Self-Care and Sleep

Physical Activity

Physical exercise is an important tool for addressing multiple sleep-related issues, including insomnia. It has been observed to have multiple beneficial effects on sleep including decreasing sleep latency, increasing slow wave sleep, and delaying onset of rapid eye movement (REM) sleep, possibly because it increases body temperature.¹ Since sleep quality as measured by the percentage of deep non-REM (slow wave) sleep declines with age, exercise may be a particularly helpful foundation for a self-care plan for insomnia that affects older patients.²

Physical activity during the day helps the mind-body unit transition into sleep at night.

A systematic review of the effect of exercise training in middle-aged and older adults with sleep problems reviewed six trials involving 305 study participants aged 40 or greater.³ All studies used the self-reported Pittsburgh Sleep Quality Index (PSQI) to asses sleep quality. Study participants were assigned to either moderate-intensity aerobic exercise or high-intensity resistance training. Those assigned to the exercise groups had improved PSQI scores and reduced sleep latency, but they did not differ in reported sleep duration, sleep efficiency, sleep disturbances, or daytime functioning.

A Cochrane Review of physical exercise for sleeping problems in adults aged 60 or greater found only one study that met criteria for inclusion in the review.⁴ In this research, study participants were randomized to either 16 weeks of moderate intensity endurance exercise (four 30-40 minute sessions per week of either brisk walking or low-impact aerobics) or a wait-listed control condition. Compared with people in the control group, those who randomized to exercise reported increased PSQI global sleep scores at 16 weeks (p<.001) as well as improved sleep quality and sleep onset latency.⁵

In a 2018 study assessing the relationship between physical activity and sleep quality, 2,649 people aged 45-86 years old were evaluated in a cross-sectional fashion. Greater amounts of physical activity and less sedentary behavior were associated with higher sleep efficiency and a lower likelihood of evening chronotype (being overactive in the evening). This paper even demonstrated that “weekend warriors” compared to predominantly inactive people, were more likely to have higher sleep efficiency. The authors did not find any associations between physical activity and sleep duration in this study.⁶