Efficacy of an m-Health Physical Activity and Sleep Intervention to Improve Sleep Quality in Middle-Aged Adults: The Refresh Study Randomized Controlled Trial

2020 ◽  
Vol 54 (7) ◽  
pp. 470-483 ◽  
Author(s):  
Anna T Rayward ◽  
Beatrice Murawski ◽  
Mitch J Duncan ◽  
Elizabeth G Holliday ◽  
Corneel Vandelanotte ◽  
...  

Abstract Background Poor sleep health is highly prevalent. Physical activity is known to improve sleep quality but not specifically targeted in sleep interventions. Purpose To compare the efficacy of a combined physical activity and sleep intervention with a sleep-only intervention and a wait-list control, for improving sleep quality in middle-aged adults without a diagnosed sleep disorder. Methods Three-arm randomized controlled trial (Physical Activity and Sleep Health (PAS), Sleep Health Only (SO), Wait-list Control (CON) groups; 3-month primary time-point, 6-month follow-up) of 275 (PAS = 110, SO = 110, CON = 55) inactive adults (40–65 years) reporting poor sleep quality. The main intervention component was a smartphone/tablet “app” to aid goal setting and self-monitoring physical activity and/or sleep hygiene behaviors (including stress management), and a pedometer for PAS group. Primary outcome was Pittsburgh Sleep Quality Index (PSQI) global score. Secondary outcomes included several self-reported physical activity measures and PSQI subcomponents. Group differences were examined stepwise, first between pooled intervention (PI = PAS + SO) and CON groups, then between PAS and SO groups. Results Compared with CON, PI groups significantly improved PSQI global and subcomponents scores at 3 and 6 months. There were no differences in sleep quality between PAS and SO groups. The PAS group reported significantly less daily sitting time at 3 months and was significantly more likely to report ≥2 days/week resistance training and meeting physical activity guidelines at 6 months than the SO group. Conclusions PIs had statistically significantly improved sleep quality among middle-aged adults with poor sleep quality without a diagnosed sleep disorder. The adjunctive physical activity intervention did not additionally improve sleep quality. Clinical Trial information Australian New Zealand Clinical Trial Registry: ACTRN12617000680369; Universal Trial number: U1111-1194-2680; Human Research Ethics Committee, Blinded by request of journal: H-2016-0267.

Author(s):  
Mitch J. Duncan ◽  
Anna T. Rayward ◽  
Elizabeth G. Holliday ◽  
Wendy J. Brown ◽  
Corneel Vandelanotte ◽  
...  

Abstract Background To examine if a composite activity-sleep behaviour index (ASI) mediates the effects of a combined physical activity and sleep intervention on symptoms of depression, anxiety, or stress, quality of life (QOL), energy and fatigue in adults. Methods This analysis used data pooled from two studies: Synergy and Refresh. Synergy: Physically inactive adults (18–65 years) who reported poor sleep quality were recruited for a two-arm Randomised Controlled Trial (RCT) (Physical Activity and Sleep Health (PAS; n = 80), or Wait-list Control (CON; n = 80) groups). Refresh: Physically inactive adults (40–65 years) who reported poor sleep quality were recruited for a three-arm RCT (PAS (n = 110), Sleep Health-Only (SO; n = 110) or CON (n = 55) groups). The SO group was omitted from this study. The PAS groups received a pedometer, and accessed a smartphone/tablet “app” using behaviour change strategies (e.g., self-monitoring, goal setting, action planning), with additional email/SMS support. The ASI score comprised self-reported moderate-to-vigorous-intensity physical activity, resistance training, sitting time, sleep duration, efficiency, quality and timing. Outcomes were assessed using DASS-21 (depression, anxiety, stress), SF-12 (QOL-physical, QOL-mental) and SF-36 (Energy & Fatigue). Assessments were conducted at baseline, 3 months (primary time-point), and 6 months. Mediation effects were examined using Structural Equation Modelling and the product of coefficients approach (AB), with significance set at 0.05. Results At 3 months there were no direct intervention effects on mental health, QOL or energy and fatigue (all p > 0.05), and the intervention significantly improved the ASI (all p < 0.05). A more favourable ASI score was associated with improved symptoms of depression, anxiety, stress, QOL-mental and of energy and fatigue (all p < 0.05). The intervention effects on symptoms of depression ([AB; 95%CI] -0.31; − 0.60,-0.11), anxiety (− 0.11; − 0.27,-0.01), stress (− 0.37; − 0.65,-0.174), QOL-mental (0.53; 0.22, 1.01) and ratings of energy and fatigue (0.85; 0.33, 1.63) were mediated by ASI. At 6 months the magnitude of association was larger although the overall pattern of results remained similar. Conclusions Improvements in the overall physical activity and sleep behaviours of adults partially mediated the intervention effects on mental health and quality of life outcomes. This highlights the potential benefit of improving the overall pattern of physical activity and sleep on these outcomes. Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12617000680369; ACTRN12617000376347. Universal Trial number: U1111–1194-2680; U1111–1186-6588. Human Research Ethics Committee Approval: H-2016-0267; H-2016–0181.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eivind Schjelderup Skarpsno ◽  
Tom Ivar Lund Nilsen ◽  
Paul Jarle Mork

AbstractSleep problems and regular leisure time physical activity (LTPA) are interrelated and have contrasting effects on risk of back pain. However, no studies have investigated the influence of long-term poor sleep quality on risk of back-related disability, or if LTPA modifies this association. The study comprised data on 8601 people who participated in three consecutive surveys over ~ 22 years, and who reported no chronic back pain at the two first surveys. Adjusted risk ratios (RRs) for back-related disability were calculated at the last survey, associated with the joint effect of changes in sleep quality between the two first surveys and meeting physical activity guidelines at the second survey. Compared to people with long-term good sleep, people with long-term poor sleep had nearly twice the risk of back-related disability (RR 1.92, 95% CI 1.48–2.49). There was no statistical interaction between sleep and LTPA but people who reported long-term poor sleep and meeting the physical activity guidelines had 35% lower risk of back-related disability compared to people with same level of sleep problems, but who not met the guidelines. These findings suggest that long-term poor sleep quality contributes to a substantially increased risk of chronic and disabling back pain irrespective of LTPA.


2020 ◽  
Vol 5 (1) ◽  
pp. 64-75
Author(s):  
Iredho Fani Reza

Many previous studies have tried to find therapies in dealing with poor sleep quality in women. Where many researchers find that women are more likely to have poor sleep quality than men. Therefore, this study is to prove the effectiveness of wudu as a psychotherapy for sleep quality. This research is a quantitative pre-experimental research with One-Group Pretest-Posttest Design. Research respondents were determined by the purposive sampling technique (N = 17) all of them were young women. To measure sleep quality using the Sleep Quality Scale developed by Yi, Shin, and Shin (2006). Data analysis techniques using the Paired Samples T-Test technique using the help of JASP (Jeffrey's Amazing Statistics Program) version: 0.8.5.1. This study found that wudu therapy is effective in improving sleep quality in young women by focusing on increasing satisfaction with sleep which consists of three indicators namely: 1) Satisfaction Level with overall sleep; 2) Sleep tight; 3) Enough sleep.


2019 ◽  
Vol 23 ◽  
pp. 1-26
Author(s):  
Andrea Wendt ◽  
Thaynã Ramos Flores ◽  
Inácio Crochemore Mohnsam Silva ◽  
Fernando César Wehrmeister

The aim of this study was to systematically examine the literature on physical activity and sleep in non-clinical and population-based settings. The inclusion criteria were original studies testing the association between physical activity (as exposure) and sleep (as outcome) in representative samples of the general population, workers, or undergraduate students. Sleep health included sleep duration, sleep quality and insomnia. Studies evaluating samples including only individuals with some disease or a health condition were excluded. A search was performed in the PubMed, Scopus, Lilacs, CINAHL, and SPORTdiscus databases in March 2018. Data extraction was performed using the following items: year, author, country, population, age group, sample size, study design, sleep measurement/definition, physical activity measurement/definition, adjustment and main results. A total of 57 studies were selected, which markedly used heterogeneous instruments to measure physical activity and sleep. The majority were conducted in high-income countries and with cross-sectional design. Physical activity was associated with lower odds of insomnia (observed in 10 of 17 studies), poor sleep quality (observed in 12 of 19 studies) and long sleep duration (observed in 7 of 11 studies). The results about short sleep or continuous sleep duration remain unclear. Physical activity seems to be associated with sleep quality and insomnia, especially among adult and elderly populations in which these outcomes are more usually measured. The short- and long-term effects of physical activity intensities and dose-response on sleep should be better evaluated.


2020 ◽  
Vol 10 (3) ◽  
pp. 33-43
Author(s):  
Sofía González Salinas ◽  
Rubí Abigail Cruz Sánchez ◽  
Luis Enrique Ferrer Juárez ◽  
Martha Edith Reyes Garduño ◽  
María José Gil Trejo ◽  
...  

Sleep quality in college students has been related to anxiety and depressive symptomatology. However, the available statistics have been focused on students from Health Sciences thus preventing to know whether the same problematic is observed in students from other Majors. We applied the scales DASS-21, PSQI, and EAT-26 to 80 Mexican undergraduate students enrolled to any of the first three semesters of Majors in Administration, Industrial Engineering, or Medicine. We report that the percentage of students with abnormal scores in anxiety (33.33%) and poor sleeping quality (71.43%) was higher in Administration students. By using a logistic regression model, we show that anxiety scores can be explained by stress level, poor sleep quality, depression scores, and by the Major of study. Our findings show that anxiety management is needed for students to alleviate other emotional affections and improve sleep quality, particularly for those of Social Sciences.


10.2196/25241 ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e25241
Author(s):  
Xiaotong Zhang ◽  
Jue Liu ◽  
Na Han ◽  
Jing Yin

Background The COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic. Objective This study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China. Methods In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19–specific information. Results Among all the 456 pregnant women, there were 82 (18.0%) who did no physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0% (n=73; 95% CI 12.6%-19.4%). Compared with women who spent 0.5-2 hours (25/247, 10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7%), 2-3 hours (26/132, 19.7%), and >3 hours (17/54, 31.5%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4% vs 34/282, 12.1%; P=.003) and a high education level (66/368, 17.9% vs 7/88, 8.0%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable. Conclusions Pregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic.


2019 ◽  
Vol 8 (12) ◽  
pp. 2097 ◽  
Author(s):  
Francisco J. Amaro-Gahete ◽  
Alejandro De-la-O ◽  
Lucas Jurado-Fasoli ◽  
Borja Martinez-Tellez ◽  
Jonatan R. Ruiz ◽  
...  

This 12-week randomized controlled trial investigates the effects of different training modalities on cardiometabolic risk in sedentary, middle-aged adults, and examines whether alterations in cardiometabolic risk are associated with changes in those health-related variables that are modifiable by exercise training. The study subjects were 71 middle-aged adults (~54 years old; ~50% women) who were randomly assigned to one of the following treatment groups: (1) no exercise (control group), (2) concurrent training based on international physical activity recommendations (PAR group), (3) high intensity interval training (HIIT) group, or (4) HIIT plus whole-body electromyostimulation (HIIT+EMS group). A cardiometabolic risk score was calculated based on the International Diabetes Federation’s clinical criteria. A significant reduction in cardiometabolic risk was observed for all exercise training groups compared to the control group (all p < 0.05), which persisted after adjusting potential confounders (all p < 0.05). However, the HIIT+EMS group experienced the most significant reduction (p < 0.001). A significant inverse relationship was detected between the change in lean mass and the change in cardiometabolic risk (p = 0.045). A 12-week exercise training programs-especially the HIIT+EMS program-significantly reduced cardiometabolic risk in sedentary, middle-aged adults independent of sex, age, and cardiorespiratory fitness.


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