Studys shows exercise is no quick cure of insomnia
Posted by on August 24, 2013 - 10:02am

Exercise is a common prescription for insomnia. But spending 45 minutes on the treadmill one day won’t translate into better sleep that night, according to new Northwestern Medicine® research.

“If you have insomnia you won’t exercise yourself into sleep right away,” said lead study author Kelly Glazer Baron, PhD, a clinical psychologist and director of the behavioral sleep program at Northwestern University Feinberg School of Medicine. “It’s a long-term relationship. You have to keep at it and not get discouraged.”

This is the first long-term study to show aerobic exercise during the day does not result in improved sleep that same night when people have existing sleep problems. Most studies on the daily effects of exercise and sleep have been done with healthy sleepers.  The study also showed people exercise less following nights with worse sleep.

The study was published August 15 in the Journal of Clinical Sleep Medicine. Baron conducted the study with coauthor Kathryn Reid, PhD, research associate professor of neurology at Feinberg and senior author Phyllis Zee, MD, PhD, the Benjamin and Virginia T. Boshes Professor of Neurology at Feinberg and director of the Sleep Disorders Center at Northwestern Memorial Hospital.

"This new study shows exercise and sleep affect each other in both directions: regular long-term exercise is good for sleep, but poor sleep can also lead to less exercise. So in the end, sleep still trumps everything as far as health is concerned," Zee said.

Baron decided to analyze the daily effect of exercise after hearing her patients with insomnia complain the exercise she recommended didn’t help them right away. “The prevailing thought is that exercise improves sleep, but I thought it probably wasn’t that simple for people with insomnia,” reported Baron.

Why does it take time for exercise to impact sleep?

“Patients with insomnia have a heightened level of brain activity and it takes time to re-establish a more normal level that can facilitate sleep,” Zee said. “Rather than medications, which can induce sleep quickly, exercise may be a healthier way to improve sleep because it could address the underlying problem.”

The study participants were older women, who have the highest prevalence of insomnia. Exercise is an optimum approach to promote sleep in an older population because drugs can cause memory impairment and falls. Baron thinks the results also could apply to men because there is no evidence of gender differences in behavioral treatments for insomnia.

The key message is that people with sleep disturbances have to be persistent with exercise.

“People have to realize that even if they don’t want to exercise, that’s the time they need to dig in their heels and get themselves out there,” Baron said. “Write a note on your mirror that says ‘Just Do It!’ It will help in the long run.”

Aerobic Exercise Relieves Insomnia
Posted by on September 20, 2010 - 3:47pm

The millions of middle-aged and older adults who suffer from insomnia have a new drug-free prescription for a more restful night’s sleep. Regular aerobic exercise improves the quality of sleep, mood and vitality, according to a small but significant new study from Northwestern Medicine and the Feinberg School of Medicine.  Insomnia is more prevalent in women.

The study is the first to examine the effect of aerobic exercise on middle-aged and older adults with a diagnosis of insomnia. About 50 percent of people in these age groups complain of chronic insomnia symptoms.  The aerobic exercise trial resulted in the most dramatic improvement in patients’ reported quality of sleep, including sleep duration, compared to any other non-pharmacological intervention.

“This is relevant to a huge portion of the population,” said Phyllis Zee, M.D., director of the Sleep Disorders Center at Northwestern Medicine and senior author of a paper to be published in the October issue of Sleep Medicine. The lead author is Kathryn Reid, research assistant professor at Feinberg.

“Insomnia increases with age,” Zee said. “Around middle age, sleep begins to change dramatically. It is essential that we identify behavioral ways to improve sleep. Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous.”   The drug-free strategy also is desirable, because it eliminates the potential of a sleeping medication interacting with other drugs a person may be taking, Reid said.

Sleep is an essential part of a healthy lifestyle, like nutrition and exercise, noted Zee, a professor of neurology, neurobiology, and physiology at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital.

“Sleep is a barometer of health, like someone’s temperature. It should be the fifth vital sign. If a person says he or she isn’t sleeping well, we know they are more likely to be in poor health with problems managing their hypertension or diabetes," notes Zee.

The study included 23 sedentary adults, primarily women, 55 and older who had difficulty falling sleep and/or staying asleep and impaired daytime functioning. Women have the highest prevalence of insomnia. After a conditioning period, the aerobic physical activity group exercised for two 20-minute sessions four times per week or one 30-to-40-minute session four times per week, both for 16 weeks. Participants worked at 75 percent of their maximum heart rate on at least two activities including walking or using a stationary bicycle or treadmill.

Participants in the non-physical activity group participated in recreational or educational activities, such as a cooking class or a museum lecture, which met for about 45 minutes three to five times per week for 16 weeks. Both groups received education about good sleep hygiene, which includes sleeping in a cool, dark and quiet room, going to bed the same time every night and not staying in bed too long, if you can’t fall asleep.

Exercise improved the participants’ self-reported sleep quality, elevating them from a diagnosis of poor sleeper to good sleeper. They also reported fewer depressive symptoms, more vitality and less daytime sleepiness. “Better sleep gave them pep, that magical ingredient that makes you want to get up and get out into the world to do things,” Reid said.

The participants’ scores on the Pittsburgh Sleep Quality Index dropped an average of 4.8 points. (A higher score indicates worse sleep.) In a prior study using t’ai chi as a sleep intervention, for example, participants’ average scores dropped 1.8 points.

“Exercise is good for metabolism, weight management and cardiovascular health and now it’s good for sleep,” Zee said.

The research was funded by the National Institute on Aging.

Source:  Marla Paul - health sciences editor at the NU Feinberg School of Medicine

Women and Sleep
Posted by on August 12, 2010 - 2:46pm

The most recent statistics on the women who participate in our Illinois Women’s Health Registry, indicate that sleep is a significant issue in their lives.  Among the most current women who are enrolled in our registry, 11% report difficulties getting to sleep, 12% have a hard time staying asleep, 15% wake up feeling fatigued, 13% report they are getting too little sleep for what they need, and 8% wake too early and cannot get back to sleep.

Our limited knowledge in sex differences is due to the fact that women are underrepresented in studies of sleep and its disorders.  The National Sleep Disorders Research Plan, released in 2004 by the National Center on Sleep Disorders Research reported that 75% of sleep research has been conducted in men.   While more recent sleep studies have included women, the small sample sizes limit sex comparisons.  However, there is a growing body of evidence that sex hormones influence sleep and circadian rhythms, and further neuroendocrine studies are needed.

To read more on women and sleep on the Institute for Women's Health Research, click here.