Effect of exercise on sleep quality and insomnia in middle-aged women: A systematic review and meta-analysis of randomized controlled trials

•Low-moderate levels of exercise for 12 weeks had a positive effect on sleep quality.•Aerobic exercise had a positive effect on sleep quality, while low levels of physical activity (yoga) did not have a significant effect.•There was a non-significant reduction in the severity of insomnia. We assesse...

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Published in:Maturitas Vol. 100; pp. 49 - 56
Main Authors: Rubio-Arias, Jacobo Á., Marín-Cascales, Elena, Ramos-Campo, Domingo J., Hernandez, Adrian V., Pérez-López, Faustino R.
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.06.2017
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ISSN:0378-5122, 1873-4111, 1873-4111
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Abstract •Low-moderate levels of exercise for 12 weeks had a positive effect on sleep quality.•Aerobic exercise had a positive effect on sleep quality, while low levels of physical activity (yoga) did not have a significant effect.•There was a non-significant reduction in the severity of insomnia. We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW). Searches were conducted in five databases from inception through December 15, 2016 for randomized controlled trials (RCTs) evaluating the effects of PE versus a non-exercising control condition on sleep quality, sleep disturbance and/or insomnia in MAW. Interventions had to last at least 8 weeks. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and insomnia with the Insomnia Severity Index (ISI). Random effects models were used for meta-analyses. The effects on outcomes were expressed as mean differences (MDs) and their 95% confidence intervals (CI). Five publications reported data from four RCTs on PE effects during 12–16 weeks on sleep quality (n=4 studies reporting PSQI results) and/or insomnia (n=3 studies reporting ISI results), including 660 MAW. Low-moderate levels of exercise significantly lowered the PSQI score (MD=−1.34; 95% CI −2.67, 0.00; p=0.05) compared with controls. In a subgroup analysis, moderate PE (aerobic exercise) had a positive effect on sleep quality (PSQI score MD=−1.85; 95% CI −3.62, −0.07; p=0.04), while low levels of physical activity (yoga) did not have a significant effect (MD-0.46, 95% CI −1.79, 0.88, p=0.50). In three studies (two studies of yoga, one study of aerobic exercise), there was a non-significant reduction in the severity of insomnia measured with the ISI score (MD −1.44, 95% CI −3.28, 0. 44, p=0.13) compared with controls. Heterogeneity of effects among studies was moderate to high. In middle-aged women, programmed exercise improved sleep quality but had no significant effect on the severity of insomnia.
AbstractList We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW). Searches were conducted in five databases from inception through December 15, 2016 for randomized controlled trials (RCTs) evaluating the effects of PE versus a non-exercising control condition on sleep quality, sleep disturbance and/or insomnia in MAW. Interventions had to last at least 8 weeks. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and insomnia with the Insomnia Severity Index (ISI). Random effects models were used for meta-analyses. The effects on outcomes were expressed as mean differences (MDs) and their 95% confidence intervals (CI). Five publications reported data from four RCTs on PE effects during 12-16 weeks on sleep quality (n=4 studies reporting PSQI results) and/or insomnia (n=3 studies reporting ISI results), including 660 MAW. Low-moderate levels of exercise significantly lowered the PSQI score (MD=-1.34; 95% CI -2.67, 0.00; p=0.05) compared with controls. In a subgroup analysis, moderate PE (aerobic exercise) had a positive effect on sleep quality (PSQI score MD=-1.85; 95% CI -3.62, -0.07; p=0.04), while low levels of physical activity (yoga) did not have a significant effect (MD-0.46, 95% CI -1.79, 0.88, p=0.50). In three studies (two studies of yoga, one study of aerobic exercise), there was a non-significant reduction in the severity of insomnia measured with the ISI score (MD -1.44, 95% CI -3.28, 0. 44, p=0.13) compared with controls. Heterogeneity of effects among studies was moderate to high. In middle-aged women, programmed exercise improved sleep quality but had no significant effect on the severity of insomnia.
•Low-moderate levels of exercise for 12 weeks had a positive effect on sleep quality.•Aerobic exercise had a positive effect on sleep quality, while low levels of physical activity (yoga) did not have a significant effect.•There was a non-significant reduction in the severity of insomnia. We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW). Searches were conducted in five databases from inception through December 15, 2016 for randomized controlled trials (RCTs) evaluating the effects of PE versus a non-exercising control condition on sleep quality, sleep disturbance and/or insomnia in MAW. Interventions had to last at least 8 weeks. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and insomnia with the Insomnia Severity Index (ISI). Random effects models were used for meta-analyses. The effects on outcomes were expressed as mean differences (MDs) and their 95% confidence intervals (CI). Five publications reported data from four RCTs on PE effects during 12–16 weeks on sleep quality (n=4 studies reporting PSQI results) and/or insomnia (n=3 studies reporting ISI results), including 660 MAW. Low-moderate levels of exercise significantly lowered the PSQI score (MD=−1.34; 95% CI −2.67, 0.00; p=0.05) compared with controls. In a subgroup analysis, moderate PE (aerobic exercise) had a positive effect on sleep quality (PSQI score MD=−1.85; 95% CI −3.62, −0.07; p=0.04), while low levels of physical activity (yoga) did not have a significant effect (MD-0.46, 95% CI −1.79, 0.88, p=0.50). In three studies (two studies of yoga, one study of aerobic exercise), there was a non-significant reduction in the severity of insomnia measured with the ISI score (MD −1.44, 95% CI −3.28, 0. 44, p=0.13) compared with controls. Heterogeneity of effects among studies was moderate to high. In middle-aged women, programmed exercise improved sleep quality but had no significant effect on the severity of insomnia.
Highlights • Low-moderate levels of exercise for 12 weeks had a positive effect on sleep quality. • Aerobic exercise had a positive effect on sleep quality, while low levels of physical activity (yoga) did not have a significant effect. • There was a non-significant reduction in the severity of insomnia.
We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW).OBJECTIVEWe assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW).Searches were conducted in five databases from inception through December 15, 2016 for randomized controlled trials (RCTs) evaluating the effects of PE versus a non-exercising control condition on sleep quality, sleep disturbance and/or insomnia in MAW. Interventions had to last at least 8 weeks. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and insomnia with the Insomnia Severity Index (ISI). Random effects models were used for meta-analyses. The effects on outcomes were expressed as mean differences (MDs) and their 95% confidence intervals (CI).METHODSSearches were conducted in five databases from inception through December 15, 2016 for randomized controlled trials (RCTs) evaluating the effects of PE versus a non-exercising control condition on sleep quality, sleep disturbance and/or insomnia in MAW. Interventions had to last at least 8 weeks. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and insomnia with the Insomnia Severity Index (ISI). Random effects models were used for meta-analyses. The effects on outcomes were expressed as mean differences (MDs) and their 95% confidence intervals (CI).Five publications reported data from four RCTs on PE effects during 12-16 weeks on sleep quality (n=4 studies reporting PSQI results) and/or insomnia (n=3 studies reporting ISI results), including 660 MAW. Low-moderate levels of exercise significantly lowered the PSQI score (MD=-1.34; 95% CI -2.67, 0.00; p=0.05) compared with controls. In a subgroup analysis, moderate PE (aerobic exercise) had a positive effect on sleep quality (PSQI score MD=-1.85; 95% CI -3.62, -0.07; p=0.04), while low levels of physical activity (yoga) did not have a significant effect (MD-0.46, 95% CI -1.79, 0.88, p=0.50). In three studies (two studies of yoga, one study of aerobic exercise), there was a non-significant reduction in the severity of insomnia measured with the ISI score (MD -1.44, 95% CI -3.28, 0. 44, p=0.13) compared with controls. Heterogeneity of effects among studies was moderate to high.RESULTSFive publications reported data from four RCTs on PE effects during 12-16 weeks on sleep quality (n=4 studies reporting PSQI results) and/or insomnia (n=3 studies reporting ISI results), including 660 MAW. Low-moderate levels of exercise significantly lowered the PSQI score (MD=-1.34; 95% CI -2.67, 0.00; p=0.05) compared with controls. In a subgroup analysis, moderate PE (aerobic exercise) had a positive effect on sleep quality (PSQI score MD=-1.85; 95% CI -3.62, -0.07; p=0.04), while low levels of physical activity (yoga) did not have a significant effect (MD-0.46, 95% CI -1.79, 0.88, p=0.50). In three studies (two studies of yoga, one study of aerobic exercise), there was a non-significant reduction in the severity of insomnia measured with the ISI score (MD -1.44, 95% CI -3.28, 0. 44, p=0.13) compared with controls. Heterogeneity of effects among studies was moderate to high.In middle-aged women, programmed exercise improved sleep quality but had no significant effect on the severity of insomnia.CONCLUSIONIn middle-aged women, programmed exercise improved sleep quality but had no significant effect on the severity of insomnia.
Author Hernandez, Adrian V.
Pérez-López, Faustino R.
Rubio-Arias, Jacobo Á.
Ramos-Campo, Domingo J.
Marín-Cascales, Elena
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  fullname: Rubio-Arias, Jacobo Á.
  organization: Department of Physical Activity and Sports Sciences, Faculty of Sports and Research Center for High Performance Sport, Catholic University of Murcia (UCAM), Murcia, Spain
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  givenname: Elena
  surname: Marín-Cascales
  fullname: Marín-Cascales, Elena
  organization: Department of Physical Activity and Sports Sciences, Faculty of Sports and Research Center for High Performance Sport, Catholic University of Murcia (UCAM), Murcia, Spain
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  givenname: Domingo J.
  surname: Ramos-Campo
  fullname: Ramos-Campo, Domingo J.
  organization: Department of Physical Activity and Sports Sciences, Faculty of Sports and Research Center for High Performance Sport, Catholic University of Murcia (UCAM), Murcia, Spain
– sequence: 4
  givenname: Adrian V.
  surname: Hernandez
  fullname: Hernandez, Adrian V.
  organization: School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima 9, Peru,University of Connecticut/Hartford Hospital Evidence-based Practice Center, 80 Seymour St, Hartford, CT 06102, USA
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  fullname: Pérez-López, Faustino R.
  email: faustino.perez@unizar.es
  organization: Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano-Blesa University Hospital, Domingo Miral s/n, Zaragoza 50009, Spain
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28539176$$D View this record in MEDLINE/PubMed
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Keywords Pittsburgh sleep quality index
Insomnia severity index
Middle-aged women
Yoga
Exercise
Insomnia
Language English
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PublicationDate 2017-06-01
PublicationDateYYYYMMDD 2017-06-01
PublicationDate_xml – month: 06
  year: 2017
  text: 2017-06-01
  day: 01
PublicationDecade 2010
PublicationPlace Ireland
PublicationPlace_xml – name: Ireland
PublicationTitle Maturitas
PublicationTitleAlternate Maturitas
PublicationYear 2017
Publisher Elsevier B.V
Publisher_xml – name: Elsevier B.V
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Snippet •Low-moderate levels of exercise for 12 weeks had a positive effect on sleep quality.•Aerobic exercise had a positive effect on sleep quality, while low levels...
Highlights • Low-moderate levels of exercise for 12 weeks had a positive effect on sleep quality. • Aerobic exercise had a positive effect on sleep quality,...
We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW). Searches were conducted in five databases from...
We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW).OBJECTIVEWe assessed the effects of programmed...
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SubjectTerms Exercise
Exercise Therapy
Female
Humans
Insomnia
Insomnia severity index
Internal Medicine
Middle Aged
Middle-aged women
Obstetrics and Gynecology
Pittsburgh sleep quality index
Randomized Controlled Trials as Topic
Sleep Initiation and Maintenance Disorders - therapy
Yoga
Title Effect of exercise on sleep quality and insomnia in middle-aged women: A systematic review and meta-analysis of randomized controlled trials
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https://dx.doi.org/10.1016/j.maturitas.2017.04.003
https://www.ncbi.nlm.nih.gov/pubmed/28539176
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