Is Less Sedentary Behavior, More Physical Activity, or Higher Fitness Associated with Sleep Quality? A Cross-Sectional Study in Singapore

Association Between Cardiorespiratory Fitness and Incident Purchase of Hypnotic Drugs in Adults: The HUNT Study

OBJECTIVE

To assess whether cardiorespiratory fitness (CRF) is associated with first purchase of a prescribed hypnotic drug in the adult population.

METHODS

A total of 34,357 adult participants (53.9% women) with a mean age of 51.5 years (SD 15.6 years) from the third Trøndelag Health Study (HUNT) of 2006 to 2008 were observed until January 1, 2018. Cardiorespiratory fitness was estimated from a validated nonexercise algorithm. Data on first hypnotics prescription were obtained through linkage to the National Norwegian Prescription Database. Cox regression with 95% CIs was used to estimate hazard ratios (HRs).

RESULTS

After 304,899 person-years of follow-up, 5791 participants had their first registered purchase of prescribed hypnotics, corresponding to an incidence rate of 1.90 per 100 person-years. Each 1-metabolic equivalent of task increase in CRF was significantly associated with 5% (HR, 0.95; 95% CI, 0.91 to 0.99; P=.02) and 4% (HR, 0.96; 95% CI, 0.92 to 1.00; P=.046) risk reduction for incident use of hypnotics in men and women, respectively. When CRF was categorized into tertiles with lowest CRF as the reference group, reduced risk was 13% (HR, 0.87; 95% CI, 0.79 to 0.96; P=.006) and 15% (HR, 0.85; 95% CI, 0.77 to 0.95; P=.003) for men in the intermediate and highest CRF category, respectively. In women with highest CRF, the reduced risk was 5% (HR, 0.95; 95% CI, 0.87 to 1.03; P=.22).

CONCLUSION

Cardiorespiratory fitness in adulthood is associated with incident purchase of prescription medication commonly used for sleep problems. These findings suggest that fitness should be considered a target for preventing sleep problems in adults.

Time spent in physical activity, sedentary behavior, and sleep: Associations with self-rated sleep quality in middle-aged and older adults

OBJECTIVES

We examined the associations of estimated allocations of time spent in physical activity, sedentary behavior and sleep with self-rated sleep quality.

METHODS

Between 2011 and 2016, 1918 participants (mean age 71 ± 9 years, 51% women) from the population-based Rotterdam Study were included. Durations of light physical activity, moderate-to-vigorous physical activity, sedentary behavior, and sleep were assessed by accelerometry, self-rated sleep quality with the Pittsburgh Sleep Quality Index. Associations were assessed with compositional isotemporal substitution analyses.

RESULTS

Spending 30 minutes more in sedentary behavior (adjusted mean difference in PSQI score: 0.21, 95% confidence interval [0.15; 0.28] or in light physical activity (adjusted mean difference in PSQI score: 0.25 [0.03; 0.46], and 30 minutes less in sleep, was associated with poorer sleep quality.

CONCLUSIONS

Our findings suggest reducing sedentary behavior and increasing sleep duration might be a potential intervention target to improve sleep quality in this population of middle-aged and older adults.

Sleep quality of Singapore residents: findings from the 2016 Singapore mental health study

Given the importance of sleep for physical and mental wellbeing, it is crucial to understand the extent of insomnia among community dwellers. However, there is a paucity of population wide epidemiological studies to estimate the prevalence of poor sleep quality. This present study aimed to 1) characterize the sleep quality of a nationally representative sample (n = 6126) of Singapore residents using Pittsburg Sleep Quality Index (PSQI) and 2) identify the sociodemographic correlates of poor sleep in this population. A total of 27.6% of respondents reported poor sleep quality (PSQI score ≥5). Sociodemographic correlates of poor sleep quality in the Singapore population included, but were not limited to, females (AOR = 1.44, 95% CI = 1.17 to 1.77, p-value = 0.001), Malays (vs Chinese) (AOR = 1.53, 95% CI = 1.23 to 1.9, p-value < 0.001), Indians (vs Chinese) (AOR = 1.22, 95% CI = 1.02 to 1.47, p-value = 0.03), ex-smokers (vs non-smokers) (AOR = 1.43, 95% CI = 1.07 to 1.92, p-value = 0.02), persons with comorbid mental health conditions (vs no mental health conditions) (AOR = 14.11, 95% CI = 6.52 to 30.54, p-value < 0.01), and persons with physical multimorbidity (vs no physical conditions) (AOR = 1.63, 95% CI = 1.24 to 2.15, p-value < 0.001). The prevalence of poor sleep in Singapore is comparable to that of other countries in the Asian region. Targeted public health campaigns to psycho-educate vulnerable groups on the importance of good sleep hygiene may improve the overall wellbeing of residents in Singapore.

Physical Exercise and Undergraduate Students’ Subjective Well-Being: Mediating Roles of Basic Psychological Need Satisfaction and Sleep Quality

This study aimed to examine the association between physical exercise and subjective well-being among undergraduate students, as well as its underlying mechanism—the potential mediating roles of basic psychological need satisfaction and sleep quality—from the perspective of self-determination theory. A sample of 770 undergraduate students (mean age was 19.90 ± 1.15 years old; 464 women) were recruited voluntarily to complete a set of measures examining physical exercise habits, psychological need satisfaction in exercise, sleep quality, and subjective well-being. The results indicated that (1) physical exercise was positively associated with undergraduate students’ subjective well-being; (2) psychological need satisfaction and sleep quality could significantly mediate this relation, which contained three pathways—the independent mediating effects of sleep quality and basic psychological need satisfaction and the sequential mediating effect of them. These findings not only reveal the mediating mechanism underlying the relation between physical exercise and subjective well-being by integrating the psychological and physical factors together but also provide an empirical basis for formulating prevention and intervention programs aimed at promoting the health and subjective well-being of undergraduate students.

Association between Objectively Measured Sedentary Behaviour and Sleep Quality in Japanese Adults: A Population-Based Cross-Sectional Study

The association between sedentary behaviour and sleep quality (SQ) remains unclear, partly due to the limited methodology for assessing sedentary time and the influence of obesity. This study aimed to examine the association between objectively measured sedentary time and poor SQ, as well as the association of visceral fat accumulation. This cross-sectional study used health check-up data obtained from 721 Japanese adults. Sedentary time and physical activity were measured using an accelerometer for ≥7 days, with ≥10 measurement hours per day. Poor SQ was determined by a Pittsburgh Sleep Quality Index score of ≥ 6. Visceral fat was measured using the abdominal bioimpedance method. A logistic regression model was used to analyse the association between sedentary time and SQ. We found that higher sedentary time was associated with poorer SQ. This association remained significant after adjustment for several covariates, including visceral fat. Compared with the lowest tertile of sedentary time, the second and highest tertile had a significantly higher OR of poor SQ (Tertile 2: OR = 2.06 [95% CI 1.14,3,73]; Tertile 3: OR = 2.76 [95% CI 1.49, 5.11]). These results suggest that managing sedentary time itself might contribute to improving SQ.

The Association between Cardiorespiratory Fitness and Reported Physical Activity with Sleep Quality in Apparently Healthy Adults: A Cross-Sectional Study

BACKGROUND

Recently, poor cardiorespiratory fitness (CRF) has been postulated as an adverse health outcome related to poor sleep quality. However, studies investigating the relationship between CRF and a subjective sleep quality index are scarce. Thus, the current study aimed to investigate the association between CRF and the Pittsburgh Sleep Quality Index (PSQI) in apparently healthy people. The secondary aim was to investigate the association between reported physical activity (PA) and PSQI.

METHODS

Thirty-three healthy male participants volunteered to participate. CRF (VO_2PEAK) was measured via cardiopulmonary exercise testing on a treadmill. A short form of the International Physical Activity Questionnaire (IPAQ) was used to measure PA, and PSQI was used for the sleep quality index.

RESULTS

There was no correlation between CRF and PSQI total score or any component of the PSQI. There was a significant inverse correlation between IPAQ and PSQI total score (r = -0.36, p = 0.04). Categorical data analysis of the two questionnaires revealed that 42.4% of the participants who reported low physical activity also had poor sleep quality.

CONCLUSIONS

The current study showed no association between CRF and the subjective sleep quality index but demonstrated a moderate inverse association between reported PA and subjective sleep quality index. The findings suggest that the more reported PA, the better the overall sleep quality.

Role of physical activity and fitness on sleep in sedentary middle-aged adults: the FIT-AGEING study

The association of physical activity and fitness with sleep still remains unclear since there is a lack of studies in this field of research using objective measurements of these variables. This study aimed to investigate the association of objectively-measured sedentariness, physical activity levels, and physical fitness with sleep quantity and quality in sedentary middle-aged adults. A total of 74 volunteers (52.7% women; aged 53.7 ± 5.1) were recruited for the present study. Cardiorespiratory fitness was measured through a maximal treadmill test, and muscular strength by extension and flexion peak torque, and by the hand grip test. Physical activity and objective sleep parameters were determined through accelerometry, and subjective sleep by the Pittsburgh Sleep Quality Index (PSQI). Reduced levels of sedentariness, greater VO_2max, and greater muscular strength were positively related to improved objective sleep quantity and quality (all P ≤ 0.05). Furthermore, higher levels of overall physical activity, VO_2max, and muscular strength were related to better subjective sleep quantity and quality (all P ≤ 0.05). Reduced sedentariness and increased physical activity and fitness may be a potential prevention and/or treatment pathway to reduce sleep disturbances and, in general, to improve patients physical and psychological health for a successful aging process.