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Exercise as it relates to Disease/Exercise to improve sleep quality in insomnia

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Insomnia is a sleeping disorder characterised by:

  • Difficulty initiating sleep1
  • Difficulty maintaining sleep1
  • Decreased quality and quantity of sleep2

Insomnia is more prevalent in adulthood and worsens with age, especially in those over 65. If left untreated, it can lead to more severe medical conditions3. It can also affect quality of life and have a negative impact on non-sleeping parts of the day by decreasing mood, causing fatigue, decreasing concentration and cognitive ability during the day.4

Treatment

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There are several different types of treatments available for insomnia:

  • CBT (Cognitive Behavior Therapy): Which includes Sleep Hygiene5, Stimulus control6 and Relaxation Technique7
  • Medications: Which includes Hypnotic Medications, Antidepressants8, Opioids9 and Antihistamines
  • Other treatments: Natural substances such as magnesium, melatonin, valerian and medical marijuana have shown to have effective responses to helping insomnia10 11

Aerobic and Resistance Exercise

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Research has shown that both aerobic and resistance exercises help reduce the effects of insomnia by:

  • Decreasing time onset to sleep and number of sleep disturbances1 12
  • Increasing sleep quality and total sleep time1 13

These changes in sleeping patterns importantly lead to: decreases in daytime dysfunction and pre-sleep anxiety 1 12, increases in mood and quality of life15

Recommendations and Considerations

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The following recommendations refer to the ideal training for maximum efficiency at reducing the effects of insomnia.
Aerobic Exercise:

  • 3–4 days per week for 30–40 minutes at a moderate intensity1 3
  • Exercises can include walking, cycling and low impact aerobics1 3 12

Resistance Exercise:

  • 2–3 days per week completing 2-3 sets, 10 repetitions 6-8 exercises 1 12
  • Exercises that utilize bother lower and upper muscle groups, including bench press, leg press, leg extension and shoulder press1 14
  • Exercises completed at 50% 1RM (moderate intensity)1 14

Considerations:

  • Age: As insomnia is more common in persons aged 65+ it is important to ensure their training program is appropriate.Persons over the age of 65 should consult a doctor or healthcare professional prior to commencing a training program
  • Exercise-Induced Insomnia and Time of Day: High intensity exercise can cause exercise-induced insomnia1. Exercising before bed time can also lead to exercise-induced insomnia. High intensity exercise and exercise in the afternoon should be avoided to decreased the symptoms of insomnia12

Further reading

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Sleep Foundation http://www.sleepfoundation.org/article/sleep-related-problems/insomnia-and-sleep

Snore Australia Insomnia Information Snore Australia Insomnia Information

References

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  1. Passos, GS., Poyares, D., Santana, MG., Garbuio, SA., Tufik, S, Mello MT. (2010). Effect of acute physical exercise on patients with chronic primary insomnia. Journal Clinical Sleep Medicine. 6(3): 270-275.
  2. Holbrook, AM., Crowther, R., Lotter, A., Cheng, C., King, D. (2000). The diagnosis and management of insomnia in clinical practice: a practical evidence-based approach. Canadian Medical Association Journal. 162(2): 216-220
  3. Montgomery, P., Dennis, J. (2002). Physical exercise for sleep problems in adults aged 60+. Cochran Database of Systematic Reviews. 1(4): CD003404.
  4. Roth, Thomas. (2007). Insomnia: Definition Prevalence, Etiology, and Consequences J Clin Sleep Med, August 15(3), S7–S10.
  5. Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006). Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). SLEEP-NEW YORK THEN WESTCHESTER-, 29(11), 1398.
  6. Running on Empty: Fatigue and Healthcare Professionals. Medscape. Aug 02, 2012.
  7. Lehrer, Paul M.; David H. (FRW) Barlow, Robert L. Woolfolk, Wesley E. Sime (2007). Principles and Practice of Stress Management, Third Edition. p. 38. ISBN 1-59385-000-X.
  8. Bertschy G, Ragama-Pardos E, Muscionico M et al. (2005). "Trazodone addition for insomnia in venlafaxine-treated, depressed inpatients: a semi-naturalistic study". Pharmacol. Res. 51 (1): 79–84
  9. Ramakrishnan, K.; Scheid, DC. (2007). "Treatment options for insomnia". Am Fam Physician 76 (4): 517–26. PMID 17853625.
  10. Zammit G; Erman M; Wang-Weigand S; Sainati S; Zhang J; Roth T. Evaluation of the efficacy and safety of ramelteon in subjects with chronic insomnia. J Clin Sleep Med 2007;3(5):495-504
  11. Meolie AL, Rosen C, Kristo D et al. (2005). "Oral nonprescription treatment for insomnia: an evaluation of products with limited evidence". Journal of Clinical Sleep Medicine 1 (2): 173–87
  12. Roveda, E., Sciolla, C., Montaruli, A., Calogiuri, G., Angeli, A., Carandente, F. (2011). Effects of endurance and strength acute exercise on night sleep quality. International SportMed Journal. 12(3): 113-124.
  13. Singh, NA., Clements, KM., Fiatarone, MA. (1997). A randomized controlled trial of the effect of exercise on sleep. Sleep. 20(2): 95-101.
  14. Ferris, LT., Williams, JS., Shen, C., O’Keefe, KA., Hale, KB. (2005). Resistance Training Improves Sleep Quality in Older Adults – A Pilot Study. Journal of Sports Science and Medicine. 4: 354-360.
  15. Reid, KJ., Baron, KG., Lu, B., Naylor, E., Wolfe, L., Zee, PC. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine. 11(9): 934-940.
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