Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations

ObjectivesTo evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations. DesignMulticenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30months. SettingLifestyle Interventions and Independence for Elders Study. ParticipantsCommunity-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N=1,635). MeasurementsSleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (8 defined insomnia), Epworth Sleepiness Scale (ESS) (10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30months. ResultsThe randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5=0.80, 95% confidence interval (CI)=0.68-0.94), including fewer new cases (aOR for PSQI >5=0.70, 95% CI=0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI 5=1.13, 95% CI=0.90-1.43). No significant intervention effects were observed for the ISI or ESS. ConclusionStructured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI.