Staying Physically Active Is Associated with Better Mental Health and Sleep Health Outcomes during the Initial Period of COVID-19 Induced Nation-Wide Lockdown in Jordan

Jordan, a Middle Eastern country, initially responded to an outbreak of COVID-19 cases within its own borders by imposing a 7-week strict lockdown and closure of international and domestic travel. Such measures drastically influenced lifestyle behaviors of the population. This study aimed to investigate the prevalence of physical activity, and its association with mental and sleep health outcomes among Jordanians during a period of COVID-19 induced lockdown. Validated questionnaires were administered using a web-based platform to evaluate moderate-to-vigorous physical activity (MVPA), anxiety and depressive symptoms, sleep health, and sociodemographic characteristics. A modified Poisson regression model with robust error variance was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Compared to participants who met the guidelines, those who did not had significantly higher prevalence of moderate or severe anxiety symptoms than that of minimal or mild anxiety symptoms and increased depressive symptoms. Insufficient MVPA was associated with higher prevalence of poor sleep quality, short sleep duration (<7 h) and sleep problems. Overall, sufficient MVPA was associated with better mental and sleep health during the COVID-19 induced nation-wide lockdown in Jordan. While further research is necessary, promoting physical activity during the lockdown could potentially improve mental and sleep health outcomes among the population.

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Anxiety and depressive symptoms are associated with poor sleep health during a period of COVID-19-induced nationwide lockdown: a cross-sectional analysis of adults in Jordan

BMJ Open ◽

10.1136/bmjopen-2020-041995 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041995

Author(s):

Yazan A Al-Ajlouni ◽

Su Hyun Park ◽

Jude Alawa ◽

Ghaith Shamaileh ◽

Aziz Bawab ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Health Outcomes ◽

Sleep Duration ◽

Sleep Problem ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Sleep Health ◽

Short Sleep

Background Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. Methods Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. Results The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose–response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). Conclusions Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.

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160 Underlying Factors Contributing to Sleep Health Among Middle-aged and Older Adults

SLEEP ◽

10.1093/sleep/zsab072.159 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A65-A65

Author(s):

Rebecca Lorenz ◽

Varun Chandola ◽

Samantha Auerbach ◽

Heather Orom ◽

Chin-Shang Li ◽

...

Keyword(s):

Physical Activity ◽

Machine Learning ◽

Older Adults ◽

Depressive Symptoms ◽

Implementation Science ◽

Poor Sleep ◽

Middle Aged ◽

Sleep Health ◽

Sampling Procedures ◽

The Impact

Abstract Introduction Although poor sleep is not inherent with aging, an estimated 50-70 million adults in the US have insufficient sleep. Sleep duration is increasingly recognized as incomplete and insufficient. Instead, sleep health (SH), a multidimensional concept describing sleep/wake patterns that promote well-being has been shown to better reflect how sleep impacts the individual. Therefore, focusing on the underlying factors contributing to sleep health may provide the opportunity to develop interventions to improve sleep health in middle-age and older adults. Methods Data from the 2014 wave of the Health and Retirement Study (HRS) were used. Sample size was restricted to those who completed an additional questionnaire containing sleep variables. A derivation of the SH composite was constructed using eight selected sleep variables from the HRS data based on the five dimensions of sleep: Satisfaction, Alertness, Timing, Efficiency, and Duration. Total score ranged from 0-100, with higher scores indicating better SH. Weighting variables were based on complex sampling procedures and provided by HRS. Machine learning-based framework was used to identify determinants for predicting SH using twenty-six variables representing individual health and socio-demographics. Penalized linear regression with elastic net penalty was used to study the impact of individual predictors on SH. Results Our sample included 5,163 adults with a mean age of 67.8 years (SD=9.9; range 50-98 years). The majority were female (59%), white (78%), and married (61%). SH score ranged from 27-61 (mean=50; SD=6.7). Loneliness (coefficient=-1.92), depressive symptoms (coefficient=-1.28), and physical activity (coefficient=1.31) were identified as the strongest predictors of SH. Self-reported health status (coefficient=-1.11), daily pain (coefficient=-0.65), being middle-aged (coefficient=-0.26), and discrimination (coefficient=-0.23) were also significant predictors in this model. Conclusion Our study identified key predictors of SH among middle-aged and older adults using a novel approach of Machine Learning. Improving SH is a concrete target for health promotion through clinical interventions tailored towards increasing physical activity and reducing loneliness and depressive symptoms among middle-aged adults. Support (if any) This study was supported by National Heart, Lung, and Blood Institute (NHLBI) UB Clinical Scholar Program in Implementation Science to Achieve Triple Aims-NIH K12 Faculty Scholar Program in Implementation Science

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0185 Sleep Behaviors and Thoughts as Links Between Social Rhythmicity and Depressive Symptoms

SLEEP ◽

10.1093/sleep/zsaa056.183 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A73-A73

Author(s):

S M Sabet ◽

N D Dautovich ◽

J M Dzierzewski

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Health Outcomes ◽

Self Efficacy ◽

Future Research ◽

Poor Sleep ◽

Daily Routine ◽

Sleep Health ◽

Mediation Analyses ◽

Sleep Behaviors

Abstract Introduction Disturbances in social circadian rhythms (e.g. regularity of meals and social interactions) and poor sleep are two potential factors that may contribute to the development of mood disorders. To date, no studies have investigated sleep behaviors (e.g. sleep health) and sleep thoughts (e.g. sleep self-efficacy) as potential links between social rhythmicity and mental health outcomes. The current study explored whether (1) higher social rhythmicity predicted fewer symptoms of depression and whether (2) sleep health and sleep self-efficacy act as mechanisms underlying this association. Methods An archival analysis was performed using data from an online study, Investigating Sleep Across Normal Development (ISLAND Study). The sample consisted of 4,261 adults aged 18+. Measures of social rhythmicity (SRM-10), sleep self-efficacy (SES), sleep health (RU SATED), and depressive symptoms (PHQ-2) were utilized. Age and gender were included as covariates in mediation analyses. Results The overall model was significant, p < .0001 and 26.4% of the total variance was accounted for by social rhythmicity. Controlling for covariates, higher social rhythmicity was directly associated with fewer depressive symptoms (95% CI [.0326, .0420]). Additionally, both sleep health 95% CI [.0034, .0078] and sleep self-efficacy [.0119, .0169] significantly mediated the association between social rhythmicity and depressive symptoms. Conclusion Individuals who have higher levels of daily routine regularity experienced less depressive symptoms than those who are more irregular in their daily routines. Furthermore, individuals who had more regular lifestyle habits were more likely to engage in healthy sleep behaviors and thoughts. Thoughts and behaviors are common factors that may have an impact on mental health given their daily reoccurrence. Also, as these factors are modifiable they could be targeted to potentially reduce depressive symptoms. Future research should continue to examine the link between social rhythmicity and sleep behaviors and thoughts on various health outcomes. Support This work was supported by the National Institute on Aging (K23AG049955, PI: Dzierzewski).

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0358 Sleep Among Transgender and Cisgender Adolescents

SLEEP ◽

10.1093/sleep/zsaa056.355 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A136-A137

Author(s):

J C Levenson ◽

B C Thoma ◽

J L Hamilton ◽

S Choukas-Bradley ◽

R H Salk

Keyword(s):

Depressive Symptoms ◽

Gender Identity ◽

Sleep Quality ◽

Health Outcomes ◽

Sleep Duration ◽

Sleep Problems ◽

Demographic Variables ◽

Poor Sleep ◽

Central Research ◽

Development Fund

Abstract Introduction Sleep problems are germane to the majority of adolescents, but stigmatized youth may experience poorer sleep than those who have not experienced stigma. However, no prior studies have examined sleep among transgender adolescents (TGAs). Investigating these sleep disparities is critical, since low sleep duration and poor sleep quality are predictive of depressive symptoms and suicidality among adolescents, two mental health outcomes experienced disproportionately by TGAs. Using a nationwide survey of adolescents, we examined sleep duration, sleep quality, and rates of insufficient sleep among a sample of adolescents, and we compared those parameters between TGAs and cisgender adolescents (CGAs). Methods Adolescents (n=1784) ages 14-18 completed an anonymous survey including measures of sleep, sexual and gender identity, depressive symptoms, and demographic variables. Participants were grouped as TGA or CGA. Unadjusted associations between gender identity and sleep outcomes were examined, followed by multivariate regression models examining associations adjusted for demographics and depressive symptoms. Results TGAs reported sleeping fewer hours, higher odds of being a ‘poor sleeper’, and lower odds of getting the right amount of sleep and getting ‘enough sleep’ than CGAs. After adjusting for key demographic variables, TGAs were still more likely to report that they were poor sleepers and less likely to report getting enough sleep compared to CGAs. When adding depressive symptoms as a covariate, the finding that TGAs reported they got enough sleep less often than CGAs remained marginally significant. Conclusion Transgender adolescents reported receiving poorer sleep than cisgender adolescents. Future studies should focus on longitudinally examining the emergence of sleep problems among TGAs and CGAs, which may also serve to identify specific biopsychosocial pathways that contribute to heightened risk for sleep problems among TGAs. Sleep disparities may be a promising target for prevention and intervention programs to improve health outcomes among stigmatized youth. Support This study was funded by the University of Pittsburgh Central Research Development Fund through an award to Drs. Salk, Choukas-Bradley, and Thoma. Dr. Levenson was supported by grant K23HD087433. Dr. Thoma was supported by grants T32MH018951 and K01MH117142, Dr. Salk was supported by grant T32MH018269, and Dr. Hamilton was supported by grant T32HL082610.

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Associations between Physical Activity, Sitting Time, and Time Spent Outdoors with Mental Health during the First COVID-19 Lock Down in Austria

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179168 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9168

Author(s):

Sandra Haider ◽

Lee Smith ◽

Lovro Markovic ◽

Felipe B. Schuch ◽

Kabir P. Sadarangani ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Depressive Symptoms ◽

Vigorous Physical Activity ◽

Positive Association ◽

Well Being ◽

Anxiety Symptoms ◽

Sitting Time ◽

Cross Sectional ◽

Mental Well Being

Measures implemented to reduce the spread of SARS-CoV-2 have resulted in a decrease in physical activity (PA) while sedentary behaviour increased. The aim of the present study was to explore associations between PA and mental health in Austria during COVID-19 social restrictions. In this web-based cross-sectional study (April–May 2020) moderate-to-vigorous physical activity (MVPA), sitting time, and time spent outdoors were self-reported before and during self-isolation. Mental well-being was assessed with the Warwick-Edinburgh Mental Well-being Scale, and the Beck depression and anxiety inventories. The majority of the participants (n = 652) were female (72.4%), with a mean age of 36.0 years and a standard deviation (SD) of 14.4. Moreover, 76.5% took part in ≥30 min/day of MVPA, 53.5% sat ≥10 h/day, and 66.1% spent ≥60 min/day outdoors during self-isolation. Thirty-eight point five percent reported high mental well-being, 40.5% reported depressive symptoms, and 33.9% anxiety symptoms. Participating in higher levels of MVPA was associated with higher mental well-being (odds ratio = OR: 3.92; 95% confidence interval = 95%CI: 1.51–10.15), less depressive symptoms (OR: 0.44; 95%CI: 0.29–0.66) and anxiety symptoms (OR = 0.62; 95%CI: 0.41–0.94), and less loneliness (OR: 0.46; 95%CI: 0.31–0.69). Participants sitting <10 h/day had higher odds of mental well-being (OR: 3.58; 95%CI: 1.13–11.35). Comparable results were found for spending ≥60 min/day outdoors. Maintaining one’s MVPA levels was associated with higher mental well-being (OR = 8.61, 95%CI: 2.68–27.62). In conclusion, results show a positive association between PA, time spent outdoors and mental well-being during COVID-19 social restrictions. Interventions aiming to increase PA might mitigate negative effects of such restrictions.

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Strange Days: Adult Physical Activity and Mental Health in the First Two Months of the COVID-19 Pandemic

Frontiers in Public Health ◽

10.3389/fpubh.2021.567552 ◽

2021 ◽

Vol 9 ◽

Author(s):

Madelaine Gierc ◽

Negin A. Riazi ◽

Matthew James Fagan ◽

Katie M. Di Sebastiano ◽

Mahabhir Kandola ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Life Satisfaction ◽

Depressive Symptoms ◽

Satisfaction With Life ◽

Vigorous Physical Activity ◽

Well Being ◽

Anxiety Symptoms ◽

Satisfaction With Life Scale ◽

Mental Health Symptomatology

Background: In addition to its physical health benefits, physical activity is increasingly recognized as a means to support mental health. Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental well-being, reduced likelihood of developing mental illness, and improved symptom management. Despite these benefits, most people fail to achieve minimum recommended levels of MVPA. Population levels of physical activity have further declined since the onset of the COVID-19 pandemic and implementation of public health measures (e.g., shelter-in-place protocols). The potential impact of this decline on mental heath outcomes warrants ongoing investigation.Purpose: To investigate associations between changes in MVPA and mental health (depressive symptoms, anxiety symptoms, and life satisfaction) in adults impacted by the COVID-19 pandemic.Method: Research followed a cross-sectional design. English-speaking adults were invited to complete an online questionnaire. MVPA was assessed retrospectively (before COVID-19) and currently (during COVID-19) with the International Physical Activity Questionnaire. Mental health was assessed with the Patient Health Questionnaire, 9-Item (PHQ-9), the Generalized Anxiety Disorder, 7-Item (GAD-7), and the Satisfaction with Life Scale (SWLS). Regression was used to assess relationships between MVPA and mental health. ANOVA with follow-up tests examined whether participants who differed in mental health status (e.g., no symptoms vs. severe symptoms) differed in their change in MVPA. T-tests were used to examine differences in mental health symptomatology between participants who were sufficiently (i.e., achieving MVPA guidelines of ≥ 150 min/week) vs. insufficiently active.Results: Prior to COVID-19, 68.2% of participants were classified as being sufficiently active, vs. 60.6% during COVID-19. The majority of participants reported experiencing some level of depressive symptoms (62.0%) or anxiety symptoms (53.7%). After controlling for covariates, changes in MVPA accounted for significant variability in the PHQ-9 (7.7%), GAD-7 (2.5%), and SWLS (1.5 %). Participants with clinically significant mental health symptomatology reported greater declines in MVPA than those who reported no symptoms. Conversely, participants who were sufficiently active during COVID-19 reported significantly lower depression and anxiety, and higher life satisfaction.Conclusion: Participants who experienced the greatest declines in MVPA reported relatively greater psychological distress and lower life satisfaction. While preliminary, these findings suggest the importance of maintaining and promoting physical activity during a period of pandemic.

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Effect of a physical activity and sleep m-health intervention on a composite activity-sleep behaviour score and mental health: a mediation analysis of two randomised controlled trials

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01112-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Mitch J. Duncan ◽

Anna T. Rayward ◽

Elizabeth G. Holliday ◽

Wendy J. Brown ◽

Corneel Vandelanotte ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Trial Registration ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Sleep Health ◽

Intervention Effects ◽

Symptoms Of Depression ◽

Randomised Controlled

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.

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Customary physical activity and odds of depression: a systematic review and meta-analysis of 111 prospective cohort studies

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103140 ◽

2021 ◽

pp. bjsports-2020-103140

Author(s):

Rodney K Dishman ◽

Cillian P McDowell ◽

Matthew Payton Herring

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Depressive Symptoms ◽

Cohort Studies ◽

Prospective Cohort ◽

Observational Studies ◽

Meta Analysis ◽

Vigorous Physical Activity ◽

Prospective Cohort Studies ◽

Over Time

ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.

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Left superior temporal sulcus morphometry mediates the impact of anxiety and depressive symptoms on sleep quality in healthy adults

Social Cognitive and Affective Neuroscience ◽

10.1093/scan/nsab012 ◽

2021 ◽

Author(s):

Yanlin Wang ◽

Ping Jiang ◽

Shi Tang ◽

Lu Lu ◽

Xuan Bu ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Sleep Problems ◽

Superior Temporal Sulcus ◽

Healthy Adults ◽

Poor Sleep ◽

Emotional Symptoms ◽

Neural Basis ◽

Poor Sleep Quality ◽

The Impact

Abstract Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.

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The effect of long-term poor sleep quality on risk of back-related disability and the modifying role of physical activity

Scientific Reports ◽

10.1038/s41598-021-94845-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eivind Schjelderup Skarpsno ◽

Tom Ivar Lund Nilsen ◽

Paul Jarle Mork

Keyword(s):

Physical Activity ◽

Back Pain ◽

Sleep Quality ◽

Sleep Problems ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Physical Activity Guidelines ◽

Adjusted Risk ◽

Increased Risk

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.

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