Effects of Morning Versus Evening Home-Based Exercise on Subjective and Objective Sleep Parameters in Older Adults: A Randomized Controlled Trial

First Published May 20, 2020 Research Article

Authors

, MD1
 
Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan

by this author
, , MD1
 
Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
by this author
, , MD2
 
Master’s Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
by this author
,
, PhD3
 
Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Shinjuku-ku, Tokyo, Japan
by this author
, , PhD4
 
Faculty of Social Welfare, Yamaguchi Prefectural University, Yamaguchi, Japan
by this author
, , PhD5
 
Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
by this author
...
First Published Online: May 20, 2020

This study aimed to determine whether the timing of exercise influenced the effects of home-based low-intensity stepping exercises on the sleep parameters of older adults.

For 8 weeks, 60 healthy older adults participated in a randomized controlled trial, performing low-intensity aerobic exercise (70-80 bpm) for about 30 minutes every day at home, either in the morning (from waking until 12:00) or evening (18:00 to bedtime).

In the evening exercise group, both subjectively and objectively measured sleep latency significantly improved throughout the intervention. Further, postintervention subjective sleep satisfaction was significantly higher in the evening group (6.2 ± 1.3 points) than in the morning group (5.2 ± 1.4 points; P = .006). Additionally, sleep variables related to evening exercise had larger effect sizes (Cohen d) than those performed in the morning.

Engaging in low-intensity stepping exercises during the evening is potentially a useful nonpharmacological approach to improving sleep quality among older adults.

1. Mander, BA, Winer, JR, Walker, MP. Sleep and human aging. Neuron. 2017;94(1):1936. doi:10.1016/j.neuron.2017.02.004
Google Scholar | Crossref | Medline
2. Kripke, DF, Garfinkel, L, Wingard, DL, Klauber, MR, Marler, MR. Mortality associated with sleep duration and insomnia. Arch Gen Psychiatry. 2002;59(2):131136. doi:10.1001/archpsyc.59.2.131
Google Scholar | Crossref | Medline
3. Stone, KL, Ancoli-Israel, S, Blackwell, T, et al. Actigraphy-measured sleep characteristics and risk of falls in older women. Arch Intern Med. 2008;168(16):17681975. doi:10.1001/archinte.168.16.1768
Google Scholar | Crossref | Medline
4. Yaffe, K, Falvey, CM, Hoang, T. Connections between sleep and cognition in older adults. Lancet Neurol. 2014;13(10):10171028. doi:10.1016/S1474-4422(14)70172-3
Google Scholar | Crossref | Medline
5. Okajima, I, Komada, Y, Nomura, T, Nakashima, K, Inoue, Y. Insomnia as a risk for depression: a longitudinal epidemiologic study on a Japanese rural cohort. J Clin Psychiatry. 2012;73(3):377383. doi:10.4088/JCP.10m06286
Google Scholar | Crossref | Medline
6. Lader, M . Benzodiazepine harm: how can it be reduced? Br J Clin Pharmacol. 2014;77(2):295301. doi:10.1111/j.1365-2125.2012.04418.x
Google Scholar | Crossref | Medline | ISI
7. McCall, WV. Sleep in the elderly: burden, diagnosis, and treatment. Prim Care Companion J Clin Psychiatry. 2004;6(1):920. doi:10.4088/pcc.v06n0104
Google Scholar | Crossref | Medline
8. Ray, WA, Thapa, PB, Gideon, P. Benzodiazepines and the risk of falls in nursing home residents. J Am Geriatr Soc. 2000;48(6):682685. doi:10.1111/j.1532-5415.2000.tb04729.x
Google Scholar | Crossref | Medline
9. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel . American Geriatrics Society 2019 updated AGS beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674694. doi:10.1111/jgs.15767
Google Scholar | Crossref | Medline
10. Alessi, C, Martin, JL, Fiorentino, L, et al. Cognitive behavioral therapy for insomnia in older veterans using nonclinician sleep coaches: randomized controlled trial. J Am Geriatr Soc. 2016;64(9):18301838. doi:10.1111/jgs.14304
Google Scholar | Crossref | Medline
11. Irwin, MR, Olmstead, R, Motivala, SJ. Improving sleep quality in older adults with moderate sleep complaints: a randomized controlled trial of Tai Chi Chih. Sleep. 2008;31(7):10011008.
Google Scholar | Medline
12. Buman, MP, King, AC. Exercise as a treatment to enhance sleep. Am J Lifestyle Med. 2010;4(6):500514. doi:10.1177/1559827610375532
Google Scholar | SAGE Journals
13. King, AC, Oman, RF, Brassington, GS, et al. Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. JAMA. 1997;277(1):3237.
Google Scholar | Crossref | Medline | ISI
14. King, AC, Pruitt, LA, Woo, S, et al. Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J Gerontol A Biol Sci Med Sci. 2008;63(9):9971004. doi:10.1093/gerona/63.9.997
Google Scholar | Crossref | Medline
15. United Nations Department of Economic and Social Affairs, Population Division . World Population Ageing 2019-Highlights (ST/ESA/SER.A/430). 2019. Accessed August 25, 2019. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf
Google Scholar
16. Brandão, GS, Gomes, GSBF, Brandão, GS, et al. Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial. Multidiscip Respir Med. 2018;13:2. doi:10.1186/s40248-017-0114-3
Google Scholar | Crossref | Medline
17. Stathokostas, L, Theou, O, Little, RM, Vandervoort, AA, Raina, P. Physical activity-related injuries in older adults: a scoping review. Sports Med. 2013;43(10):955963. doi:10.1007/s40279-013-0076-3
Google Scholar | Crossref | Medline
18. Riemann, D, Baglioni, C, Bassetti, C, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675700. doi:10.1111/jsr.12594
Google Scholar | Crossref | Medline
19. Alessi, C, Vitiello, MV. Insomnia (primary) in older people: non-drug treatments. BMJ Clin.Evid. 2015;pii:2302.
Google Scholar
20. Driver, HS, Taylor, SR. Exercise and sleep. Sleep Med Rev. 2000;4(4):387402. doi:10.1053/smrv.2000.0110
Google Scholar | Crossref | Medline | ISI
21. Stutz, J, Eiholzer, R, Spengler, CM. Effects of evening exercise on sleep in healthy participants: a systematic review and meta-analysis. Sports Med. 2019;49(2):269287. doi:10.1007/s40279-018-1015-0
Google Scholar | Crossref | Medline
22. Morita, Y, Sasai-Sakuma, T, Inoue, Y. Effects of acute morning and evening exercise on subjective and objective sleep quality in older individuals with insomnia. Sleep Med. 2017;34:200208. doi:10.1016/j.sleep.2017.03.014
Google Scholar | Crossref | Medline
23. Edinger, JD, Morey, MC, Sullivan, RJ, et al. Aerobic fitness, acute exercise and sleep in older men. Sleep. 1993;16(4):351359. doi:10.1093/sleep/16.4.351
Google Scholar | Crossref | Medline
24. Tsunoda, K, Kitano, N, Kai, Y, et al. Prospective study of physical activity and sleep in middle-aged and older adults. Am J Prev Med. 2015;48(6):662673. doi:10.1016/j.amepre.2014.12.006
Google Scholar | Crossref | Medline
25. Doi, Y, Minowa, M, Uchiyama, M, et al. Psychometric assessment of subjective sleep quality using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) in psychiatric disordered and control subjects. Psychiatry Res. 2000;97(2-3):165172. doi:10.1016/s0165-1781(00)00232-8
Google Scholar | Crossref | Medline
26. Tudor-Locke, C, Han, H, Aguiar, EJ, et al. How fast is fast enough? Walking cadence (step/min) as a practical estimate of intensity in adults: a narrative review. Br J Sports Med. 2018;52(12):776788. doi:10.1136/bjsports-2017-097628
Google Scholar | Crossref | Medline
27. Santos, RV, Tufik, S, Mello, MT. Exercise, sleep and cytokines: is there a relation? Sleep Med Rev. 2007 11(3):231239. doi:10.1016/j.smrv.2007.03.003
Google Scholar | Crossref | Medline
28. Kurita, S, Yano, S, Ishii, K, et al. Comparability of activity monitors used in Asian and Western-country studies for assessing free-living sedentary behaviour. PLoS One. 2017;12(10): e0186523. doi:10.1371/journal.pone.0186523
Google Scholar | Crossref | Medline
29. Glass, S, Gregory, B. ACSM’s Metabolic Calculations Handbook. Lippincott Willams & Wilkins, 2007;6869.
Google Scholar
30. Beltrame, T, Amelard, R, Wong, A, et al. Prediction of oxygen uptake dynamics by machine learning analysis of wearable sensors during activities of daily living. Sci Rep. 2017;7:45738. doi:10.1038/srep45738
Google Scholar | Crossref | Medline
31. Mâsse, LC, Fuemmeler, BF, Anderson, CB, et al. Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables. Med Sci Sports Exerc. 2005;37(suppl 11):S544S554. doi:10.1249/01.mss.0000185674.09066.8a
Google Scholar | Crossref | Medline
32. Cole, RJ, Kripke, DF, Gruen, W, et al. Automatic sleep/wake identification from wrist activity. Sleep. 1992;15(5):461469. doi:10.1093/sleep/15.5.461
Google Scholar | Crossref | Medline | ISI
33. SA . Sleep and aging: prevalence of disturbed sleep and treatment considerations in older adults. J Clin Psychiatry. 2005;66(suppl 9):2430.
Google Scholar
34. Sheikh, JI, Yesavage, JA. Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. Clin Gerontol. 1986;5(1-2):165173. doi:10.3109/09638288.2010.503835
Google Scholar | Crossref
35. Harvie, MN, Pegington, M, Mattson, MP, et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. Int J Obes (Lond). 2011;35(5):714727. doi:10.1038/ijo.2010.171
Google Scholar | Crossref | Medline
36. Cohen, J . Statistical Power Analysis for the Behavioral Sciences. Routledge Academic; 1988.
Google Scholar
37. Espie, CA, Emsley, R, Kyle, SD, et al. Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: a randomized clinical trial. JAMA Psychiatry. 2019;76(1):2130. doi:10.1001/jamapsychiatry.2018.2745
Google Scholar | Crossref | Medline
38. Buman, MP, Hekler, EB, Haskell, WL, et al. Objective light-intensity physical activity associations with rated health in older adults. Am J Epidemiol. 2010;172(10):11551165. doi:10.1093/aje/kwq249
Google Scholar | Crossref | Medline | ISI
39. Buxton, OM, Lee, CW, Hermite Baleriaux, ML, et al. Exercise elicits phase shifts and acute alterations of melatonin that vary with circadian phase. Am J Physiol Requl Integr Comp Physiol. 2003;284(3):R714R724. doi:10.1152/ajpregu.00355.2002
Google Scholar | Crossref | Medline | ISI
40. Hauri, P . Effects of evening activity on early night sleep. Psychophysiology. 1968;4(3):266277. doi:10.1111/j.1469-8986.1968.tb02767.x
Google Scholar | Crossref | Medline
41. Youngstedt, SD, Elliott, JA, Kripke, DF. Human circadian phase-response curves for exercise. J Physiol. 2019; 597(8):22532268. doi:10.1113/JP276943
Google Scholar | Crossref | Medline
42. Buman, MP, Philips, BA, Youngstedt, SD, et al. Does nighttime exercise really disturb sleep? Results from the 2013 National Sleep Foundation Sleep in America Poll. Sleep Med. 2014;15(7):755761. doi:10.1016/j.sleep.2014.01.008
Google Scholar | Crossref | Medline
43. Silva, GE, Goodwin, JL, Sherrill, DL, et al. Relationship between reported and measured sleep times: the Sleep Heart Health Study (SHHS). J Clin Sleep Med. 2007;3(6):622630.
Google Scholar | Crossref | Medline
44. Geiger-Brown, JM, Rogers, VE, Liu, W, et al. Cognitive behavioral therapy in persons with comorbid insomnia: a meta-analysis. Sleep Med Rev. 2015;23:5467. doi:10.1016/j.smrv.2014.11.007
Google Scholar | Crossref | Medline
45. Hill, KD, Hunter, SW, Batchelor, FA, et al. Individualized home-based exercise programs for older people to reduce falls and improve physical performance: a systematic review and meta-analysis. Maturitas. 2015;82:7284. doi:10.1016/j.maturitas.2015.04.005
Google Scholar | Crossref | Medline
46. van den Berg, JF, Miedema, HM, Tulen, JH, et al. Sex differences in subjective and actigraphic sleep measures: a population-based study of elderly persons. Sleep. 2009;32(10):13671375. doi:10.1093/sleep/32.10.1367
Google Scholar | Crossref | Medline | ISI

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.
  • Access Options

    My Account

    Welcome
    You do not have access to this content.

    Chinese Institutions / 中国用户

    Click the button below for the full-text content

    请点击以下获取该全文

    Institutional Access

    does not have access to this content.

    Purchase Content

    24 hours online access to download content

    Research off-campus without worrying about access issues. Find out about Lean Library here


Purchase

JGP-article-ppv for $41.50

Article available in:

Related Articles

Articles Citing this One: 0

Cookies Notification

This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Find out more.
Top