Resistance training, or muscle-strengthening exercise, is the most effective type of exercise for improving sleep quality, experts conclude.
The study found that using weights or the body itself may be the best type of exercise for tackling insomnia in older age, compared to aerobic or combined exercises.
The findings come from a pooled data analysis of available research by researchers in Thailand, and are published in Family Medicine and Community Health.
One in five adults report suffering from insomnia, and sleep quality is known to decline with age. Disturbed sleep is linked to poor health and contributes to cognitive decline, mental health issues such as depression and anxiety and poorer physical health, with research linking sleeplessness with metabolic syndrome, hypertension and heart disease. Previous studies have suggested exercise is a cheap and easy method to improve sleep in older people, but it is unclear which exercise is the most helpful.
Researchers conducted a meta-analysis of clinical trials examining physical activity levels in individuals formally diagnosed with insomnia. The study comprised 2045 adults from 24 trials and drew data from major databases, including Medline, Embase, CINAHL, Scopus, ClinicalTrials.gov, and ThaiJO, collected from the database inception to October 2022. Sleep quality was assessed using The Global Pittsburgh Sleep Quality Index (GPSQI) alongside the frequency and type of exercise participants engaged in.
Exercise subcategories included aerobic (such as cycling, dancing, swimming, brisk walking, and gardening), resistance (such as using weights, push-ups, and planks), balance (such as step-ups, heel-to-toe walking), flexibility (such as gymnastics, yoga, and Pilates) and combination of these exercises. All of the adults were 60 years of age and older. Over half of the studies were carried out in Asia (54 per cent), with the rest in North America (16%), South America (16%), and Europe (12%).
More than half of the reported exercise sessions were of mild to moderate intensity and lasted, on average, just over 50 minutes. Exercise programmes typically spanned 14 weeks, with participants exercising two to three times per week.
Resistance training was the most effective type of exercise for improving sleep quality, increasing the GPSQI score by 5.75 points and indicating significant improvements in sleep. The analysis also revealed improvements for participants who undertook combined exercise routines, incorporating aerobic, resistance, balance, and flexibility exercises. Participants who followed a combined exercise programme saw a 2.35-point increase in their GPSQI score, while aerobic exercise led to a 4.35-point improvement, highlighting significantly better sleep.
The researchers advise caution when interpreting the results due to the small number of studies and the variability of exercises. However, the results highlight the significant benefits of exercise in improving sleep quality among older adults compared to routine activities.
While some forms of exercise may be challenging for older people due to restricted physical capabilities, the researchers hope these insights will help the multidisciplinary team determine which type of exercise is the most effective intervention, translating into significant sleep improvements and real-life, meaningful gains in health. They conclude: ‘Exercise, particularly strengthening exercise and aerobic exercise, is beneficial for enhancing subjective sleep quality at a clinically significant level compared with normal activities.’
