Background: One in two older adults report sleep problems, which not only cause fatigue, but also negatively affect general functioning, activities of daily living, and physical and mental health. Although it is known that physical activity is positively associated with sleep in older adults, the effects of physical activity programs on sleep in older adults has not been reviewed. The aim of this systematic review was to systematically review the effects of physical activity programs on sleep in generally healthy older adults aged 60+ years.
Methods: Searches were performed in PubMed, Embase, Web of Science, SPORTDiscus, PEDro and CINAHL. The methodological quality of the included studies was rated using the 'Quality Assessment Tool for Quantitative Studies'. Only studies of moderate and strong quality were included. This review was registered in PROSPERO (CRD42018094007).
Results: Fourteen studies met the inclusion criteria (six randomised controlled trials and eight pretest-posttest studies). Of these studies, five were moderate and nine were strong quality studies. Mean age of study samples ranged from 64 to 76 years. Exercise programs included various activities aimed at improving mobility, endurance and strength. Intervention duration ranged from 2 weeks to 12 months. Eleven studies used subjective measures of sleep, two used objective measures and one used both. Sixteen different sleep outcomes were reported. All but one study, found at least one significant improvement on sleep outcomes. No significantly detrimental effects were reported. Effect sizes, calculated in ten studies, ranged from 0,34-1,55 and were substantial (≥0,8) in four studies.
Conclusions: This systematic review suggests that exercise programs positively affect various aspects of sleep in generally healthy older adults. More specifically, moderate intensity exercise programs, with a frequency of three times per week and a duration of 12 weeks up to 6 months, showed the highest number of significant improvements in different sleep outcomes in older adults. Furthermore, programs that offered single exercise types, such as Baduanjin, Tai chi and the silver yoga program, or a combination of exercises showed the highest proportion of significant versus reported effects on sleep outcomes.
Keywords: Aged; Elderly; Exercise; Older adults; Physical activity; Sleep; Sleep quality; Sleep quantity.
Conflict of interest statement
The authors declare that they have no competing interests.
Exercise interventions on health-related quality of life for people with cancer during active treatment.Cochrane Database Syst Rev. 2012 Aug 15;(8):CD008465. doi: 10.1002/14651858.CD008465.pub2. Cochrane Database Syst Rev. 2012. PMID: 22895974 Review.
The effectiveness of web-based programs on the reduction of childhood obesity in school-aged children: A systematic review.JBI Libr Syst Rev. 2012;10(42 Suppl):1-14. doi: 10.11124/jbisrir-2012-248. JBI Libr Syst Rev. 2012. PMID: 27820152
Exercise for reducing fear of falling in older people living in the community.Cochrane Database Syst Rev. 2014 Nov 28;(11):CD009848. doi: 10.1002/14651858.CD009848.pub2. Cochrane Database Syst Rev. 2014. PMID: 25432016 Review.
Exercise interventions on health-related quality of life for cancer survivors.Cochrane Database Syst Rev. 2012 Aug 15;(8):CD007566. doi: 10.1002/14651858.CD007566.pub2. Cochrane Database Syst Rev. 2012. PMID: 22895961 Review.
Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Jul. Report No.: 15-05222-EF-1. Agency for Healthcare Research and Quality (US). 2017. PMID: 29364620 Free Books & Documents. Review.
- Ohayon M, Wickwire EM, Hirshkowitz M, Albert SM, Avidan A, Daly FJ, Dauvilliers Y, Ferri R, Fung C, Gozal D, Hazen N, Krystal A, Lichstein K, Mallampalli M, Plazzi G, Rawding R, Scheer FA, Somers V, Vitiello MV. National Sleep Foundation's sleep quality recommendations: first report. Sleep Health. 2017;3(1):6–19. doi: 10.1016/j.sleh.2016.11.006. - DOI - PubMed
- National sleep foundation . What is good quality sleep? 2019.
- Neubauer DN. Sleep problems in the elderly. Am Fam Physician. 1999;59(9):2551–2558. - PubMed