The Impact of Moderate to High Intensity Physical Activity on Sleep Health in Cancer Survivors

Abstract

Background: Sleep disturbances are common among cancer survivors and negatively impact quality of life. Regular moderate- to high-intensity physical activity may provide a cost-effective, low-risk alternative strategy to improve sleep.

Methods: Data collected as part of two distinct studies, the Detroit Research On Cancer Survivors (ROCS) cohort and the CrossFit And Physical Activity: A Better Life Experience (CAPABLE) High-Intensity Interval Training (HIIT) trial, were analyzed to evaluate the association between participation in moderate- to high-intensity physical activity and sleep health. Sleep health was assessed using the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS).

Results: Among Detroit ROCS cohort members who completed the supplemental sleep survey at baseline and/or follow-up (n = 3022), those meeting 2012 American Cancer Society (ACS) physical activity guidelines reported sleep outcomes compared with inactive participants, including lower ISI scores (4.5 vs. 5.9, p < 0.001), lower ESS scores (5.6 vs. 6.6, p < 0.001), and lower PSQI (6.3 vs. 7.9, p < 0.001). In the CAPABLE trial (n = 73), ISI scores improved from 4.5 at baseline to 3.4 at exit (p < 0.001), while PSQI scores showed more modest improvement (6.1 to 5.4, p = 0.063). ESS scores remained unchanged (5.4 to 5.2, p = 0.708).

Conclusions: These findings support the role of moderate- to high-intensity physical activity in improving sleep health in a diverse cancer survivor population. Future research should further refine current methodologies to maximize benefit to survivors and implementation science to increase uptake and promote adherence to evidence-based guidelines.

Keywords: exercise; insomnia; quality of life; sleep health; sleep score.