthy older adults and people with mild Parkinson Disease in this study.People with mild Parkinson Disease slept less and were less active than a group of healthy older adults.Less sleep was associated with more sedentary behavior in both groups.The relationship between poor sleep and sedentary behavior in mild Parkinson Disease suggests that rehabilitation interventions may be optimized by targeting both physical activity and sleep deficits.
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Affiliation(s)
- Rachel A Prusynski
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Valerie E Kelly
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Donald J Fogelberg
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Sujata Pradhan
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
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Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention. Int J Obes (Lond) 2022; 46:1510-1517. [PMID: 35577898 PMCID: PMC9850430 DOI: 10.1038/s41366-022-01141-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVES To examine the association between indices of sleep quantity and quality with dietary adherence, physical activity adherence, and weight loss during a behavioral weight loss intervention. METHODS Adults (n = 156) with overweight and obesity (40 ± 9 years, 84% female, BMI: 34.4 ± 4.2 kg/m2) participated in an 18-month behavioral weight loss intervention which prescribed a reduced calorie diet (1200-1800 kcal/d) and increased physical activity (300 min/wk). Body weight, indices of sleep (SenseWear armband; SWA), energy intake (EI, 3-day food records), and moderate-to-vigorous physical activity (SWA) were measured at baseline, 6, 12, and 18 months. Linear mixed effects models examined the association between sleep and weight change over time. Additional models were adjusted for covariates including age, BMI, sex, race, ethnicity, study completion, randomization, EI, and physical activity. Secondary analyses examined the association between sleep and adherence to diet and physical activity recommendations. RESULTS Mean weight loss was 7.7 ± 5.4, 8.4 ± 7.9, and 7.1 ± 9.0 kg at 6, 12, and 18 months, respectively. Lower sleep efficiency, higher wake after sleep onset (WASO), more awakenings, and higher sleep onset latency (SOL) were significantly associated with attenuated weight loss (p < 0.05). Lower sleep efficiency, more awakenings, and higher SOL remained significantly associated with blunted weight loss after adjustment for covariates (p < 0.05). Later waketime, longer time in bed, longer sleep duration, higher WASO, more awakenings, and higher SOL were associated with lower odds of achieving ≥300 min/wk of moderate-to-vigorous physical activity, adjusted for covariates (FDR p < 0.05). CONCLUSIONS Future studies should evaluate whether incorporating strategies to improve sleep health within a behavioral weight loss intervention leads to improved adherence to diet and physical activity recommendations and enhanced weight loss. CLINICAL TRIALS IDENTIFIER NCT01985568.
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15
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Effectiveness of physical activity programs in enhancing sleep outcomes among adolescents: a systematic review. Sleep Breath 2022; 27:431-439. [PMID: 35771387 DOI: 10.1007/s11325-022-02675-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/18/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Adolescence is a developmental period characterised by rapid physical and psychological changes that heighten the risk for inadequate sleep. Fortunately, physical activity programs (PAPs) are an easy-to-do intervention that has been associated with improved sleep outcomes in different population groups. This systematic review aimed to provide evidence to support the effects of PAPs on sleep outcomes among apparently healthy adolescents. METHODS A systematic literature search was performed in online databases of PubMed, Cochrane Library, and PEDro for all dates up to April 2022. All relevant clinical trials reporting on the effects of PAPs on sleep among adolescents were included using a pre-defined inclusion/exclusion criterion (PROSPERO: CRD42020171852). The methodological quality of the included studies was assessed using 'specific checklists per design' (RCTs) provided by the Dutch Cochrane Centre. Qualitative synthesis was used to report the results of the review. RESULTS Two RCTs were included and analysed in the review. Both studies were of good methodological quality but lacked blinding. The PAPs in the reviewed studies included mainly aerobic exercises in the form of cross-country running in the mornings, SMS-delivered motivational messages to increase daily step counts, and use of a pedometer and step diaries. Sleep was measured both subjectively by means of sleep questionnaires and objectively using sleep electroencephalographic recordings. Nevertheless, qualitative synthesis is suggestive of an overall positive effect of PAPs on some sleep outcomes in adolescents, albeit with limited to moderate evidence. CONCLUSION PAPs appear to have a beneficial effect on some sleep outcomes among apparently healthy adolescents. Nevertheless, the body of evidence is currently scanty, thus warranting the need for more high-quality RCTs.
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Sun-Suslow N, Balon E, Montoya JL, Saloner R, Campbell LM, Serrano V, Ellis RJ, Moore DJ. Frailty Syndrome Is Associated with Poorer Self-Reported Sleep Quality Among Older Persons with Human Immunodeficiency Virus. AIDS Res Hum Retroviruses 2022; 38:87-96. [PMID: 34779233 PMCID: PMC8861916 DOI: 10.1089/aid.2020.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Older people with HIV (PWH) experience heightened risk for the acquisition of cumulative, multisystem decline, that is, frailty syndrome. Frailty relates to poorer sleep quality in the general older adult population; however, this association has yet to be explored among PWH. A cross-sectional analysis of 285 PWH ≥50 years of age (mean age 60.5 ± 7.0) examined the relationship between frailty (Fried frailty phenotype) and self-reported sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Three separate multivariable linear regression models examined global PSQI as a function of (1) frailty phenotype, (2) total number of frailty symptoms, or (3) specific individual frailty symptoms. Models covaried for demographic and biopsychosocial risk factors, including age, sex, race/ethnicity, education, premorbid verbal IQ estimate, current depressive symptoms, and diagnosis of a substance abuse disorder. Compared to nonfrail (B = 0.151; p = .021) and prefrail (B = 0.144; p = .021), frail phenotype was related to poorer sleep quality (increased global PSQI; F(5,278) = 11.34, p < .001; R2 = 0.17). Increased number of frailty symptoms (B = 0.144; p = .019; F(4,276) = 12.719, p < .001; R2 = 0.16) and exhaustion was associated with increased global PSQI scores (B = 0.218, p < .001; F(6,247) = 10.436, p < .001; R2 = 0.19). In all models, older age, female sex, and elevated current depressive symptoms were associated with poorer sleep quality. In older PWH, greater frailty symptoms related to poorer sleep quality, independent of psychosocial risk factors for poor sleep. Frailty and poor sleep individually have adverse effects on health and everyday functioning; thus, establishing this association may better aid providers to screen for and treat problems with sleep quality and/or frailty among PWH.
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Affiliation(s)
- Ni Sun-Suslow
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Emily Balon
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jessica L. Montoya
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Rowan Saloner
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Laura M. Campbell
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Vanessa Serrano
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Ronald J. Ellis
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - David J. Moore
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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17
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Sleep health mediates the relationship between physical activity and depression symptoms. Sleep Breath 2021; 26:1341-1349. [PMID: 34561758 PMCID: PMC8475358 DOI: 10.1007/s11325-021-02496-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/09/2021] [Accepted: 09/17/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE This study aimed to investigate cross-sectional associations between physical activity, sleep health, and depression symptoms using mediation models. METHODS Participants (N = 1576, MAge = 39.3 years, 40% female) were recruited online from Amazon's Mechanical Turk crowd-sourcing service. Physical activity was measured using a single-item self-report measure and depression symptoms were reported using the Hospital Anxiety and Depression Scale. Sleep health was measured using the 6-question RUSATED Sleep Health survey V2.0. RESULTS Good sleep health (direct effect: β = - .273, t = - 13.87, p < .0001) and high levels of physical activity (direct effect: β = - .092, t = - 4.73, p < .0001) were both individually associated with fewer depression symptoms. Sleep health significantly mediated 19% of the association between physical activity and depression symptoms (indirect effect: β = - .022, 95% CI [- .036 to - .008]), while physical activity significantly mediated 3% of the relationship between sleep health and depression symptoms (indirect effect: β = - .008, 95% CI [- .014 to - .003]). CONCLUSION Physical activity and sleep health act as predictors and mediators of depression symptoms.
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18
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Liao Y, Robertson MC, Winne A, Wu IHC, Le TA, Balachandran DD, Basen-Engquist KM. Investigating the within-person relationships between activity levels and sleep duration using Fitbit data. Transl Behav Med 2021; 11:619-624. [PMID: 32667039 DOI: 10.1093/tbm/ibaa071] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The advancement of wearable technologies provides opportunities to continuously track individuals' daily activity levels and sleep patterns over extended periods of time. These data are useful in examining the reciprocal relationships between physical activity and sleep at the intrapersonal level. The purpose of this study is to test the bidirectional relationships between daily activity levels and sleep duration. The current study analyzed activity and sleep data collected from a Fitbit device as part of a 6 month employer-sponsored weight loss program. A total of 105 overweight/obese adults were included (92% female, 70% obese, and 44% Hispanic). Multilevel models were used to examine (a) whether daily active and sedentary minutes predicted that night's sleep duration and (b) whether sleep duration predicted active and sedentary minutes the following day. Potential extended effects were explored by using a 2 day average of the activity minutes/sleep duration as the predictor. No significant relationships between active minutes and sleep duration were found on a daily basis. However, having less sleep over two nights than one's usual level was associated with an increased likelihood of engaging in some physical activity the following day. There was a significant bidirectional negative association between sedentary minutes and sleep duration for both the daily and 2 day models. Data from wearable trackers, such as Fitbit, can be used to investigate the daily within-person relationship between activity levels and sleep duration. Future studies should investigate other sleep metrics that may be obtained from wearable trackers, as well as potential moderators and mediators of daily activity levels and sleep.
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Affiliation(s)
- Yue Liao
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael C Robertson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrea Winne
- Department of Adult Bone Marrow Transplant and Leukemia, Michigan Medicine University of Michigan, Ann Arbor, MI, USA
| | - Ivan H C Wu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Thuan A Le
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Diwakar D Balachandran
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Heiland EG, Ekblom Ö, Bojsen-Møller E, Larisch LM, Blom V, Ekblom MM. Bi-Directional, Day-to-Day Associations between Objectively-Measured Physical Activity, Sedentary Behavior, and Sleep among Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157999. [PMID: 34360287 PMCID: PMC8345408 DOI: 10.3390/ijerph18157999] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 01/18/2023]
Abstract
The bi-directional, day-to-day associations between daytime physical activity and sedentary behavior, and nocturnal sleep, in office workers are unknown. This study investigated these associations and whether they varied by weekday or weekend day. Among 324 Swedish office workers (mean age 42.4 years; 33.3% men), moderate-to-vigorous physical activity (MVPA), and sedentary behaviors and sleep (total sleep time (TST) and sleep efficiency (SE)) were ascertained by using accelerometers (Actigraph GT3X) over 8 days. Multilevel linear mixed models were used to assess the bi-directional, day-to-day, within-person associations. Additional analyses stratified by weekend/weekday were performed. On average, participants spent 6% (57 min) of their day in MVPA and 59% (9.5 h) sedentary, and during the night, TST was 7 h, and SE was 91%. More daytime sedentary behavior was associated with less TST that night, and reciprocally, more TST at night was associated with less sedentary behavior on the following weekday. Greater TST during the night was also associated with less MVPA the next day, only on weekdays. However, daytime MVPA was not associated with TST that night. Higher nighttime SE was associated with greater time spent sedentary and in MVPA on the following day, regardless if weekday or weekend day. Sleep may be more crucial for being physically active the following day than vice versa, especially on weekdays. Nevertheless, sedentary behavior's relation with sleep time may be bi-directional. Office workers may struggle with balancing sleep and physical activity time.
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20
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Lifestyle Factors and Sleep Health across the Lifespan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126626. [PMID: 34202991 PMCID: PMC8296445 DOI: 10.3390/ijerph18126626] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/10/2021] [Accepted: 06/18/2021] [Indexed: 11/17/2022]
Abstract
Sleep health, operationalized as a multidimensional construct consisting of sleep regularity, satisfaction, alertness, timing, efficiency, and duration, is an emerging concept in the field of sleep medicine which warrants further investigation. The purpose of the present study was to: (1) compare sleep health across the lifespan, (2) determine lifestyle factors associated with sleep health, and (3) examine whether lifestyle factors associated with sleep health varied between and within age groups. Participants consisted of 3284 individuals (Mean age = 42.70; 45% male) who participated in a cross-sectional online survey of sleep and health. Sleep health was measured using the RU-SATED scale, while demographic and lifestyle factors (e.g., daily social media use, sedentary activity, fast food consumption, etc.) were all self-reported. Sleep health was the highest among older adults (M = 8.09) followed by middle-aged (M = 7.65) and younger adults (M = 7.16). Across age groups, fast-food consumption, daily regularity, and daily TV, social media, or internet use were all negatively correlated with sleep health (ps < 0.05). Few differences in the association between lifestyle factors and sleep health across age groups were found. Overall, these findings may help to inform sleep health promotion efforts by targeting the most pertinent lifestyle factors for promoting sleep health.
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21
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Filipczyk K, Smolarczyk-Kosowska J, Kunert Ł, Filipczyk P, Dębski P, Piegza M, Pudlo R. Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105148. [PMID: 34067939 PMCID: PMC8152037 DOI: 10.3390/ijerph18105148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 11/16/2022]
Abstract
The aim of the study was to assess cognitive functions and sleep quality after a 3-month holistic intervention including physical, social and cognitive rehabilitation in patients 65+. Twenty-nine people participated in the study. The study was divided into two stages. In the first stage, a self-administered questionnaire consisting of sociodemographic questions was used, and cognitive functions were assessed using the Rey-Osterrieth complex figure test, Addenbrooke's Cognitive Examination III (ACE III) test, Montreal Cognitive Function Assessment Scale (MoCA) and digit repetition test. All patients were also assessed for sleep quality using the Athens Insomnia Scale (AIS). After three months, the patients were assessed for cognitive functions and sleep quality, which was the second stage of the study. Analysis of the results obtained by patients in the study showed a statistically significant improvement in sleep quality and cognitive function. Rehabilitation activities, including physical training, cognitive exercises and occupational therapy, reduce the severity of mild cognitive disorders and reduce insomnia.
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Affiliation(s)
- Karolina Filipczyk
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
- Correspondence: ; Tel.: +48-32-285-43-58
| | - Joanna Smolarczyk-Kosowska
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Łukasz Kunert
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Przemysław Filipczyk
- Faculty of Health Sciences, Jan Długosz University in Czestochowa, 42-200 Czestochowa, Poland;
| | - Paweł Dębski
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Robert Pudlo
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
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22
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Tracy EL, Reid KJ, Baron KG. The relationship between sleep and physical activity: The moderating role of daily alcohol consumption. Sleep 2021; 44:6261962. [PMID: 34009345 PMCID: PMC8503823 DOI: 10.1093/sleep/zsab112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/10/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Studies have demonstrated a daily, bidirectional relationship between sleep and physical activity. However, little is known about how other health behaviors, such as alcohol consumption affect this relationship. This study examined how daily and average alcohol consumption affects the relationships between sleep and physical activity. METHODS Participants included 70 men and women, ages 18-50 with sleep duration >6.5 h. Participants wore an actigraph, physical activity monitor and recorded number of alcoholic drinks by daily food logs for 7 days. Results were analyzed using multi-level models to evaluate the 7-day average (i.e., between-person effects) and daily effects (i.e., within-person effects) simultaneously. RESULTS Those with more average (7 day) minutes of vigorous physical activity had less wake after sleep onset (WASO). Furthermore, a higher number of alcoholic drinks was associated with longer sleep duration and higher WASO over 7 days. Days with a higher number of alcoholic drinks were associated with higher WASO and sleep fragmentation that night. Alcohol intake moderated the average (7 day) and daily relationships between sleep and physical activity such that high average (7 days) WASO was associated with shorter average total physical activity duration, but only for those with higher alcohol intake. In addition, longer physical activity duration during the day was associated with lower sleep fragmentation that night, but only for those with lower alcohol intake. CONCLUSIONS These data demonstrate that in a naturalistic setting, alcohol intake negatively impacts sleep and diminishes the benefits of physical activity on sleep.
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Affiliation(s)
- Eunjin Lee Tracy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn Jean Reid
- Department of Neurology Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Kelly Glazer Baron
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
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23
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Taber JM, Cribbet MR, Cadmus-Bertram L, Mays D, Smith MEB, Rana B, Paljarvi T. Associations Among Sleep and Cancer Risk Behaviors: a Scoping Review of Experimental Studies in Healthy Adult Populations. Int J Behav Med 2021; 28:162-176. [PMID: 32405919 DOI: 10.1007/s12529-020-09892-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Links among poor sleep and cancer risk behaviors have been largely overlooked in the context of cancer prevention and behavioral medicine. The goal of this scoping review was to determine the extent and nature of experimental studies conducted with healthy adult populations that tested the associations among poor sleep and cancer risk behaviors. METHOD Electronic databases and major sleep journals were searched to identify experimental studies in healthy adult samples published through January 2018. Studies examined associations among eight pairings of manipulated behaviors and outcomes ("independent variable (IV)-outcome pairs"): the impact of sleep manipulations on physical activity (PA), diet, alcohol consumption, and tobacco use outcomes; and the impact of PA, diet, alcohol consumption, and tobacco use manipulations on sleep outcomes. Studies were characterized in terms of sample characteristics; study design; IV type, dose, and duration; and outcome measurement and duration. RESULTS Abstracts of 5697 papers and 345 full texts were screened. Eighty-eight studies describing 125 comparisons met inclusion criteria. Only two studies tested the association between tobacco use and sleep; none tested whether sleep influenced alcohol consumption. Sample sizes were typically small, most studies used crossover designs, and studies tended to include younger and more male participants. Within each IV-outcome pair, there was substantial heterogeneity in how behaviors were manipulated, outcome measurement, and type of control group. Few studies assessed mechanisms. CONCLUSION There is a need for larger experimental studies with more representative samples. Overall, heterogeneity and limitations in study designs make it difficult to synthesize evidence across studies.
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Affiliation(s)
- Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242-0001, USA.
| | - Matthew R Cribbet
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, 35401, USA
| | - Lisa Cadmus-Bertram
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, 20007, USA
| | - M E Beth Smith
- Department of Medicine, Oregon Health & Science University, Portland, OR, 97237-3098, USA.,Legacy Health Systems, Portland, OR, 97209, USA
| | - Brinda Rana
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Tapio Paljarvi
- Division of Population Medicine, Cardiff University, Cardiff, CF14 4YS, UK
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24
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Imes CC, Bizhanova Z, Kline CE, Rockette-Wagner B, Chasens ER, Sereika SM, Burke LE. Bidirectional relationship between sleep and sedentary behavior in adults with overweight or obesity: A secondary analysis. ACTA ACUST UNITED AC 2021; 2:zpab004. [PMID: 33870194 PMCID: PMC8038645 DOI: 10.1093/sleepadvances/zpab004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/25/2021] [Indexed: 01/14/2023]
Abstract
Study Objectives The relationships between daytime sedentary behavior and that night’s sleep and sleep and next day’s sedentary behavior are unknown. The purpose of this analysis was to examine these potentially bidirectional associations. Methods This study was a secondary analysis of baseline data from an ecological momentary assessment study to determine the triggers for dietary lapses during a weight loss intervention. Sedentary behavior, physical activity, and sleep were objectively measured using accelerometers. Linear mixed modeling was used to examine the bidirectional multivariate associations between activity and sleep characteristics for each outcome examined separately. The models included sex, age, body mass index (BMI), education, and day of the week (weekday vs. weekend). Results Participants were predominantly white (81.5%) and female (88.9%) with a mean age of 51.2 ± 10.6 years. Longer previous night’s total sleep time (TST) (b = −0.320, standard error [SE] = 0.060; p < .001) and being a weekend (b = −63.845, SE = 9.406; p < .001) were associated with less sedentary time the next day. More daytime sedentary time was associated with less wake after sleep onset (b = −0.018, SE = 0.008; p = .016), fewer awakenings (b = −0.010, SE = 0.004; p = .016), and less TST (b = −0.060, SE = 0.028; p = .029) that night. Conclusions The bidirectional relationships between sedentary time and sleep characteristics are complex and may vary depending on participant characteristics and duration of sedentary and sleep time. Interventions to decrease sedentary behavior may benefit by targeting sleep duration and weekday activity.
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Affiliation(s)
| | - Zhadyra Bizhanova
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Christopher E Kline
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Lora E Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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McDevitt B, Moore L, Akhtar N, Connolly J, Doherty R, Scott W. Validity of a Novel Research-Grade Physical Activity and Sleep Monitor for Continuous Remote Patient Monitoring. SENSORS (BASEL, SWITZERLAND) 2021; 21:2034. [PMID: 33805690 PMCID: PMC7998122 DOI: 10.3390/s21062034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 11/23/2022]
Abstract
In the midst of the COVID-19 pandemic, Remote Patient Monitoring technologies are highly important for clinicians and researchers. These connected-health technologies enable monitoring of patients and facilitate remote clinical trial research while reducing the potential for the spread of the novel coronavirus. There is a growing requirement for monitoring of the full 24 h spectrum of behaviours with a single research-grade sensor. This research describes a free-living and supervised protocol comparison study of the Verisense inertial measurement unit to assess physical activity and sleep parameters and compares it with the Actiwatch 2 actigraph. Fifteen adults (11 males, 23.4 ± 3.4 years and 4 females, 29 ± 12.6 years) wore both monitors for 2 consecutive days and nights in the free-living study while twelve adults (11 males, 23.4 ± 3.4 years and 1 female, 22 ± 0 years) wore both monitors for the duration of a gym-based supervised protocol study. Agreement of physical activity epoch-by-epoch data with activity classification of sedentary, light and moderate-to-vigorous activity and sleep metrics were evaluated using Spearman's rank-order correlation coefficients and Bland-Altman plots. For all activity, Verisense showed high agreement for both free-living and supervised protocol of r = 0.85 and r = 0.78, respectively. For physical activity classification, Verisense showed high agreement of sedentary activity of r = 0.72 for free-living but low agreement of r = 0.36 for supervised protocol; low agreement of light activity of r = 0.42 for free-living and negligible agreement of r = -0.04 for supervised protocol; and moderate agreement of moderate-to-vigorous activity of r = 0.52 for free-living with low agreement of r = 0.49 for supervised protocol. For sleep metrics, Verisense showed moderate agreement for sleep time and total sleep time of r = 0.66 and 0.54, respectively, but demonstrated high agreement for determination of wake time of r = 0.83. Overall, our results showed moderate-high agreement of Verisense with Actiwatch 2 for assessing epoch-by-epoch physical activity and sleep, but a lack of agreement for activity classifications. Future validation work of Verisense for activity cut-point potentially holds promise for 24 h continuous remote patient monitoring.
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Affiliation(s)
- Bríd McDevitt
- Department of Computing, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - Lisa Moore
- Department of Science, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland; (L.M.); (W.S.)
| | - Nishat Akhtar
- Department of Computing, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - James Connolly
- Department of Computing, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - Rónán Doherty
- Department of Law & Humanities, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - William Scott
- Department of Science, Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland; (L.M.); (W.S.)
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Suzuki F, Morita E, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kannon T, Tajima A, Matsumoto S, Ishihara A, Hori D, Doki S, Oi Y, Sasahara S, Satoh M, Matsuzaki I, Yanagisawa M, Ikaga T, Nakamura H. Protein intake in inhabitants with regular exercise is associated with sleep quality: Results of the Shika study. PLoS One 2021; 16:e0247926. [PMID: 33635905 PMCID: PMC7909647 DOI: 10.1371/journal.pone.0247926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/17/2021] [Indexed: 01/12/2023] Open
Abstract
STUDY OBJECTIVES Although associations between sleep quality and environmental factors and nutrient intake have been reported, interactions between these factors have not been elucidated in detail. Therefore, this cross-sectional study examined the effects of regular exercise and nutrient intake on sleep quality using the Pittsburgh Sleep Quality Index (PSQI), which is the most frequently used index for sleep evaluation. METHODS The participants included 378 individuals aged 40 years or older living in Shika Town, Ishikawa Prefecture. Of these individuals, 185 met the inclusion criteria. The participants completed a self-administered questionnaire assessing lifestyle habits and frequency and duration of exercise, the PSQI, and the brief-type self-administered diet history questionnaire (BDHQ) on nutrient intake. RESULTS A two-way analysis of covariance on regular exercise and PSQI scores indicated that protein intake (17.13% of energy) was significantly higher in the regular exercise and PSQI ≤10 groups than in the non-regular exercise or PSQI ≥11 groups (p = 0.002). In a multiple logistic regression analysis with PSQI scores (≤10 and ≥11), protein intake was a significant independent variable in any of the models adjusted for confounding factors such as age, sex, body mass index, current smoker, and current drinker (OR: 1.357, 95% CI: 1.081, 1.704, p = 0.009) in the regular exercise group but not in the non-regular exercise group.Conclusions We identified a positive relationship between sleep quality and protein intake in the regular exercise group. These findings suggest that regular exercise at least twice a week for 30 minutes or longer combined with high protein intake contributes to good sleep quality.
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Affiliation(s)
- Fumihiko Suzuki
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Emi Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
- Forestry and Forest Products Research Institute, Forest Research and Management Organization, Tsukuba, Ibaraki, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hiromasa Tsujiguchi
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Akinori Hara
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Thao Thi Thu Nguyen
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong, Vietnam
| | - Yukari Shimizu
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Nursing, Faculty of Health Sciences, Komatsu University, Komatsu, Ishikawa, Japan
| | - Koichiro Hayashi
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Keita Suzuki
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Sumire Matsumoto
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
- Ph.D. Program in Human Biology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Asuka Ishihara
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
- Ph.D. Program in Human Biology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Daisuke Hori
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shotaro Doki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuichi Oi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | - Makoto Satoh
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ichiyo Matsuzaki
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Toshiharu Ikaga
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Kohoku, Yokohama, Japan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
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Gencarelli A, Sorrell A, Everhart CM, Zurlinden T, Everhart DE. Behavioral and exercise interventions for sleep dysfunction in the elderly: a brief review and future directions. Sleep Breath 2021; 25:2111-2118. [PMID: 33630239 PMCID: PMC7905198 DOI: 10.1007/s11325-021-02329-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/26/2021] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
Purpose The impact of sleep-related changes and disorders in the geriatric populations are of utmost concern due to health consequences and increased risk of injury as well as injuring others as a result of poor sleep. The purpose of this paper is to provide a brief review of the current state of the literature with regard to sleep, aging, common non-pharmacological interventions, and the potential use of exercise in combination with behavioral interventions. Methods Initially, this manuscript focuses on a brief (nonsystematic) review of sleep parameters and physiology that are associated with the aging process. Subsequently, information regarding sleep disorders in the elderly in general, and insomnia in particular are discussed. Last, a brief review of current recommended interventions is provided. Results The current major nonpharmacological interventions are described including Cognitive Behavioral Therapy for Insomnia (CBT-I). The potential use of exercise as a safe intervention for poor sleep is discussed. Finally, a call is made for increased research that examines the combination of traditional behavioral interventions with exercise.
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Affiliation(s)
- Amy Gencarelli
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | - Anne Sorrell
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | | | - Taylor Zurlinden
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | - D Erik Everhart
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA.
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28
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Kim DE, Roberts TJ, Moon C. Relationships among types of activity engagement and insomnia symptoms among older adults. BMC Geriatr 2021; 21:87. [PMID: 33516192 PMCID: PMC7847011 DOI: 10.1186/s12877-021-02042-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/20/2021] [Indexed: 01/18/2023] Open
Abstract
Background An increasing awareness exists that lack of activity engagement is associated with insomnia symptoms. However, the majority of studies have focused on the association between a single type of activity engagement and insomnia symptoms. Methods This is a cross-sectional study using secondary data from the Health and Retirement Study examining the relationships among different types of activity engagement and insomnia symptoms among older adults. The sample for this study included 3321 older adults who responded to survey modules on activity engagement and insomnia symptoms in 2016. Activity engagement was measured using items for three types of activities (i.e., social, cognitive, and physical) validated in this study. Insomnia symptoms were measured using four items (i.e., difficulty of falling asleep, waking up during the night, waking up too early, and feeling rested). Independent t-tests were conducted to identify the differences in insomnia symptoms according to activity engagement level. Regressions were conducted to examine the associations among three types of activity engagement and insomnia symptoms after adjusting for covariates such as demographics, chronic disease, activities of daily living difficulty, cognitive function, sleep disorder, loneliness, and caregiving. Results The respondents in the high-level social, cognitive, and physical activity engagement groups were found to show fewer insomnia symptoms. Furthermore, higher social (β = − 0.04, p = 0.040) and cognitive (β = − 0.06, p = 0.007) activity engagements were associated with fewer insomnia symptoms even after adjusting for other types of activity engagement and all covariates. Conclusions This study suggests that older adults with higher social and cognitive activity engagements may be likely to have fewer insomnia symptoms. Based on these results, future research is needed to develop multi-component intervention programs that can encourage older adults to engage in these activities. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02042-y.
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Affiliation(s)
- Da Eun Kim
- College of Nursing and Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea.
| | - Tonya J Roberts
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Chooza Moon
- College of Nursing, University of Iowa, Iowa City, IA, USA
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29
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Atoui S, Chevance G, Romain AJ, Kingsbury C, Lachance JP, Bernard P. Daily associations between sleep and physical activity: A systematic review and meta-analysis. Sleep Med Rev 2021; 57:101426. [PMID: 33571893 DOI: 10.1016/j.smrv.2021.101426] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/22/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023]
Abstract
The day-to-day variations of sleep and physical activity are associated with various health outcomes in adults, and previous studies suggested a bidirectional association between these behaviors. The daily associations between sleep and physical activity have been examined in observational or interventional contexts. The primary goal of the current systematic review and meta-analysis was to summarize existing evidence about daily associations between sleep and physical activity outcomes at inter- and intra-individual level in adults. A systematic search of records in eight databases from inception to July 2019 identified 33 peer-reviewed empirical publications that examined daily sleep-physical activity association in adults. The qualitative and quantitative analyses of included studies did not support a bidirectional daily association between sleep outcomes and physical activity. Multilevel meta-analyses showed that three sleep parameters were associated with physical activity the following day: sleep quality, sleep efficiency, and wake after sleep onset. However, the associations were small, and varied in terms of direction and level of variability (e.g., inter- or intra-individual). Daytime physical activity was associated with lower total sleep time the following night at an inter-person level with a small effect size. From a clinical perspective, care providers should monitor the effects of better sleep promotion on physical activity behaviors in their patients. Future studies should examine sleep and physical activity during a longer period and perform additional sophisticated statistical analyses. SYSTEMATIC REVIEW REGISTRATION: https://osf.io/w6uy5/.
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Affiliation(s)
- Sarah Atoui
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
| | - Guillaume Chevance
- Center for Wireless & Population Health Systems, Department of Family Medicine and Public Health, UC San Diego, San Diego, CA 92093, USA
| | - Ahmed-Jérôme Romain
- Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada; École de kinésiologie et des sciences de l'activité physique, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Célia Kingsbury
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
| | - Jean-Philippe Lachance
- Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada.
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30
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Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Almotwa J, Feldpausch CE, Folk SYL, Gadd S, Wang L, Wang W, Zhang X, Tucker RM. Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk. Clocks Sleep 2021; 3:12-30. [PMID: 33467418 PMCID: PMC7838912 DOI: 10.3390/clockssleep3010002] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Richard Hsiao
- Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Chang-Chi Lai
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - HeeSoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Juman Almotwa
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Clare E. Feldpausch
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Sara Yi Ling Folk
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Suzannah Gadd
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Linyutong Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Xinyi Zhang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
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Vanderlinden J, Biddle GJH, Boen F, van Uffelen JGZ. Are Reallocations between Sedentary Behaviour and Physical Activity Associated with Better Sleep in Adults Aged 55+ Years? An Isotemporal Substitution Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9579. [PMID: 33371373 PMCID: PMC7767359 DOI: 10.3390/ijerph17249579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
Physical activity has been proposed as an effective alternative treatment option for the increasing occurrence of sleep problems in older adults. Although higher physical activity levels are associated with better sleep, the association between specific physical activity intensities and sedentary behaviour (SB) with sleep remains unclear. This study examines the associations of statistically modelled time reallocations between sedentary time and different physical activity intensities with sleep outcomes using isotemporal substitution analysis. Device-measured physical activity data and both objective and subjective sleep data were collected from 439 adults aged 55+ years. Replacing 30 min of SB with moderate to vigorous intensity physical activity (MVPA) was significantly associated with an increased number of awakenings. Moreover, a reallocation of 30 min between light physical activity (LPA) and MVPA was significantly associated with increased sleep efficiency. Furthermore, reallocating 30 min of SB to LPA showed a significant association with decreased sleep efficiency. There were no significant associations of time reallocations for wake time after sleep onset, length of awakenings, and sleep quality. These results improve our understanding of the interrelationships between different intensities of movement behaviours and several aspects of sleep in older adults.
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Affiliation(s)
- Julie Vanderlinden
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, University of Leuven, 3000 Leuven, Belgium; (F.B.); (J.G.Z.v.U.)
- Department of Health Care, Odisee University College, 1000 Brussels, Belgium
| | - Gregory J. H. Biddle
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK;
| | - Filip Boen
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, University of Leuven, 3000 Leuven, Belgium; (F.B.); (J.G.Z.v.U.)
| | - Jannique G. Z. van Uffelen
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, University of Leuven, 3000 Leuven, Belgium; (F.B.); (J.G.Z.v.U.)
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McCrae CS, Curtis AF. From bit player to key mechanism: the role of sleep in exercise. J Clin Sleep Med 2020; 16:19-20. [DOI: 10.5664/jcsm.8886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Christina S. McCrae
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| | - Ashley F. Curtis
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
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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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Liu Z, Yang C. The impact of sleep medications on physical activity among diabetic older adults. Geriatr Nurs 2020; 41:400-405. [DOI: 10.1016/j.gerinurse.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 01/01/2023]
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Vanderlinden J, Boen F, van Uffelen JGZ. Effects of physical activity programs on sleep outcomes in older adults: a systematic review. Int J Behav Nutr Phys Act 2020; 17:11. [PMID: 32024532 PMCID: PMC7003368 DOI: 10.1186/s12966-020-0913-3] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND One in two older adults report sleep problems, which not only cause fatigue, but also negatively affect general functioning, activities of daily living, and physical and mental health. Although it is known that physical activity is positively associated with sleep in older adults, the effects of physical activity programs on sleep in older adults has not been reviewed. The aim of this systematic review was to systematically review the effects of physical activity programs on sleep in generally healthy older adults aged 60+ years. METHODS Searches were performed in PubMed, Embase, Web of Science, SPORTDiscus, PEDro and CINAHL. The methodological quality of the included studies was rated using the 'Quality Assessment Tool for Quantitative Studies'. Only studies of moderate and strong quality were included. This review was registered in PROSPERO (CRD42018094007). RESULTS Fourteen studies met the inclusion criteria (six randomised controlled trials and eight pretest-posttest studies). Of these studies, five were moderate and nine were strong quality studies. Mean age of study samples ranged from 64 to 76 years. Exercise programs included various activities aimed at improving mobility, endurance and strength. Intervention duration ranged from 2 weeks to 12 months. Eleven studies used subjective measures of sleep, two used objective measures and one used both. Sixteen different sleep outcomes were reported. All but one study, found at least one significant improvement on sleep outcomes. No significantly detrimental effects were reported. Effect sizes, calculated in ten studies, ranged from 0,34-1,55 and were substantial (≥0,8) in four studies. CONCLUSIONS This systematic review suggests that exercise programs positively affect various aspects of sleep in generally healthy older adults. More specifically, moderate intensity exercise programs, with a frequency of three times per week and a duration of 12 weeks up to 6 months, showed the highest number of significant improvements in different sleep outcomes in older adults. Furthermore, programs that offered single exercise types, such as Baduanjin, Tai chi and the silver yoga program, or a combination of exercises showed the highest proportion of significant versus reported effects on sleep outcomes.
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Affiliation(s)
- J Vanderlinden
- Department of Movement Sciences, KU Leuven, B-3000, Leuven, Belgium.
- Department of Health Care, Odisee University College, Brussels, Belgium.
| | - F Boen
- Department of Movement Sciences, KU Leuven, B-3000, Leuven, Belgium
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Petrov ME, Hasanaj K, Hoffmann CM, Epstein DR, Krahn L, Park JG, Hollingshead K, Yu TY, Todd M, St Louis EK, Morgenthaler TI, Buman MP. Rationale, design, and development of SleepWell24: A smartphone application to promote adherence to positive airway pressure therapy among patients with obstructive sleep apnea. Contemp Clin Trials 2020; 89:105908. [PMID: 31843639 PMCID: PMC8415005 DOI: 10.1016/j.cct.2019.105908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/17/2019] [Accepted: 12/06/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Positive airway pressure (PAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA), a chronic disorder that affects 6-13% of the adult population. However, adherence to PAP therapy is challenging, and current approaches to improve adherence have limited efficacy and scalability. METHODS/DESIGN To promote PAP adherence, we developed SleepWell24, a multicomponent, evidence-based smartphone application that delivers objective biofeedback concerning PAP use and sleep/physical activity patterns via cloud-based PAP machine and wearable sensor data, and behavior change strategies and troubleshooting of PAP therapy interface use. This randomized controlled trial will evaluate the feasibility, acceptability, and initial efficacy of SleepWell24 compared to a usual care control condition during the first 60 days of PAP therapy among patients newly diagnosed with OSA. DISCUSSION SleepWell24 is an innovative, multi-component behavior change intervention, designed as a self-management approach to addressing the psychosocial determinants of adherence to PAP therapy among new users. The results will guide lengthier future trials that assess numerous patient-centered and clinical outcomes.
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Affiliation(s)
- Megan E Petrov
- Edson College of Nursing and Health Innovation, Arizona State University, United States of America.
| | - Kristina Hasanaj
- College of Health Solutions, Arizona State University, United States of America
| | - Coles M Hoffmann
- Edson College of Nursing and Health Innovation, Arizona State University, United States of America
| | - Dana R Epstein
- Edson College of Nursing and Health Innovation, Arizona State University, United States of America; College of Health Solutions, Arizona State University, United States of America
| | - Lois Krahn
- Center for Sleep Medicine, Mayo Clinic, Scottsdale, AZ, United States of America
| | - John G Park
- Center for Sleep Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, United States of America
| | - Tsung-Yen Yu
- College of Health Solutions, Arizona State University, United States of America
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, United States of America
| | - Erik K St Louis
- Center for Sleep Medicine, Mayo Clinic, Rochester, MN, United States of America
| | | | - Matthew P Buman
- College of Health Solutions, Arizona State University, United States of America.
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Mesas AE, Hagen EW, Peppard PE. The bidirectional association between physical activity and sleep in middle-aged and older adults: a prospective study based on polysomnography. Sleep 2019; 41:5025915. [PMID: 29860437 DOI: 10.1093/sleep/zsy114] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Indexed: 01/06/2023] Open
Abstract
Study Objectives To examine the bidirectional association between physical activity (PA) and polysomnographically (PSG)-assessed sleep parameters characterized by total sleep time (TST), sleep onset latency (SOL), wake time after sleep onset (WASO), sleep efficiency and percentage of TST in N1, N2, and N3 stages and rapid eye movement (REM) sleep in middle-aged and older adults. Methods Longitudinal study based on a subsample of the Wisconsin Sleep Cohort. Self-reported PA information was used to estimate the metabolic equivalents of task (MET-minutes/week) activity and in-laboratory PSG exams provided information on sleep parameters at baseline and after 3-11 years of follow-up between 2004 and 2015. Poisson and linear regression models controlling for confounders estimated associations of sleep outcomes with changes in PA. Results A total of 424 participants (45.8% female; mean ± SD age 60.1 ± 7.5 years) were followed over an average of 5.0 ± 1.6 years. Compared to baseline PA of <500 MET-minutes/week (reference category), 500 to 1500 MET-minutes/week of PA was associated with lower incidences of TST <6 hours (relative risk, RR: 0.49; 95% confidence interval, CI: 0.27; 0.88), WASO >60 minutes (RR: 0.58; 95% CI: 0.41; 0.82) and sleep efficiency <80% (RR: 0.61; 95% CI: 0.39; 0.94), adjusting for sociodemographic, health behaviors and medical conditions. No significant associations were observed between baseline sleep characteristics and changes in PA through the follow-up. Conclusion In this prospective study, an intermediate level of PA at baseline predicted lower risk of incident short sleep time, higher WASO and lower sleep efficiency measured with PSG.
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Affiliation(s)
- Arthur E Mesas
- Department of Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, Brazil.,Department of Population Health Sciences, University of Wisconsin - School of Medicine and Public Health, Madison, WI
| | - Erika W Hagen
- Department of Population Health Sciences, University of Wisconsin - School of Medicine and Public Health, Madison, WI
| | - Paul E Peppard
- Department of Population Health Sciences, University of Wisconsin - School of Medicine and Public Health, Madison, WI
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The Effect of Structured Exercise on Sleep During the Corresponding Night Among Older Women in an Exercise Program. J Aging Phys Act 2019; 27:482-488. [PMID: 30507280 DOI: 10.1123/japa.2018-0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study investigated the acute effect of exercise on sleep outcomes among healthy older women by comparing days with structured exercise versus days without structured exercise during 4 months of exercise training. Participants (n = 51) in this study had wrist-worn actigraphic sleep data available following at least 3 days with structured exercise and 3 days without structured exercise at mid-intervention and at the end of intervention. The exercise intervention was treadmill walking. Multilevel models were used to examine whether structured exercise impacted sleep outcomes during the corresponding night. Overall, 1,362 nights of data were included in the analyses. In unadjusted and adjusted models, bedtimes were significantly earlier on evenings following an acute bout of structured exercise than on evenings without structured exercise. No other sleep parameters differed between exercise and nonexercise days. Understanding the effects of exercise on sleep in this understudied population may help to improve their overall sleep quality.
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Audiffren M, André N. The exercise-cognition relationship: A virtuous circle. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:339-347. [PMID: 31333886 PMCID: PMC6620209 DOI: 10.1016/j.jshs.2019.03.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/16/2018] [Accepted: 12/15/2018] [Indexed: 06/01/2023]
Abstract
Exercise and health psychology have generated 2 sets of empirical studies guided by separate theory-driven axes. The first axis focuses on the causal relationship between chronic exercise and cognition and, more particularly, high-level cognitive functions such as executive functions (EFs). The second axis examines factors influencing the adherence process to physical activity (PA). Research conducted during the past decade shows that these 2 topics are closely linked, with EFs and effortful control playing a pivotal role in the bidirectional relationship linking PA and mental/brain health. The present article supports the idea that an individual engaged in the regular practice of effortful PA initiates a virtuous circle linking PA and effortful control in a bidirectional way. On the one hand, chronic exercise leads to an improvement of EFs and effortful control. On the other hand, gains in EFs and effortful control effectiveness lead to a reciprocal facilitation of the maintenance of PA over time. Some limitations and perspectives to this effort hypothesis are proposed in the last part of the article.
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Semplonius T, Willoughby T. Long-Term Links between Physical Activity and Sleep Quality. Med Sci Sports Exerc 2019; 50:2418-2424. [PMID: 30048409 DOI: 10.1249/mss.0000000000001706] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Findings from cross-sectional research indicate that the relationship between sleep quality and physical activity is mixed. For research that does indicate a significant association, the interpretation of the finding most often is that physical activity leads to better sleep, or less frequently, that better sleep leads to more involvement in physical activity (see sleep deprivation studies). Cross-sectional studies, however, are not able to assess the direction of these effects, and experimental studies have tested only one direction of the effects. Longitudinal studies, with their focus on temporal order, are needed to specifically examine the link between sleep and physical activity as well as the direction of effects. The current study had three goals: to examine 1) the longitudinal relationship between sleep and physical activity, 2) the direction of effects, and 3) whether emotion regulation mediates the relationship between sleep and physical activity. METHODS Participants included a sample of 827 (Mage at baseline = 19.04 yr, SD = 0.92 yr, 73.88% female) students at a university in Southwestern Ontario, who took part in a larger longitudinal survey that started in their first year of university. Participants were surveyed annually for 3 yr (2011, 2012, 2013; retention, 83.9%). Measures assessed sleep quality, physical activity, emotion regulation, and involvement in sports clubs. RESULTS A cross-lagged autoregressive path analysis revealed that sleep quality indirectly predicted increased high-, moderate-, and low-intensity physical activity over time through its positive effect on emotion regulation. Moderate levels of physical activity indirectly predicted sleep quality over time through emotion regulation. CONCLUSIONS Overall, there appears to be support for a bidirectional relationship between sleep and physical activity over time (at least for moderate physical activity) but only indirectly through emotion regulation.
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Affiliation(s)
- Thalia Semplonius
- Department of Psychology, Brock University, St. Catharines, ON, CANADA
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Kuerbis A, Reid MC, Lake JE, Glasner-Edwards S, Jenkins J, Liao D, Candelario J, Moore AA. Daily factors driving daily substance use and chronic pain among older adults with HIV: An exploratory study using ecological momentary assessment. Alcohol 2019; 77:31-39. [PMID: 30308287 PMCID: PMC6456439 DOI: 10.1016/j.alcohol.2018.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/13/2018] [Accepted: 10/02/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adults 50 and older make up approximately 50% of persons living with HIV. Multiple co-morbidities are common among this group, including chronic pain and substance abuse, yet little is known about the daily factors that either enhance or inhibit these experiences or behaviors. This study explored daily drivers of substance use, pain, and relief from pain among older adults living with HIV utilizing ecological momentary assessment (EMA). METHOD Participants (N = 55), ages 49-71, completed seven consecutive days of daily EMA online surveys prior to treatment initiation within a randomized controlled trial. Multilevel modeling tested predictors of pain, substance use, and relief from pain by examining within- and between-person relationships. RESULTS Results revealed an associational, reciprocal relationship between daily worst pain and daily drinking, where greater worst pain ratings predicted heavier drinking and heavier drinking predicted greater daily and overall pain. Greater happiness and poorer quality of sleep predicted greater daily worst pain. Exercising and overall confidence to cope with pain without medication were associated with lower levels of daily worst pain. Finally, spending less time with a loved one over time and reporting any coping behavior were associated with relief from pain. CONCLUSION Investigation of daily factors that drive pain and substance use behaviors among this unique population help inform which daily factors are most risky to their health and well-being. Alcohol use emerged as the only substance associated with both driving pain and responding to pain. Findings suggest key points for prevention and intervention.
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Affiliation(s)
- Alexis Kuerbis
- Silberman School of Social Work, Hunter College at City University of New York, 2180 Third Avenue, New York 10035, United States.
| | - M Carrington Reid
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, United States
| | - Jordan E Lake
- Division of Infectious Diseases, University of California, Los Angeles, CA, United States
| | - Suzette Glasner-Edwards
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, School of Nursing, University of California, Los Angeles, CA, United States
| | - Jessica Jenkins
- Department of Psychiatry and Human Behavior, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Diana Liao
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles, CA, United States
| | - Jury Candelario
- APAIT, A Division of Special Services for Groups, Los Angeles, CA, United States
| | - Alison A Moore
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles, CA, United States
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Nguyen-Michel VH, Pallanca O, Brion A, Vecchierini MF. [Sleep habits and lifestyle of elderly patients with insomnia]. SOINS. GERONTOLOGIE 2019; 24:38-42. [PMID: 31084808 DOI: 10.1016/j.sger.2019.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Certain inappropriate routines can have a negative impact on sleep, leading to sleep disorders or even aggravating pre-existing sleep pathologies. An observational study of 176 patients aged 60 or over, suffering from chronic insomnia, has been carried out in order to find out more about these patients' sleep habits and lifestyles and to identify those that can be corrected to improve insomnia in this population.
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Affiliation(s)
- Vi-Huong Nguyen-Michel
- Unité d'explorations fonctionnelles du sujet âgé, département de neurophysiologie clinique, GHU Pitié-Salpêtrière/Charles-Foix, AP-HP, 7 avenue de la République, 94000 Ivry-sur-Seine, France.
| | - Olivier Pallanca
- Centre d'investigation et de traitement de l'insomnie, département de neurophysiologie clinique, GHU Pitié-Salpêtrière/Charles-Foix, AP-HP, 75013 Paris, France
| | - Agnès Brion
- Centre d'investigation et de traitement de l'insomnie, département de neurophysiologie clinique, GHU Pitié-Salpêtrière/Charles-Foix, AP-HP, 75013 Paris, France
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Rosenberger ME, Fulton JE, Buman MP, Troiano RP, Grandner MA, Buchner DM, Haskell WL. The 24-Hour Activity Cycle: A New Paradigm for Physical Activity. Med Sci Sports Exerc 2019; 51:454-464. [PMID: 30339658 PMCID: PMC6377291 DOI: 10.1249/mss.0000000000001811] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The physiologic mechanisms by which the four activities of sleep, sedentary behavior, light-intensity physical activity, and moderate-to-vigorous physical activity (MVPA) affect health are related, but these relationships have not been well explored in adults. Research studies have commonly evaluated how time spent in one activity affects health. Because one can only increase time in one activity by decreasing time in another, such studies cannot determine the extent that a health benefit is due to one activity versus due to reallocating time among the other activities. For example, interventions to improve sleep possibly also increase time spent in MVPA. If so, the overall effect of such interventions on risk of premature mortality is due to both more MVPA and better sleep. Further, the potential for interaction between activities to affect health outcomes is largely unexplored. For example, is there a threshold of MVPA minutes per day, above which adverse health effects of sedentary behavior are eliminated? This article considers the 24-h Activity Cycle (24-HAC) model as a paradigm for exploring inter-relatedness of health effects of the four activities. It discusses how to measure time spent in each of the four activities, as well as the analytical and statistical challenges in analyzing data based on the model, including the inevitable challenge of confounding among activities. The potential usefulness of this model is described by reviewing selected research findings that aided in the creation of the model and discussing future applications of the 24-HAC model.
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Affiliation(s)
| | - Janet E Fulton
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
| | - Richard P Troiano
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - David M Buchner
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL
| | - William L Haskell
- Stanford Prevention Research Center, Stanford University, Stanford, CA
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Parsey CM, Schmitter-Edgecombe M. Using Actigraphy to Predict the Ecological Momentary Assessment of Mood, Fatigue, and Cognition in Older Adulthood: Mixed-Methods Study. JMIR Aging 2019; 2:e11331. [PMID: 31518282 PMCID: PMC6715102 DOI: 10.2196/11331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/26/2018] [Accepted: 10/30/2018] [Indexed: 11/23/2022] Open
Abstract
Background Sleep quality has been associated with cognitive and mood outcomes in otherwise healthy older adults. However, most studies have evaluated sleep quality as aggregate and mean measures, rather than addressing the impact of previous night’s sleep on next-day functioning. Objective This study aims to evaluate the ability of previous night’s sleep parameters on self-reported mood, cognition, and fatigue to understand short-term impacts of sleep quality on next-day functioning. Methods In total, 73 cognitively healthy older adults (19 males, 54 females) completed 7 days of phone-based self-report questions, along with 24-hour actigraph data collection. We evaluated a model of previous night’s sleep parameters as predictors of mood, fatigue, and perceived thinking abilities the following day. Results Previous night’s sleep predicted fatigue in the morning and midday, as well as sleepiness or drowsiness in the morning; however, sleep measures did not predict subjective report of mood or perceived thinking abilities the following day. Conclusions This study suggests that objectively measured sleep quality from the previous night may not have a direct or substantial relationship with subjective reporting of cognition or mood the following day, despite frequent patient reports. Continued efforts to examine the relationship among cognition, sleep, and everyday functioning are encouraged.
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Affiliation(s)
- Carolyn M Parsey
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, United States
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Lee SH, Kim SJ, Bang JW, Lee JH. Relationship of the Duration and Timing of Exercise with Sleep Quality in Community-Dwelling Adults. SLEEP MEDICINE RESEARCH 2018. [DOI: 10.17241/smr.2018.00248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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RAYWARD ANNAT, BURTON NICOLAW, BROWN WENDYJ, HOLLIDAY ELIZABETHG, PLOTNIKOFF RONALDC, DUNCAN MITCHJ. Associations between Changes in Activity and Sleep Quality and Duration over Two Years. Med Sci Sports Exerc 2018; 50:2425-2432. [DOI: 10.1249/mss.0000000000001715] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Psychological Interventions for Late-life Insomnia: Current and Emerging Science. CURRENT SLEEP MEDICINE REPORTS 2018; 4:268-277. [PMID: 31106115 DOI: 10.1007/s40675-018-0129-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of Review Late-life insomnia is a serious medical condition associated with many untoward consequences. The high prevalence of late-life insomnia, along with the concomitant risks inherent in the use of hypnotic medications in older adults necessitates non-pharmacological (i.e., psychological) treatment options. We aim to summarize and evaluate the state-of-the-science of psychological treatment options for late-life insomnia. Recent Findings Cumulative scientific evidence suggests the efficacy of psychological treatment of late-life insomnia. During the previous decade, trials of psychological treatments for insomnia have begun to test various modifications to treatments that have the potential to improve access for older adults, along with expanding their focus to include individuals with comorbid conditions that are common to older adults. While these modifications represent positive advances in the science of treatment for late-life insomnia, the evidence is still largely explanatory/efficacious in nature. Summary Psychological strategies represent the best approaches for the treatment of late-life insomnia. Future investigations would be wise to progressively move towards increasingly pragmatic/effectiveness investigations, adding to the literature base regarding the treatment of late-life insomnia under usual/real-world conditions as opposed to ideal/artificial conditions.
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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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Tyndall AV, Clark CM, Anderson TJ, Hogan DB, Hill MD, Longman R, Poulin MJ. Protective Effects of Exercise on Cognition and Brain Health in Older Adults. Exerc Sport Sci Rev 2018; 46:215-223. [DOI: 10.1249/jes.0000000000000161] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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