Sleep, Physical Activity in Adults Over 55 is Studied in Real-Life Setting

J Vanderlihnden, PhD

A study evaluating the effects of a real-life lifestyle program on physical activity and sleep in adults 55 years and older suggested that the program was effective in increasing physical activity in the individuals but it did not seem to improve sleep.

According to the investigators, poor sleep in mid-aged and older adults is prevalent due to age-related changes. Physical activity has been acknowledged as a way to improve quality of sleep, however, the studies on this were conducted in controlled settings.

Through a real-life lifestyle program, investigators aimed to examine the effects of moderate-to-vigorous physical activity and sleep in older adults. Additionally, the effect this program had on good and poor sleepers was evaluated for differences.

The Real-Life Intervention

The controlled pretest-posttest trial was led by J Vanderlinden, PhD, Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven, University of Leuven.

The basis of the “Lekker Actief”, or “nice and active”, program was a 12-week progressive walking commitment, complemented by a healthy nutrition educational session and an optional muscle strengthening program.

Physical activity and sleep were measured using accelerometers and the Pittsburgh Sleep Quality Index (PSQI) was included to provide objective and subjective sleep measurements. This included sleep efficiency, total sleep time, wake time after sleep onset, number of awakenings, and sleep quality as reported by the participant.

The received information was analyzed in crude and adjusted multiple regression models. A control versus intervention interaction term between the program and sleep category was attributed across all models.

The Effects of the Lifestyle Program

A total of 451 participants were tested pre-intervention and 357 participants completed the posttest assessment. At the conclusion of the study, 200 participants remained in the intervention group and 157 in the control group.

The lifestyle program seemed to impact participants in the intervention group because their moderate-to-vigorous physical activity levels significantly increased when compared with the control group.

Alternatively, no significant effects on sleep were identified. Although the crude model displayed 2 interactions that were significant–predicting wake after sleep onset and predicting the number of awakenings–the simple slopes were not significant or clinically relevant in the partially or fully adjusted model.

As for the comparison between good and poor sleepers, no differences were discovered by the interaction terms regarding how the intervention affected activity levels. Investigators cited previous studies that found regular exercise improved the sleep of older adults who were considered poor sleepers.

Discussing the Differences

In the Discussion, investigators contemplated why their study displayed such contradictory results regarding the effect of physical activity on sleep when compared to previous literature. Since this trial was unique in studying the effects in a real-life environment, the sleep outcomes could have been diluted, they wrote.

Accelerometry was another possible reason mentioned for the clinically limited findings. While these devices are reliable, detailed data regarding sleep stages could have been factored in if polysomnography was used.

Previous studies have established the positive effect that physical activity has on sleep, but the impact of timing and exercise type is still unclear. Investigators noted that engaging in activity at different times throughout the circadian rhythm could have varying impacts on sleep.

“Although this program was effective in increasing physical activity, it did not improve sleep. Lifestyle programs should be promoted to increase physical activity, but more is needed to improve sleep as well,” investigators concluded.

The study “The effects of a real-life lifestyle program on physical activity and objective and subjective sleep in adults aged 55+ years” was published in BMC Public Health.