Does exercise improve sleep for adults with insomnia? A systematic review with quality appraisal. (March 2019)

• Record Type: Journal Article
• Authors: Lowe, Hayley; Haddock, Gillian; Mulligan, Lee D.; Gregg, Lynsey; Fuzellier-Hart, Annabel; Carter, Lesley-Anne; Kyle, Simon D.
• Is Part Of: Clinical psychology review. Volume 68(2019)
• Page Start: 1
• Page End: 12
• Publication Date: 2019-03
• Subjects: Exercise -- Physical activity -- Insomnia -- Sleep -- Systematic review; AIS Athens Insomnia Scale -- BNSQ Basic Nordic Sleep Questionnaire -- CBT Cognitive behavioural therapy -- CTAM Clinical Trials Assessment Measure -- HAE high-intensity aerobic exercise -- ISI Insomnia Severity Index -- ITT intention to treat analysis -- MAE moderate-intensity aerobic exercise -- MRE moderate-intensity resistance exercise -- NRS non-randomised controlled study -- OA older adult -- PSD Pittsburgh Sleep Diary -- PSQI Pittsburgh Sleep Quality Index -- PSG polysomnography -- QOL quality of life -- RCT randomised controlled trial -- SE sleep efficiency -- SMD standardised mean difference -- SOL sleep onset latency -- SQ sleep quality -- SQAW Sleep Questionnaire and Assessment of Wakefulness -- TST total sleep time -- UK United Kingdom -- US United States -- WASO wake-time after sleep onset -- WHO World Health Organisation; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2018.11.002
• Languages: English
• ISSNs: 0272-7358

Abstract

Abstract: Insomnia is recognised as the most prevalent sleep disorder. Untreated insomnia carries a heavy burden for patients and society. Exercise is proposed as a safe, inexpensive, and accessible non-pharmacological treatment. To the author's knowledge this is the first systematic review to investigate the sleep-enhancing effects of exercise by focusing exclusively on controlled trials comprising poor sleepers only and examining interventions consistent with national guidelines. Using a narrative synthesis, this review aimed to identify whether exercise improves objective and subjective sleep outcomes for people with insomnia. Five papers including participants with insomnia disorder, and six papers including participants with insomnia symptoms were identified through electronic database searches (CINAHL plus, PsycINFO, EMBASE, MEDLINE, SPORTDiscus, CENTRAL) and quality assessed using the Clinical Trial Assessment Measure. We found that exercise interventions led to improvements in subjective sleep quality for people with insomnia disorder and insomnia symptoms. However, exercise only improved objective and subjective measures of sleep continuity (sleep onset latency and sleep efficiency) for people presenting with insomnia symptoms, with a reduction in sleep onset latency being the most consistently observed effect across studies. The reliability of significant findings is reduced by methodological limitations. Recommendations are made to improve the quality of future research. Highlights: Findings indicate that exercise may improve sleep for people with insomnia. Differential effects were observed for insomnia disorder and insomnia symptoms. Differential effects were observed for objective and subjective sleep outcomes.