Long-Term Links between Physical Activity and Sleep Quality

Patterns of dietary quality, physical activity, and sleep duration among cancer survivors and caregivers

Fruit and vegetable intake (FVI), moderate-to-vigorous physical activity (MVPA), and sleep duration are each independently associated with cancer-related and general health outcomes among cancer survivors. Past research suggests that health behaviors cluster among cancer survivors, with caregivers demonstrating similar patterns. This analysis examined co-occurrence of FVI, MVPA, and sleep duration among cancer survivors and informal cancer caregivers and identified sociodemographic and clinical correlates of health behavior engagement. Using data from the Health Information National Trends Survey (HINTS), an exploratory latent profile analysis (LPA) was conducted among those self-reporting a history of cancer or identifying as a cancer caregiver. The LPA model was fit with daily self-reported FVI (cups/d), MPVA (minutes/d) and sleep duration (hours/d). Multinomial logistic regression models were used to predict profile membership based on sociodemographic and clinical characteristics. Four health behavior profiles were identified (Least Engaged-No MVPA, Least Engaged-Low MVPA, Moderately Engaged, and Highly Engaged). The largest profile membership was Least Engaged-No MVPA, capturing 37% of the sample. Profiles were most distinguished by MVPA, with the lowest variance in sleep duration. Participants reporting higher FVI also often reported greater MVPA and longer sleep duration. Profile membership was significantly associated with age, relationship status, education, income, rurality, alcohol use, self-efficacy, psychological distress, BMI, and cancer type. This study identified four health behaviors patterns and sociodemographic correlates that distinguished those patterns among cancer survivors and caregivers drawn from a nationally representative sample. Results may help identify for whom health behavior interventions could be of greatest benefit.

Objectively assessed sleep quality parameters in Multiple Sclerosis at home: Association to disease, disease severity and physical activity

BACKGROUND

Multiple Sclerosis (MS) is a chronic inflammatory autoimmune, neurodegenerative disease that affects regular mobility and leads predominantly to physical disability. Poor sleep quality, commonly reported in MS patients, impacts their physical activity (PA). Accelerometers monitor 24-h activity patterns, offering insights into disease progression in daily life.

OBJECTIVE

To test if the sleep quality variables of MS patients, as assessed with wrist-worn accelerometers, differ from those of controls and are associated with PA and disease severity variables.

METHODS

Seven-day raw accelerometer data collected from 40 MS patients and 24 controls was processed using an open-source GGIR package, from which variables of sleep quality (sleep efficiency, wake after sleep onset (WASO), sleep regularity index (SRI), intradaily variability (IV)) and PA (of different intensities: inactivity, light (LPA), moderate (MPA), vigorous (VPA)) were analyzed. The variables were compared between the two study groups and in MS patients, correlation tested associations among the variables of sleep quality, PA, and disease severity (assessed with the Expanded Disability Status Scale, EDSS).

RESULTS

Sleep efficiency was the only variable that differed significantly between MS patients and controls (lower in MS, p = 0.01). Both SRI (positively) and IV (negatively) correlated with the time spent in LPA and MPA. WASO correlated negatively with inactivity.

CONCLUSION

This is one of the few studies with a wrist-worn accelerometer that shows a difference in sleep efficiency between MS patients and controls and, in MS, an association of sleep quality variables with PA variables.

Sleep and Activity Patterns in Autism Spectrum Disorder

Background

Autism spectrum disorder (ASD) is a highly heritable and heterogeneous neurodevelopmental disorder characterized by impaired social interactions, repetitive behaviors, and a wide range of comorbidities. Between 44-83% of autistic individuals report sleep disturbances, which may share an underlying neurodevelopmental basis with ASD.

Methods

We recruited 382 ASD individuals and 223 of their family members to obtain quantitative ASD-related traits and wearable device-based accelerometer data spanning three consecutive weeks. An unbiased approach identifying traits associated with ASD was achieved by applying the elastic net machine learning algorithm with five-fold cross-validation on 6,878 days of data. The relationship between sleep and physical activity traits was examined through linear mixed-effects regressions using each night of data.

Results

This analysis yielded 59 out of 242 actimetry measures associated with ASD status in the training set, which were validated in a test set (AUC: 0.777). For several of these traits (e.g. total light physical activity), the day-to-day variability, in addition to the mean, was associated with ASD. Individuals with ASD were found to have a stronger correlation between physical activity and sleep, where less physical activity decreased their sleep more significantly than that of their non-ASD relatives.

Conclusions

The average duration of sleep/physical activity and the variation in the average duration of sleep/physical activity strongly predict ASD status. Physical activity measures were correlated with sleep quality, traits, and regularity, with ASD individuals having stronger correlations. Interventional studies are warranted to investigate whether improvements in both sleep and increased physical activity may improve the core symptoms of ASD.

Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects

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.

Temporal Interactions between Maintenance of Cerebral Cortex Thickness and Physical Activity from an Individual Person Micro-Longitudinal Perspective and Implications for Precision Medicine

Maintenance of brain structure is essential for neurocognitive health. Precision medicine has interests in understanding how maintenance of an individual person's brain, including cerebral cortical structure, interacts with lifestyle factors like physical activity. Cortical structure, including cortical thickness, has recognized relationships with physical activity, but concepts of these relationships come from group, not individual, focused findings. Whether or how group-focused concepts apply to an individual person is fundamental to precision medicine interests but remains unclear. This issue was studied in a healthy man using concurrent micro-longitudinal tracking of magnetic resonance imaging-defined cortical thickness and accelerometer-defined steps/day over six months. These data permitted detailed examination of temporal relationships between thickness maintenance and physical activity at an individual level. Regression analyses revealed graded significant and trend-level temporal interactions between preceding activity vs. subsequent thickness maintenance and between preceding thickness maintenance vs. subsequent activity. Interactions were bidirectional, delayed/prolonged over days/weeks, positive, bilateral, directionally asymmetric, and limited in strength. These novel individual-focused findings in some ways are predicted, but in other ways remain unaddressed or undetected, by group-focused work. We suggest that individual-focused concepts of temporal interactions between maintenance of cortical structure and activity can provide needed new insight for personalized tailoring of physical activity, cortical, and neurocognitive health.

Sporting Mind: The Interplay of Physical Activity and Psychological Health

The symbiotic relationship between sports practice and psychological well-being has, in recent times, surged to the forefront of academic and public attention. The aim of this narrative review is to comprehensively explore the intricate pathways linking physical engagement in sports to its subsequent impacts on mental health and synthesize the multifarious effects of sports on psychological health, offering insights for integrating physical and psychological strategies to enhance well-being. From neurobiological underpinnings to therapeutic applications, this comprehensive manuscript provides an in-depth dive into the multifaceted world of sports and psychology. Highlighting evidence-based interventions, this review aspires to offer actionable insights for practitioners, athletes, and individuals alike, advocating for a holistic approach to mental well-being. This manuscript highlights the profound impact of sports on mental health, emphasizing its role in emotional regulation, resilience, cognitive function, and treating psychological conditions. It details how sports induce neurochemical changes, enhance brain functions like memory and learning, and aid against cognitive decline. This review also notes the benefits of regular exercise in mood improvement, stress management, and social skill enhancement, particularly when combined with mindfulness practices. It underscores the importance of considering cultural and gender perspectives in sports psychology, advocating for an integrated physical-psychological approach to promote overall well-being.

Effect of short video addiction on the sleep quality of college students: chain intermediary effects of physical activity and procrastination behavior

Introduction

The purpose of this study was to examine the impact of short video addiction on college students' sleep quality and to elucidate the mechanism underlying this relationship. Thus, we examined the correlation between short video addiction and sleep quality and analyzed the roles of physical activity and procrastination.

Methods

The Short Video Addiction Scale, Pittsburgh Sleep Quality Index, Aitken Procrastination Inventory, and Physical Activity Rating Scale were administered to 337 college students. Data were analyzed using SPSS 27.0. Pearson's correlation analysis and mediation analysis using the bootstrapping test were performed for the standard method bias test.

Results

(1) Overall, 25.2% of college students had problems with sleep quality (indicated by a PSQI score ≥ 8). (2) Short video addiction score is positively correlated with college students' sleep quality score; procrastination score was positively associated with both short video addiction score and sleep quality score, and physical activity score was negatively associated with them. (3) Short video addiction significantly positive predicted sleep quality (β = 0.458, P < 0.001), a significant negative predictive effect on physical exercise (β = -0.183, P < 0.001), and a significant positive effect on procrastination behavior (β = 0.246, P < 0.001). After physical exercise and procrastination behavior were entered into the regression equation, short video addiction and procrastination were significantly positive predictors of sleep quality, and physical activity was significantly negative predictor of sleep quality. (4) After accounting for the variables of age, gender, and grade, physical activity and procrastination behaviors independently mediated the association between short-video addiction and sleep quality. Physical activity and procrastination behavior acted as chain mediators in the association between short video addiction and sleep quality, with a chain mediation effect percentage of 1.04%. Short video addiction directly affects college students' sleep quality, indirectly through physical activity and procrastination behavior.

Association of sociodemographic, anthropometric, and sleep quality factors with accelerometer-measured sitting and physical activity times among Emirati working women during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

Although a significant lack of physical activity has been linked to an increase in obesity among Emirati women, the factors associated with accelerometer-measured sitting and physical activity times in Emirati women remain unclear.

OBJECTIVES

To explore the association of accelerometer-measured sitting and physical activity times with sociodemographic, anthropometric, and sleep quality factors among Emirati working women.

DESIGN

A cross-sectional study.

METHODS

A convenience sample of 163 healthy working Emirati women aged 18-45 years was used. Sedentary and physical activity times were measured using the Fibion accelerometers worn on the thighs for 4-7 days. General demographic information, anthropometric measurements, and self-reported sleep quality (Pittsburgh sleep quality index score) were collected. Only participants who had valid data (i.e. wear time of ⩾600 min (10 h) per day for a minimum of 4-7 days) were evaluated. All values were normalized to a 16-h day to mitigate differences in wear time among the participants.

RESULTS

Overall, 110 Emirati women were included. The mean sitting time per 16-h day was 11.6 ± 1.1 h; mean moderate activity time per day, 40.88 ± 17.99 min; and mean vigorous activity time per day, 2.41 ± 1.21 min. Longer sitting time was associated with high body fat, secondary education, and divorce. Sitting time was reduced in those with good sleep quality. Moderate-to-vigorous physical activity time was increased in women with postgraduate education and was decreased in women with a longer work experience and with comorbidities. The total activity time increased with increasing age and good sleep quality, whereas it decreased with increasing body fat, presence of at least one comorbidity, secondary education, and divorce.

CONCLUSION

Certain demographic, anthropometric, and sleep quality factors were associated with accelerometer-measured sitting and physical activity times among Emirati working women. Future longitudinal studies should consider these factors when investigating predictors of physical activity levels in this population.

Development of an interpretable machine learning-based intelligent system of exercise prescription for cardio-oncology preventive care: A study protocol

Background

Cardiovascular disease (CVD) and cancer are the first and second causes of death in over 130 countries across the world. They are also among the top three causes in almost 180 countries worldwide. Cardiovascular complications are often noticed in cancer patients, with nearly 20% exhibiting cardiovascular comorbidities. Physical exercise may be helpful for cancer survivors and people living with cancer (PLWC), as it prevents relapses, CVD, and cardiotoxicity. Therefore, it is beneficial to recommend exercise as part of cardio-oncology preventive care.

Objective

With the progress of deep learning algorithms and the improvement of big data processing techniques, artificial intelligence (AI) has gradually become popular in the fields of medicine and healthcare. In the context of the shortage of medical resources in China, it is of great significance to adopt AI and machine learning methods for prescription recommendations. This study aims to develop an interpretable machine learning-based intelligent system of exercise prescription for cardio-oncology preventive care, and this paper presents the study protocol.

Methods

This will be a retrospective machine learning modeling cohort study with interventional methods (i.e., exercise prescription). We will recruit PLWC participants at baseline (from 1 January 2025 to 31 December 2026) and follow up over several years (from 1 January 2027 to 31 December 2028). Specifically, participants will be eligible if they are (1) PLWC in Stage I or cancer survivors from Stage I; (2) aged between 18 and 55 years; (3) interested in physical exercise for rehabilitation; (4) willing to wear smart sensors/watches; (5) assessed by doctors as suitable for exercise interventions. At baseline, clinical exercise physiologist certificated by the joint training program (from 1 January 2023 to 31 December 2024) of American College of Sports Medicine and Chinese Association of Sports Medicine will recommend exercise prescription to each participant. During the follow-up, effective exercise prescription will be determined by assessing the CVD status of the participants.

Expected outcomes

This study aims to develop not only an interpretable machine learning model to recommend exercise prescription but also an intelligent system of exercise prescription for precision cardio-oncology preventive care.

Ethics

This study is approved by Human Experimental Ethics Inspection of Guangzhou Sport University.

Clinical trial registration

http://www.chictr.org.cn, identifier ChiCTR2300077887.

Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices

Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.

Better sleep quality and higher physical activity levels predict lower emotion dysregulation among persons with major depression disorder

BACKGROUND

People with Major Depression Disorders (MDD) often complain about sleep problems and experience emotion dysregulation. Prior research suggests physical activity can improve both sleep quality and emotional control. However, there is limited research on emotion regulation and the impact of physical activity and sleep in this population.

OBJECTIVES

The present study examined the relationships between sleep quality, emotion regulation, and physical activity levels among patients with MDD.

METHODS

The sample consisted of 118 patients with MDD (mean age: 31.85 years) who completed questionnaires on sleep quality, physical activity, emotion regulation, and depression.

RESULTS

Results showed that more sleep problems were associated with worse emotion dysregulation, and more physical activity was associated with fewer sleep problems and less emotion dysregulation. Furthermore, physical activity and sleep quality significantly predicted emotion dysregulation, with physical activity being the stronger predictor.

CONCLUSIONS

Results from this study suggest that individuals with MDD who are able to engage in physical activity and get better sleep could experience emotional regulation benefits.

Relationship between free-time physical activity and sleep quality in Brazilian university students

Poor sleep quality and low or no free-time physical activity (FTPA) practice are highly prevalent among university students, but the association between these conditions is still unclear. This cross-sectional study analyzed the relationship between FTPA and sleep quality. An online questionnaire was conducted with university students from a public university in southern Brazil in 2019. The weekly frequency of FTPA was self-reported, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and ANCOVA models were performed and adjusted for confounders. Among the 2,626 students analyzed, 52.2% did not practice the FTPA, and 75.6% had poor sleep quality (PSQI > 5). In the adjusted analysis, practicing FTPA 4-7 times/week was associated with poor sleep quality (odds ratio = 0.71; 95% confidence interval = 0.52, 0.97) compared with not practicing FTPA. In addition, those who practiced FTPA had significantly lower means of the global PSQI, subjective sleep quality and duration, sleep disturbances, and daytime dysfunction scores than those who did not practice FTPA. In conclusion, the FTPA may contribute to better sleep quality among university students.

Mining Sensor Data to Assess Changes in Physical Activity Behaviors in Health Interventions: Systematic Review

BACKGROUND

Sensors are increasingly used in health interventions to unobtrusively and continuously capture participants' physical activity in free-living conditions. The rich granularity of sensor data offers great potential for analyzing patterns and changes in physical activity behaviors. The use of specialized machine learning and data mining techniques to detect, extract, and analyze these patterns has increased, helping to better understand how participants' physical activity evolves.

OBJECTIVE

The aim of this systematic review was to identify and present the various data mining techniques employed to analyze changes in physical activity behaviors from sensors-derived data in health education and health promotion intervention studies. We addressed two main research questions: (1) What are the current techniques used for mining physical activity sensor data to detect behavior changes in health education or health promotion contexts? (2) What are the challenges and opportunities in mining physical activity sensor data for detecting physical activity behavior changes?

METHODS

The systematic review was performed in May 2021 using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We queried the Association for Computing Machinery (ACM), IEEE Xplore, ProQuest, Scopus, Web of Science, Education Resources Information Center (ERIC), and Springer literature databases for peer-reviewed references related to wearable machine learning to detect physical activity changes in health education. A total of 4388 references were initially retrieved from the databases. After removing duplicates and screening titles and abstracts, 285 references were subjected to full-text review, resulting in 19 articles included for analysis.

RESULTS

All studies used accelerometers, sometimes in combination with another sensor (37%). Data were collected over a period ranging from 4 days to 1 year (median 10 weeks) from a cohort size ranging between 10 and 11615 (median 74). Data preprocessing was mainly carried out using proprietary software, generally resulting in step counts and time spent in physical activity aggregated predominantly at the daily or minute level. The main features used as input for the data mining models were descriptive statistics of the preprocessed data. The most common data mining methods were classifiers, clusters, and decision-making algorithms, and these focused on personalization (58%) and analysis of physical activity behaviors (42%).

CONCLUSIONS

Mining sensor data offers great opportunities to analyze physical activity behavior changes, build models to better detect and interpret behavior changes, and allow for personalized feedback and support for participants, especially where larger sample sizes and longer recording times are available. Exploring different data aggregation levels can help detect subtle and sustained behavior changes. However, the literature suggests that there is still work remaining to improve the transparency, explicitness, and standardization of the data preprocessing and mining processes to establish best practices and make the detection methods easier to understand, scrutinize, and reproduce.

Knowledge and attitudes of physiotherapists toward sleep: A survey study

BACKGROUND: Sleep has been considered as a critical brain state that affects various body functions relevant to physiotherapy (PTs) practice such as motor learning and relearning, pain management, and cognitive function. Despite the importance of sleep for successful rehabilitation outcomes, sleep is often overlooked by PTs. OBJECTIVE: The purpose of this study was to assess the attitude and perception of PTs on the need to assess sleep and provide education about sleep for their patients, as well as the perceived need for PTs to be educated on sleep topics. METHODS: A survey questionnaire to assess physical therapist’s perceptions and attitudes about sleep was utilized in this study. RESULTS: 90 PTs fill out the survey. All respondents agreed that poor sleep is important to people’s health, 93% agreed that PTs should assess patients’ sleep habits and sleep quality and 88% agreed that addressing sleep issues may impact PTs outcomes. The majority did not receive education about sleep during PT education (75%) or following graduation (86%). Most respondents (95%) think PTs should receive education about sleep. CONCLUSIONS: our findings indicated that PTs recognize that sleep impacts their outcomes and patients’ sleep should be assessed, as well as the need to receive education about sleep. Therefore, PT education programs may consider incorporating education about sleep, and the development of continuing education courses is also needed.

Objective Measurement of Walking Activity Using Wearable Technologies in People with Parkinson Disease: A Systematic Review

Parkinson’s disease (PD) is a complex neurodegenerative disease with a multitude of disease variations including motor and non-motor symptoms. Quality of life and symptom management may be improved with physical activity. Due to technological advancement, development of small new wearable devices recently emerged and allowed objective measurement of walking activity in daily life. This review was specifically designed to synthesize literature on objective walking activity measurements using wearable devices of patients with PD. Inclusion criteria included patients with a diagnosis of PD and exclusion criteria included studies using animal models or mixed syndromes. Participants were not required to undergo any type of intervention and the studies must have reported at least one output that quantifies daily walking activity. Three databases were systematically searched with no limitation on publication date. Twenty-six studies were eligible and included in the systematic review. The most frequently used device was the ActiGraph GT3X which was used in 10 studies. Duration of monitoring presented a range from 8 h to one year. Nevertheless, 11 studies measured walking activity during a 7-day period. On-body sensor wearing location differed throughout the included studies showing eight positions, with the waist, ankle, and wrist being the most frequently used locations. The main procedures consisted of measurement of walking hours during a 2-day period or more, equipped with a triaxial accelerometer at the dominant hip or ankle. It is also important for further research to take care of different factors such as the population, their pathology, the period, and the environment.

Independent and Combined Associations between Physical Activity and Sedentary Time with Sleep Quality among Chinese College Students

OBJECTIVE

To investigate the independent and combined associations between physical activity and sedentary time with sleep quality among Chinese college students.

METHODS

A cross-sectional study was conducted among Chinese college students (N = 2347; M age = 20 years; 67.1% students were female). We used the International Physical Activity Questionnaire-Short Form, the Adolescent Sedentary Activity Questionnaire, and the Pittsburgh Sleep Quality Index to assess the subjects' physical activity level, sedentary time, and sleep quality, respectively. Analyses were conducted using a multivariate logistic regression model.

RESULT

Of the total participants, 48.6% had poor sleep quality and 10% were at low physical activity levels, and the mean (±SD) sedentary time was 5.33 ± 2.34 h/day. No significant association was found between physical activity and sleep quality (OR = 1.27, 95% CI: 0.95~1.70) among Chinese college students after adjustment for potential confounders. Sedentary time was significantly positively associated with poor sleep quality (OR = 1.37, 95% CI: 1.14~1.65). The risks for those with a low physical activity level and high sedentary time, and a moderate physical activity level and high sedentary time were 2.78 (OR = 2.78, 95% CI: 1.61~4.80) and 1.49 (OR = 1.49, 95% CI: 1.13~1.95) times higher, respectively, than those with a high physical activity level and low sedentary time.

CONCLUSION

Among Chinese college students, high sedentary time was significantly negatively associated with sleep quality. A low physical activity level was insignificantly associated with sleep quality. A moderate physical activity level and high sedentary time, and a low physical activity level and high sedentary time were interactively associated with increased risks of poor sleep quality, respectively.

Worsening sleep predicts lower life space mobility during the onset of the COVID-19 pandemic

BACKGROUND

Poor sleep health is an understudied yet potentially modifiable risk factor for reduced life space mobility (LSM), defined as one's habitual movement throughout a community. The objective of this study was to determine whether recalled changes in sleep traits (e.g., sleep quality, refreshing sleep, sleep problems, and difficulty falling asleep) because of the COVID-19 pandemic were associated with LSM in older adults.

METHODS

Data were obtained from a University of Florida-administered study conducted in May and June of 2020 (n = 923). Linear regression models were used to assess the impact of COVID-related change in sleep traits with summary scores from the Life Space Assessment. Analyses were adjusted for demographic, mental, and physical health characteristics, COVID-related avoidant behaviors, and pre-COVID sleep ratings.

RESULTS

In unadjusted models, reporting that any sleep trait got "a lot worse" or "a little worse" was associated with a decrease in LSM (all p < 0.05). Results were attenuated when accounting for demographic, mental, and physical health characteristics. In fully adjusted models, reporting that problems with sleep got "a lot worse" or that refreshing sleep got "a little worse" was associated with a lower standardized LSM score (β = -0.38, 95% CI: -0.74, -0.01, and β = -0.19, 95% CI: -0.37, -0.00, respectively).

CONCLUSIONS

While additional research is needed in diverse people and environments, the results demonstrate an association between sleep traits that worsen in response to a health threat and reduced LSM. This finding suggests that interventions that focus on maintaining sleep health in times of heightened stress could preserve LSM.

Sleep quality, valence, energetic arousal, and calmness as predictors of device-based measured physical activity during a three-week mHealth intervention

Physical inactivity is known to be a risk factor for several noncommunicable diseases and has a high prevalence in today’s society. Therefore, it is crucial to understand the psychological factors associated with physical activity (PA). Recent developments in the field of ambulatory assessment and technological advances are promising to enhance our understanding of this relationship by analyzing longitudinal data within- and between-persons. These analyses can reveal important factors to design behavior change interventions to enhance PA. Therefore, this study used an ecological momentary assessment during the 3‑week intervention period in the SMARTFAMILY2.0 trial and aimed to investigate whether valence, calmness, energetic arousal, and sleep quality predict daily steps and moderate to vigorous PA. Overall, 49 adults (35–60 years) and 40 children (5–19 years) were included in this analysis and self-rated their mental state within our smartphone application while also wearing a hip-worn accelerometer for 21 consecutive days (996 days included) during the intervention period. Multilevel analyses were conducted to predict daily PA while considering covariables (e.g., child/adult and non-wear time) both within- and between-persons. The results indicated that higher than average ratings of a person’s valence and energetic arousal on one day predicted increased PA while higher than average calmness predicted decreased PA at the same day within this person. Sleep quality and between-person effects of the affective states showed no clear associations to PA. Overall, these results showed that within-person associations of valence, calmness, and energetic arousal should be considered when designing PA interventions for both children and adults. The influence of sleep quality, as well as between-person effects, should be further explored by future studies.

Sleep health of Australian community tennis players during the COVID-19 lockdown

Background

Poorer sleep health outcomes have been documented in the general population during the COVID-19 outbreak. However, the impact of the COVID-19 outbreak on sleep health outcomes in specific population groups, including the sporting community, has not been extensively investigated. This study evaluated sleep health outcomes and their relationship with lifestyle behaviours during the initial COVID-19 lockdown period in Australian community tennis players.

Methods

This cross-sectional study evaluated sleep health outcomes and lifestyle behaviours using an online survey. The survey was disseminated online between the 24th of April and the 6th of June 2020 and comprised the Sleep Health Index, Sleep Satisfaction Tool and questions regarding weekly hours of tennis play, general physical activity, training location and alcohol consumption. Two-hundred and eighty-five individuals completed the survey.

Results

Compared to normative data, respondents displayed positive sleep health values during the initial COVID-19 lockdown period, with median values (IQR) of 85.3 (73.4, 91.7) and 64.8 (54.4, 73.4) for the Sleep Health Index and Sleep Satisfaction Tool, respectively. Sleep health outcomes were not significantly correlated (p > 0.05) with tennis play (Tb = 0.054-0.077), physical activity (Tb = -0.008 to 0.036), training location (Tb = -0.012 to -0.005) or alcohol consumption (Tb = -0.079 to -0.018).

Conclusion

Positive sleep health values were observed in Australian community-level tennis players during the initial COVID-19 pandemic. Sleep health values were not associated with lifestyle behaviours. Other unexplored factors may have influenced sleep health outcomes, including personal finances and socialisation, however these factors need to be investigated in future studies.

Better health indicators of FitSpirit participants meeting 24-h movement guidelines for Canadian children and youth

This study aims to determine the proportion of girls who meet the recommendations for moderate-to-vigorous physical activity (MVPA), screen time and sleep duration among FitSpirit participants and evaluate the associations of these recommendations with perceived health-related quality of life (QOL), perceived health, physical activity (PA), self-efficacy and body mass index. Cross-sectional analyses of FitSpirit data were performed. All variables were collected through an online questionnaire. The proportion of girls meeting all recommendations was 2.2%, while 72.5% met either one or two and 25.4% met none. A greater percentage of girls with ≥3 years in FitSpirit met MVPA and sleep recommendations combined when compared with fewer years (12.9% vs. 1.7% with 1 year; vs. 10.1% with 2 years; p < 0.05). Meeting the combinations of MVPA and screen time (β = 0.19, 95% CI = 0.40, 1.68), MVPA and sleep (β = 0.20, 95% CI = 0.27, 1.04) and all three combined (β = 0.17, 95% CI = 0.33, 1.71) was the most significant predictors of better perceived QOL. Respecting MVPA recommendations predicted a better perceived health (β = 0.18, 95% CI = 0.18, 0.87) while girls who slept as recommended had a better PA-related self-efficacy (β = 0.23, 95% CI = 0.51, 2.11). Not meeting any recommendation was associated with inferior PA-related self-efficacy (β = -0.32, 95% CI = -3.03, -1.21). Lastly, meeting MVPA and sleep recommendations was significantly associated with lower body mass index z-scores (β = -0.14, 95% CI = -1.16, -0.11). There was a small percentage of girls following all of the recommendations. Furthermore, meeting individual and combined recommendations was associated with better perceived QOL and health, PA self-efficacy as well as healthier body mass index z-score.

Bi-Directional, Day-to-Day Associations between Objectively-Measured Physical Activity, Sedentary Behavior, and Sleep among Office Workers

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.

Effect of physical activity goals on aerobic physical activity: testing the mediating role of external and internal motivation

Prior work has shown that primary care patients endorse one or more of the following PA goals, weight maintenance, overall benefits, stress reduction, weight loss, tone/body shape, overall well-being, cardiovascular fitness, and increased energy. Using self-determination theory as a guide, the present study tested whether these eight goals had indirect effects on likelihood of meeting aerobic PA guidelines through internal motivation, external motivation or both. Patients (N = 642; 60.7% female; 44.5% Black; M_age = 50.26 years) were recruited from the waiting room of a primary care clinic to complete a questionnaire. Results showed that PA goals of tone/shape, weight maintenance, and stress reduction had dual, opposing influences on likelihood of meeting aerobic PA guidelines via internal and external motivation. The goal of weight loss had a negative indirect effect on likelihood of meeting guidelines via external motivation. The PA goals of overall health benefits and cardiovascular health had singular, positive indirect effects on PA via internal motivation. Well-being had a direct positive effect on PA and a negative indirect effect via external motivation. Finally, the goal of improved energy had a direct positive effect on likelihood to meet PA guidelines. Implications for clinical practice and theory development are discussed.

Daily associations between sleep and physical activity: A systematic review and meta-analysis

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/.

Mediating Effect of Perceived Stress on the Association between Physical Activity and Sleep Quality among Chinese College Students

BACKGROUND

While physical activity has been reported to positively affect stress and sleep quality, less is known about the potential relationships among them. The present study aimed to investigate the mediating effect of stress on the association between physical activity and sleep quality in Chinese college students, after controlling for age, nationality, and tobacco and alcohol use.

PARTICIPANTS

The sample comprised 6973 college students representing three Chinese universities.

METHODS

Physical activity, perceived stress, and sleep quality were respectively measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), Perceived Stress Scale-10 Items (PSS-10), and Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Mediating effects of perceived stress on the association between physical activity and sleep quality were observed in males and females, with 42.4% (partial mediating effect) and 306.3% (complete mediating effect) as percentages of mediation, respectively.

CONCLUSION

The results of this study may provide some suggestions that physical activity could improve sleep by aiding individuals in coping with stress and indicate that stress management might be an effective non-pharmaceutical therapy for sleep improvement.

Investigating Causal Relations Between Sleep-Related Traits and Risk of Type 2 Diabetes Mellitus: A Mendelian Randomization Study

Objective

Extensive literature put forward the link between sleep and type 2 diabetes mellitus (T2DM), however, little is known about the underlying causality of the associations. Here we aim to assess the causal relationships between five major sleep-related traits and T2DM.

Design, Setting, and Participants

Two-sample Mendelian randomization (MR) was utilized to investigate the potential causal relations. Independent genetic variants associated with five sleep-related phenotypes—insomnia, sleep duration, short sleep duration, long sleep duration, and morningness—were chosen as instrumental variables to estimate the causal associations with T2DM. Summary statistics were acquired from the genome-wide association studies of UK Biobank and 23andMe (for sleep-related measures), the DIAbetes Genetics Replication And Meta-analysis and the FinnGen (for T2DM).

Main Methods

Individual Cochran’s Q statistic was applied to remove the pleiotropic instruments, global Q statistics and MR-Egger regression were adopted to test for the global heterogeneity and horizontal pleiotropy of the screened instruments, respectively. Two T2DM cohorts were selected to analyze their associations with sleep traits. A modified inverse variance weighted (IVW) estimate was performed to combine the ratio estimators from each instrument and acquire the causal estimate, alternative methods including IVW with first-order weights, simple and weighted median estimations, and MR-Egger regression were conducted as sensitivity analyses, to ensure the robustness and solidity of the findings.

Results

Two-sample MR supported findings for an adverse effect of genetically predicted insomnia on T2DM risk (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.09–1.19, p = 1.29E–08) at the Bonferroni-adjusted level of significance (p < 0.005). We further investigated the causal role of T2DM on insomnia but obtained a non-significant estimation. There was also little evidence for the causal effect of other sleep-related measures on T2DM. Results were largely consistent when leveraging two different T2DM cohorts, and were robust among various sensitivity analyses.

Conclusion

Findings provide significant evidence for an adverse effect of insomnia on T2DM risk. The study extends fundamental knowledge to further understanding of the pathophysiological mechanisms of T2DM, and points out the non-negligible role of insomnia on epidemiologic intervention and clinical therapeutics of T2DM.

Emotion regulation and healthy behaviors of the body energy balance in adults: A review of evidence

There is no document that analyzes the state of the art of scientific research published between 2013 and 2018 in relation to possible interdependence links between emotional regulation [ER] and healthy behaviors associated with Body Energy Balance [BEB] (physical activity, balanced diet and sleep hygiene). To achieve this purpose, an exploratory systematic review was conducted, whose search criteria were “emotion regulation”, “emotion dysregulation” connected with the Boolean operator “AND” to the keywords “sleep hygiene”, “eating behavior” and “physical activity”. Terms like “alexithymia”, “depression”, “stress”, “negative emotions”, and “rumination” were omitted. The methodological quality of the evidence was assessed with a patented rubric. After applying the analysis criteria, 35 articles were obtained, reporting theexistence of reciprocal associations and interactions between ER and at least one of the three behaviors associated with BEB were analyzed. It is concluded that, despite the importance of these behaviors in the vital maintenance of people and the clear impact that emotional regulation has on them, their research has not been sufficient, and more empirical studies in this regard in Latin America are needed.

Maternal Sleep Quality is Associated with Personal and Parenting Weight-Related Behaviors

Mothers of young children tend to report poor-quality sleep, yet little is known about links between maternal sleep quality and weight-related behaviors and parenting practices. Thus, mothers of preschoolers completed an online cross-sectional survey assessing their sleep, physical activity, dietary behaviors, eating styles, child feeding practices, family meal behaviors, and health parameters. Comparisons by sleep quality using the Pittsburgh Sleep Quality Index item (i.e., very bad/bad, n = 87; fair, n = 255; and good/very good, n = 193) revealed mothers with poor-quality sleep had weight-related behaviors associated with higher Body Mass Index (BMI) (lower physical activity, fewer fruits/vegetables, more emotional and disinhibited eating). Poor-quality sleepers also engaged in parenting practices contrary to recommendations, such as less frequent modeling of healthy eating and physical activity, more control of child feeding, and fewer family meals. Mothers reporting poor-quality sleep tended to have lower parenting self-efficacy, poorer overall health status, more days of poor mental and physical health, greater depression, more stress, and higher BMIs. Future nutrition research should establish the directionality between sleep quality and health behaviors. Future interventions should help mothers develop strategies for improving sleep quality, such as increased physical activity and fruit and vegetable intake, and helping mothers realize how their sleep quality may affect parenting practices.

Concurrent changes in sleep and physical activity during the transition to retirement: a prospective cohort study

BACKGROUND

Currently, little is known regarding whether changes in physical activity are associated with changes in sleep in general population. The aim of this study was to examine the association between changes in physical activity and changes in sleep duration and difficulties at retirement transition point.

METHODS

Data from the prospective Finnish Retirement and Aging study of 2745 retired public sector employees was used. Participants answered questionnaires before and after the retirement with one year interval, in which they reported average weekly hours of physical activity, sleep duration and the frequency of sleep difficulties. The level of physical activity, classified as 'low', 'moderate' or 'high', before and after retirement was used to classify the participants to five physical activity groups. Changes in sleep duration (in minutes) and sleep difficulties (no, moderate, severe) were examined in these physical activity groups.

RESULTS

Before retirement, high physical activity was associated with longest sleep duration (7 h 8 min) and low physical activity was associated with severe sleep difficulties (OR 1.23, 95% CI 1.06-1.44) in comparison to high physical activity. During retirement transition, sleep duration increased in all physical activity change groups and sleep difficulties decreased significantly in 'stable', 'increase from moderate', 'decrease from moderate' and 'decrease from high' groups. Changes in sleep duration and sleep difficulties were not statistically significantly different between the physical activity change groups.

CONCLUSION

Sleep duration increases and sleep difficulties decrease after retirement. Changes in sleep during retirement transition seem to be independent of changes in physical activity during the same time period.

Association between sleep quality and physical activity in postpartum women

OBJECTIVE

To describe sleep quality and sleep duration in primiparous women 6 months postpartum and to determine whether sleep quality is associated with 24-hour physical activity assessed using triaxial wrist accelerometry and a novel analytic technique, functional data analysis (FDA).

METHODS

Six months postpartum, participants wore a triaxial wrist accelerometer for 7 days and completed the Pittsburgh Sleep Quality Index (PSQI). We categorized sleep quality as good (score ≤5) or poor (>5). Data were summarized as vector magnitude of accelerations net of local gravity, or "Euclidean Norm Minus One" (ENMO, mg), in 5-second epochs. Using FDA, we modeled ENMO as a continuously changing, functional outcome predicted by sleep quality. We also compared mean total ENMO per 24-hour day, mean minutes of moderate to vigorous physical activity (MVPA) and of light activity/day, and mean minutes of MVPA in 10-minute bouts/day by sleep quality.

RESULTS

Of 365 women that completed the PSQI, 215 (59%) reported poor sleep quality. Two hundred ninety-six women completed both the PSQI and valid accelerometry. With the exception of one brief period around noon, sleep quality was not significantly associated with 24-hour physical activity according to FDA. Women with poor sleep quality had slightly greater total mean activity, minutes of light activity, and minutes of MVPA per day, but no difference in minutes of MVPA in at least 10-minute bouts.

CONCLUSION

Poor sleep quality is common 6 months postpartum. We identified no clinically significant differences in physical activity metrics between women with good and poor quality sleep.

Sedentary behaviour facilitates conditioned pain modulation in middle-aged and older adults with persistent musculoskeletal pain: a cross-sectional investigation

INTRODUCTION

Higher physical activity (PA) and lower sedentary behaviour (SB) levels have demonstrated beneficial effects on temporal summation (TS) and conditioned pain modulation (CPM) in healthy adults. This cross-sectional study investigated the relationships between PA and SB and TS/CPM responses in individuals with chronic musculoskeletal pain.

METHODS

Sixty-seven middle-aged and older adults with chronic musculoskeletal pain were recruited from the community. Questionnaires measuring demographics, pain, and psychological measures were completed. Physical activity/SB levels were measured using the International Physical Activity Questionnaire-short form and Sedentary Behaviour Questionnaire, respectively. Semmes monofilament was used to assess mechanical TS (MTS) at the most symptomatic (MTS-S) and a reference region (MTS-R); change in the pain scores (baseline-10th application) was used for analysis. Conditioned pain modulation procedure involved suprathreshold pressure pain threshold (PPT-pain4) administered before and after (CPM30sec, CPM60sec, and CPM90sec) conditioning stimulus (2 minutes; ∼12°C cold bath immersion). For analysis, PPT-pain4 (%) change scores were used.

RESULTS

PPT-pain4 (%) change scores at CPM30sec and CPM60sec demonstrated significant weak positive correlations with SB levels and weak negative correlations with PA measures. After adjusting for confounding variables, a significant positive association was found between SB (h/d) and PPT-pain4 (%) change scores at CPM30sec and CPM60sec. No significant associations between MTS and PA/SB measures.

CONCLUSION

Sedentariness is associated with higher pain inhibitory capacity in people with chronic musculoskeletal pain. The observed relationship may be characteristic of a protective (sedentary) behaviour to enhance pain modulatory mechanism. Prospective longitudinal studies using objective PA/SB measures are required to validate the observed relationship in a larger sample size.

Sleep Deprivation and Physiological Responses. A Case Report

BACKGROUND

The aim of this study was to evaluate the effects of 72-h sleep deprivation on normal daily activities (work, family, and sports), and to investigate whether sleep can be chronically reduced without dangerous consequences.

METHODS

The participant in this study was an adult male (age 41 years; mass 69 kg; height 173 cm). During the 72 h, data were collected every 6 h, involving a baseline (pre-deprivation). We monitored various parameters: Oxidative Stress (D-Rom and Bap test), Psychological Responses (test POMS and Measure of Global Stress), Metabolic expenditure (kJ) using a metabolic holter, EEG records, Cortisol, and Catecholamines level.

RESULTS

An interesting result was observed in the post-test phase, when a brief moment of deep sleep and total absence of a very deep sleep occurred, while an almost normal condition occurred in the pre-test sleep.

CONCLUSION

During the 72-h sleep deprivation, no psycho-physiological stress was recorded. The participant has remained within the threshold of well-being. Only a peak was recorded during the 66th hour, but it was within the wellness threshold.

Is There an Association between Physical Activity and Sleep in Community-Dwelling Persons with Dementia: An Exploratory Study Using Self-Reported Measures?

Sleep disturbances are common in persons with dementia (PWD). While pharmacotherapy is widely used, non-pharmacological interventions are beginning to surface as first-line management strategies. This study sought to investigate if physical activity was associated with more favourable sleep patterns in PWD, and to compare the sleep quantity and quality between active and inactive PWD. We conducted an exploratory study to tackle these research questions. Self-reported telephone questionnaires were administered to 40 caregivers of PWD, who answered questions as proxies on behalf of their care recipient. Just over half (55%) of our participants met the criteria for being active. Walking was the most popular form of physical activity for both active and inactive PWD. Active PWD also preferred exercise classes and gardening, whereas inactive PWD favoured chair exercises. Compared to their inactive counterparts, active PWD were more likely to experience appropriate sleep quantity (p = 0.00). The active group also reported significantly better overall sleep quality (p = 0.003). Together, our findings suggest that physical activity may be associated with improved sleep in PWD. Future studies are warranted to investigate whether physical activity can be promoted as a safe and effective means to improve quality-of-life in this population.