Effects of Exercise on Sleep: Difference between revisions

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== Introduction ==
== Introduction ==
[[Sleep: Theory, Function and Physiology|Sleep]] is defined as a reversible behavioral state of perceptual disconnection from and impassiveness to the surroundings<ref>Carskadon MA, Dement WC. [https://www.researchgate.net/publication/312968446_Normal_human_sleep_An_overview Normal human sleep: an overview. Principles and practice of sleep medicine.] 2005 Jan 1;4:13-23.</ref>. It is usually divided into two sleep states, namely rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep. While sleeping at night there is a sequential rotation occurs quite a lot of times (5 to 6 times) among these two sleep states<ref>Moser D, Anderer P, Gruber G, Parapatics S, Loretz E, Boeck M, Kloesch G, Heller E, Schmidt A, Danker-Hopfe H, Saletu B. [https://www.researchgate.net/publication/24036421_Sleep_Classification_According_to_AASM_and_Rechtschaffen_Kales_Effects_on_Sleep_Scoring_Parameters Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters.] Sleep. 2009 Feb 1;32(2):139-49.</ref>. According to American sleep association, there are many sleep disorders that humans suffer from; including dyssomnias such as Sleep Apnea, Hypersomnia and Insomnia; Bruxism; parasomnias such as REM Behavior Disorder and sleepwalking, and circadian rhythm sleep disorders. Furthermore, sleep disorders are so common among individuals and it could lead to chronic sleep deprivation which is completely dangerous. There are numerous pharmacological interventions available to treat these sleep disorders, however one of the best non-pharmacological intervention approved by American Sleep Disorders Association regarding improving your sleep is considered to be Exercise, Wide epidemiological studies indicate that the general population recognizes the therapeutic and sleep promoting advantages of moderate to regular physical activity<ref>Driver HS, Taylor SR. [https://www.researchgate.net/publication/10948102_Exercise_and_sleep Exercise and sleep. Sleep medicine reviews]. 2000 Aug 1;4(4):387-402.</ref>. Also, there are few researches that has been conducted on subjects to identify the effects of exercise upon sleep quality and quantity<ref>Horne JA. [https://www.sciencedirect.com/science/article/abs/pii/0301051181900016 The effects of exercise upon sleep: a critical review. Biological psychology.] 1981 Jun 1;12(4):241-90.</ref>. Since exercise induces physical exhaustion, moreover its physiological and psychological calming effects are well known, it can be obvious to assume that exercise promotes sleep<ref name=":0">Youngstedt SD. [https://www.tandfonline.com/doi/abs/10.3810/psm.1997.10.1473?journalCode=ipsm20 Does exercise truly enhance sleep?. The physician and sportsmedicine.] 1997 Oct 1;25(10):72-82.</ref>. 
[[File:Sleep.jpg|thumb|'''''Sleep'''''|201x201px]]
[[Sleep: Theory, Function and Physiology|Sleep]] is defined as a reversible state where your responsiveness to external environmental stimuli is reduced<ref>Carskadon MA, Dement WC. [https://www.researchgate.net/publication/312968446_Normal_human_sleep_An_overview Normal human sleep: an overview. Principles and practice of sleep medicine.] 2005 Jan 1;4:13-23.</ref>. We can divide sleep into two sleep states, namely rapid eye movement (REM) sleep, and non-rapid eye movement (NREM) sleep. While sleeping at night there is a sequential rotation occurs quite a lot of times (5 to 6 times) among these two sleep states<ref>Moser D, Anderer P, Gruber G, Parapatics S, Loretz E, Boeck M, Kloesch G, Heller E, Schmidt A, Danker-Hopfe H, Saletu B. [https://www.researchgate.net/publication/24036421_Sleep_Classification_According_to_AASM_and_Rechtschaffen_Kales_Effects_on_Sleep_Scoring_Parameters Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters.] Sleep. 2009 Feb 1;32(2):139-49.</ref>. According to the American Sleep Association, there are many sleep disorders that humans suffer from; including dyssomnias such as [[Sleep Apnea]], Hypersomnia, and Insomnia; [[Bruxism and Temporomandibular Disorders|Bruxism]]; parasomnias such as REM Behavior Disorder and sleepwalking, and circadian rhythm sleep disorders. Furthermore, sleep disorders are so common among individuals and it could lead to chronic sleep deprivation which is completely dangerous. There are numerous pharmacological interventions available to treat these sleep disorders, however, one of the best non-pharmacological interventions approved by the American Sleep Disorders Association regarding improving your sleep is considered to be Exercise. Wide epidemiological studies indicate the therapeutic advantages of moderate to regular physical activity regarding sleep<ref>Driver HS, Taylor SR. [https://www.researchgate.net/publication/10948102_Exercise_and_sleep Exercise and sleep. Sleep medicine reviews]. 2000 Aug 1;4(4):387-402.</ref>. Also, researchers can conduct various studies among the population to identify the effects of exercise on sleep quality and quantity<ref>Horne JA. [https://www.sciencedirect.com/science/article/abs/pii/0301051181900016 The effects of exercise upon sleep: a critical review. Biological psychology.] 1981 Jun 1;12(4):241-90.</ref>. Since shreds of evidence can find the physiological and psychological calming effects of exercise that are well known, which it could be obvious to assume that exercise can promote sleep<ref name=":0">Youngstedt SD. [https://www.tandfonline.com/doi/abs/10.3810/psm.1997.10.1473?journalCode=ipsm20 Does exercise truly enhance sleep?. The physician and sportsmedicine.] 1997 Oct 1;25(10):72-82.</ref>.


 {{#ev:youtube|LNjxw-00_rM}}<ref>PictureFit. Can Exercise Improve Your Sleep. Published 30 September 2016. Available from https://www.youtube.com/watch?v=LNjxw-00_rM</ref>
{{#ev:youtube|LNjxw-00_rM}}<ref>PictureFit. Can Exercise Improve Your Sleep. Published 30 September 2016. Available from https://www.youtube.com/watch?v=LNjxw-00_rM</ref>


== Does Exercise reduces Sleeplessness? ==
== Does Exercise Reduce Sleeplessness? ==
Exercise is a variety of physical fitness that mainly withstand physiological stress. Many would have told us that exercising regularly is good for your mind and body. However, preferences of choosing for exercises extremely vary among individuals. Some individuals might prefer doing exercises on regular basis, while others might prefer to avoid exercises fully. Here, our actual concern is to understand whether there is any kind of relation present between exercise and sleeplessness and whether exercise should be a part of prescription for people suffering from sleeplessness. In order to identify the effect of exercise among insomniacs, two researches have been performed which mainly showed improvement among individuals and encourage to sleep. Guilleminault et al<ref>Guilleminault C, Clerk A, Black J, Labanowski M, Pelayo R, Claman D. [https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/620415 Nondrug treatment trials in psychophysiologic insomnia.] Archives of Internal Medicine. 1995 Apr 24;155(8):838-44.</ref> have carried out a complete 4-week therapy session in his study, where he allocated 30 persons with an average age of 44yrs into 3 different groups in random and the target population was people suffering from psychophysiologic insomnia. Considering those 3 sets, he suggested to provide education to people regarding sleep hygiene in his primary set of intervention. Especially, he tried to focus on sleep-wake timetable of people by inspiring them to sustain a proper preset timetable and pay no attention to diurnal nap or not to sleep during the day.Further, he moved onto phototherapy and followed teaching regarding sleep hygiene to people during his secondary set of intervention. He instructed people to be seated opposite to bright light with 3,000 lux for approximately 45 minutes just after waking up from sleep.Regarding intervention to tertiary set of people, he instructed them to go for evening fast walk in the early hours. He also followed teaching populace about sleep hygiene in his session. Here, we have solid data, which proved that exercise is extremely helpful for people suffering from sleeplessness. We can see an improvement in sleep due to people exposing themselves to outside light during their exercise or other daytime period. Furthermore, considering people’s expectations about improvement in sleep linked with each intervention provided can also be one of the factors apart from outdoor exposure<ref name=":0" />.King et al<ref>King AC, Oman RF, Brassington GS, Bliwise DL, Haskell WL. [https://jamanetwork.com/journals/jama/article-abstract/412611 Moderate-intensity exercise and self-rated quality of sleep in older adults: a randomized controlled trial.] Jama. 1997 Jan 1;277(1):32-7.</ref> in his study included randomized sample of 43 people with mean age of 50-76 yrs with target population complaining about moderate sleep were assigned to 16 weeks exercise session. The session included 30-40 minutes of moderate aerobic exercise during daytime or in the early hours evening hours for 4 times/week. Pittsburgh Sleep Quality Index was an outcome measure used to assess the sleep quality of individuals following the complete exercise session that showed extreme improvement in sleep. By looking into all these above-proved evidences, we can say that exercise is helpful in improving the sleep quality of people suffering from sleeplessness and exercise should be a part of daily routine for every individual for healthy benefits<ref name=":0" />.
Exercise is a variety of physical fitness that mainly withstand physiological stress. Many would have told us that exercising regularly is good for your mind and body. However, preferences of choosing for exercises extremely vary among individuals. Some individuals might prefer doing exercises regularly, while others might prefer to avoid exercises fully. Here, our actual concern is to understand the relationship between exercise and sleeplessness and whether exercise should be a part of the prescription for people suffering from sleeplessness. To identify the effect of exercise among insomniacs, two types of research have been performed which mainly showed improvement among individuals and encouraged them to sleep.                              


== Acute Exercise and Sleep ==
Sleep plays a crucial role in promoting memory consolidation and learning as well as allowing the body to recover and restore itself. Unfortunately, many people face issues such as insomnia, [[Sleep Apnea-Hypopnea Syndrome|sleep apnea]], and restless legs syndrome that disrupt their sleep. However, physical activity can be a helpful strategy to enhance sleep quality and decrease the risk of sleep disorders, as it has a positive impact on sleep quality.<ref name=":2">Alnawwar MA, Alraddadi MI, Algethmi RA, Salem GA, Salem MA, Alharbi AA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503965/#:~:text=Regular%20physical%20activity%20can%20lead%20to%20improved,promise%20in%20managing%20sleep%20disorders%20like%20insomnia. The Effect of Physical Activity on Sleep Quality and Sleep Disorder: A Systematic Review.] Cureus. 2023 Aug 16;15(8):e43595.</ref>
A recent meta-analysis of 38 studies carried out by Youngstedt et al<ref>Youngstedt SD, O'connor PJ, Dishman RK. [https://www.researchgate.net/publication/14039740_The_Effects_of_Acute_Exercise_on_Sleep_A_Quantitative_Synthesis#:~:text=These%20authors%20reported%20that%20exercise,analysis%20by%20Youngstedt%20et%20al. The effects of acute exercise on sleep: a quantitative synthesis.] Sleep. 1997 Mar 1;20(3):203-14.</ref> examined the mean impact of acute exercise on sleep. Additionally, these studies pay attention exclusively on subjects who are good sleepers. Even the sleeping pills can have little effect on healthy sleepers. The small size of the results relating to exercise does not inherently undermine their meaning<ref name=":0" />.


In all studies, sleep was assessed by polysomnography and the analysis concluded that:
Regular physical activity can improve your sleep quality in several ways. Firstly, it boosts the production of melatonin, a [[Hormones|hormone]] that regulates the sleep-wake cycle of the body. This helps you fall asleep faster and enjoy better quality sleep. Secondly, physical activity helps reduce stress levels, which is a common barrier to falling and staying asleep. Thirdly, engaging in physical activity improves your mood, leading to increased enthusiasm for exercise and creating a positive feedback loop. Research shows that physically active individuals have higher levels of positive emotions and tranquility during exercise, and lower levels of negative emotions and tiredness. Finally, physical activity helps regulate body temperature, which is necessary for falling asleep. An increase in body temperature during exercise aids in the eventual drop 30-90 minutes post-exercises, facilitating easier sleepiness.<ref name=":2" />
* No effects on the amount of time it took to fall asleep;
* Statistically significant yet marginal improvement in overall sleep time (average 10 minutes) and slow-wave sleep time (average 4 minutes)
* Statistically significant but limited decrease in rapid eye movement ( REM) sleep (average 7 minutes), increases    in the time for REM sleep to occur following sleep onset (average, 13  minutes)<ref name=":0" />.
Although the research focused on healthy sleepers, the results reveal nothing about the impact of acute exercise on sleep disorder sufferers. Furthermore, there are lack of evidence to prove the effects of acute exercise in such individuals<ref name=":0" />.


== '''Factors Influencing Exercise and Sleep''' ==
According to studies, engaging in regular physical activity can enhance the quality and duration of sleep. Scientific literature suggests that adults who exercise for at least 30 minutes a day tend to sleep for an average of 15 minutes longer than those who do not exercise.<ref name=":2" />


There are numerous factors that can potentially contribute to effects of sleep on exercise. It includes individual’s level of fitness, thermoregulation, duration of exercise, time of exercise, and light exposure. Examining such factors could facilitate us to know the mechanism by which exercise influences sleep and the parameter that most influence sleep<ref name=":0" />.
By looking into the above-proved evidence, we can say that exercise can help improve the sleep quality of people suffering from sleeplessness and exercise should be a part of the daily routine for every individual for healthy benefits
* '''Fitness-'''  Some researchers have hypothesized that the extreme, comprehensive exercise believed to be important for sleep enhancement can only be done by fit subjects. Since unfit subjects are unable to reach the exercise level that might be required for better    sleep, the claim goes, exercise will profit them less than it would    benefit fit individuals. Experimental evidence, however, suggests that fitness does not affect the effects of acute sleep exercise, and these findings are consistent with surveys indicating that exercise in the general population encourages sleep<ref name=":0" />.


* '''Thermoregulation-''' The thermo-genic hypothesis, which posits that exercise enhances sleep by heating the body    or brain, has been a widespread theory for the effects of exercise on    sleep. This hypothesis is consistent with findings that passive body heating promotes slow-wave sleep via a hot tub or sauna.    Neurophysiologic evidence also indicates an association in the anterior hypothalamus between heat loss and sleep processes that are triggered when the temperature is elevated. Therefore, exercise may work as a thermo-genic stimulus to enhance sleep. Since body temperature rises as a result of exercise intensity during    exercise, the thermo-genic hypothesis indicates that the more intensive the exercise, the greater the increase in sleep. As individuals have a general    habit of exercising at lower intensities which would also suggest that exercise would not benefit for most individuals sleep<ref name=":0" />.
==== '''''Impact of Acute & Chronic Exercise on Sleep Disorders''''' ====
There are numerous non-pharmacological interventions available to treat sleeplessness, such as relaxation therapy, sleep hygiene techniques, and sleep restriction therapy. However, some researchers suggest that acute morning exercise can effectively improve sleep quality among individuals. The relationship between exercise and sleep has been extensively studied, with many people relying on exercise as an alternative or adjunct to traditional sleep-related therapies. Exercise has been shown to reduce the risk of cardiovascular diseases, promote overall fitness, reduce mortality rates, and improve mental health. By identifying the potential effects of exercise on sleep, individuals can make informed decisions about managing sleep-related disorders without relying on medication, which can have negative side effects.<ref name=":1">Youngstedt SD, O'connor PJ, Dishman RK. [https://www.researchgate.net/publication/14039740_The_Effects_of_Acute_Exercise_on_Sleep_A_Quantitative_Synthesis#:~:text=These%20authors%20reported%20that%20exercise,analysis%20by%20Youngstedt%20et%20al. The effects of acute exercise on sleep: a quantitative synthesis.] Sleep. 1997 Mar 1;20(3):203-14.</ref>.


* '''Duration of exercise-'''  Meta-analysis suggested that duration of exercise was considered to be one of the major factor modifying the influence of exercise on sleep.    As the exercise duration increased beyond 1 hour a day, there was a steady rise in overall sleep time. Additional research is needed to clarify whether very prolonged exercise will improve overall sleep<ref name=":0" />.
A study investigates the effect of acute exercise on good sleepers and they can use Polysomnography to assess sleep. The parameters that are focused for examination include sleep onset latency (SOL), stage 2 sleep, SWS, rapid eye movement (REM) sleep, REM latency (REM-L), total sleep time (TST), and wakefulness after sleep onset (WASO). We can observe little to moderate effects on SWS, REM, REM-L, and TST. Nevertheless, the research has focused completely on good sleepers; as even sleeping pills could bring a difference to good sleepers, we are unable to identify the variation in the magnitude of effects of exercise on sleep among people suffering from sleep disorders due to lack of evidence<ref name=":0" />.


* '''Time of exercise-'''  Performing intense exercise before bed time interrupts sleep is recognized to be a common belief among individuals. Recent evidence    questions the supposition that sleep is disrupted by late-night exercise. Sleep was not adversely affected in aerobically fit subjects by a 1 hour bout of exercise at 60% VO2 max or by 3 hours of exercise at 70% VO2 max done 30 minutes prior to bed time. On the other hand, a population study found that exercise improved or had no effect on sleep for most individuals within 2 hours of bedtime<ref name=":0" />.
In a pilot study, researchers investigated the impact of acute aerobic exercise on 17 young females. They were instructed to use the treadmill for 30 minutes, maintaining a heart rate reserve of 65%-88%. The study used worry, anxiety, feelings of energy, and fatigue as outcome measures. The results showed a moderate to large decrease in anxiety and fatigue levels, as well as an improvement in feelings of energy. This provides evidence supporting the positive effects of acute aerobic exercise on individuals with generalized anxiety disorder.<ref>Herring MP, Hallgren M, Campbell MJ. [https://www.sciencedirect.com/science/article/abs/pii/S1469029216301790 Acute exercise effects on worry, state anxiety, and feelings of energy and fatigue among young women with probable generalized anxiety disorder: a pilot study.] Psychology of Sport and Exercise. 2017 Nov 1;33:31-6.</ref>


* '''Light exposure-'''  Insufficient exposure to bright light has been related to disrupted sleep. Conversely, exposure to bright light can cause rapid and drastic changes    in sleep. Although the average adult receives just around 20 minutes of    daily exposure to bright light-more than 2,500 lux-it is fair to believe that at least three times as much is obtained by people who exercise regularly outdoors. In view of the recent study suggesting that exposure to bright  light could boost sleep more than exercise. It is important to examine this issue more carefully. The synergistic effects of exercise and bright  light on sleep may be fascinating<ref name=":0" />.
Similarly, looking for the evidence regarding chronic exercise on sleep, there is an absolute increase in parameters such as TST, and SWS and a decrease in sleep onset latency, REM sleep, and WASO. Chronic exercise provides extreme benefits to older people suffering from sleep disorders. Besides, controlled studies prove that individuals who are suffering from sleeplessness and anxiety can see improvement post-chronic exercise. However, these studies are limited to self-reported measures and further researches are required to find the benefits of chronic exercise on sleep<ref>Driver HS, Taylor SR. [https://www.sciencedirect.com/science/article/abs/pii/S1087079200901102 Exercise and sleep.] Sleep medicine reviews. 2000 Aug 1;4(4):387-402.</ref>.


== '''Anti-Depressant Effects''' ==
==  Theories behind Exercise Influencing Sleep  ==
Anxiety is considered as one of the primary cause of insomnia, especially transitory, situational insomnia. Because exercise has shown to reduce psychophysiological and subjective anxiety indices, and anxiolytic therapeutic therapies have been successful for insomnia, it is possible that exercise by reducing anxiety can promote sleep. Chronic exercise may also promote sleep by its antidepressant effects. Acute exercise delays REM onset and decreases REM sleep overall. Vogel et al have argued that these REM effects are the mechanism by which all antidepressant treatments work<ref name=":0" />.
 
There are numerous findings regarding the positive effects of exercise towards good sleepers however, there is less evidence to prove the efficacy of exercise on sleep sufferers. Furthermore, future research is required to identify the role of acute and chronic exercise on sleep. On the other hand, we could be able to see some misconceptions & predicted positive hypotheses towards the effects of exercise here, which will help us to gain knowledge regarding the exact working mechanism behind exercise promoting sleep among the population.       
 
==== '''''Thermoregulation''''' ====
When an individual performs exercise or intense physical training, their body experiences vasodilation resulting in increased blood flow to the skin, which in turn increases body temperature and promotes sleep. The Anterior hypothalamus plays a crucial role in regulating the body temperature and promoting sleep before bedtime. After exercise, when the body temperature rises, sweating increases, and metabolic rate decreases, resulting in a decrease in body temperature during sleep. According to the thermoregulatory hypothesis, exercise needs to be intense enough to raise the body temperature for it to have a positive effect on sleep. Low-intensity exercise doesn't provide any benefits to sleep. Besides active exercises, research also suggests that passive methods such as sauna baths or hot tubs can also promote SWS. Therefore, evidence suggests that there is a clear connection between temperature regulation and increased sleep.<ref name=":0" />.   
 
==== '''''Exercise before bedtime''''' ====
Time of exercise is the most important parameter here that could have an acute effect on sleep. There are common questions that usually arise among individuals regarding the perfect time for performing the exercise. Individuals believe that performing exercise before going to sleep can hurt their sleep. However, observing the findings from research has proved doing exercises 2 hours before going to sleep can improve the quality of sleep among individuals or have no effect on others. Another recent evidence shows that performing a 1-hour session of exercise at 60% VO2 max or a 3-hour session of exercise at 70% VO2 max by aerobically fit individuals 30 minutes before going to sleep did not affect the sleep quality<ref name=":0" />.
 
==== '''''Exercise Duration''''' ====
It is necessary to know the duration of exercise before commencing with any exercise protocol. When talking about the effect of exercise on sleep, it is required to know whether performing exercises for how long may perhaps bring a reliable effect among individuals. A meta-analytical study shows that exercise increases SWS, reduces REM sleep, and delays REM latency in already fit individuals. We can see the effects of an actual increase in sleep changes when individuals perform exercise longer than 1 hour a day. However, further research is required to know, if performing exercise for longer periods will bring an improvement in sleep quality in individuals<ref name=":0" />.
 
==== '''''Exercise and Fitness''''' ====
We can say that physical fitness is achieved when we consume appropriate nutrition, perform moderate to vigorous exercises, and have adequate rest. If an individual is not able to fulfill these criteria, he/she is falling sick, has a low energy level, suffering from disease and hopelessness we consider them unfit. There are a few researches suggest that a vigorous level of exercise can help in improving sleep quality. However, there is a misconception that fit individuals can only perform vigorous intensity exercises, rather unfit individuals and they can be able to benefit from such exercise for sleep. An experimental study proved this statement wrong, and suggests, that there is no role of fitness with regards to exercise & sleep and such findings indicate that exercise encourages sleep in a wide range of the population<ref name=":0" />.
 
==== '''''Exposure to Outdoor light''''' ====
Appropriately, timely exposure to bright light can enhance sleep quality among the population. Individuals going out and receiving bright light for more than 2,500 lux for almost 20 minutes, 3 times a day could help in increasing the sleep as much as possible more than exercise<ref name=":0" />.
 
==== '''''Anti-Depressant effects''''' ====
Sleep disturbance is one of the most common characteristic features among individuals suffering from anxiety. According to evidence, the findings can prove that anxiolytic therapeutic therapies are effective in treating patients suffering from sleeplessness.  Moreover, speaking about exercise, researchers are also able to show that exercises are effective in reducing anxiety by providing psychophysiological treatment effects. It promotes better control between the mind and body and helps in improving the conditions and symptoms of patients suffering from anxiety. Possibly, exercise could promote better sleep by reducing anxiety symptoms. Apart from that, evidence also suggests that individuals suffering from sleeplessness are more prone to developing depression. Thus, findings support that chronic exercise can encourage sleep by promoting anti-depressant effects and reducing depression. There is an observable reduction in REM sleep due to acute exercise and such reductions can be found in anti-depressant treatments<ref name=":0" />.


== '''Conclusion''' ==
== '''Conclusion''' ==
Clearly there is a need for more studies to investigate the impact of exercise on sleep and to assess if they can be linked to exercise or related factors. Until such study findings are available a formal exercise prescription for sleep disorders is not warranted. However, physicians and scientists may also recommend exercising as a way to boost sleep. Based on epidemiological data and recent insomnia experimental research, the recommendations seem rational, particularly if exercise is part of an overall treatment regimen and indicates with the patient's understanding that it could yield little or no sleep improvement. Although exercise does not improve sleep, exercise can reduce overall mortality and morbidity<ref name=":0" />.
Regular exercise is beneficial for those with sleep disorders as it reduces worry, anxiety, and depressive symptoms, leading to improved sleep quality. Moderate-intensity physical activities are effective in managing sleep disorders like insomnia, while high-intensity activities, especially in the evening, may lead to difficulty sleeping. Factors affecting the effectiveness of physical activities include gender, age, activity type, timing, duration, and consistency. Promoting regular physical activity can improve sleep health and overall well-being.<ref name=":2" />
 
== Resource  ==
[https://www.youtube.com/watch?v=BHY0FxzoKZE The brain-changing benefits of exercise]<ref>TED. Wendy Suzuki. The brain-changing benefits of exercise. Published 21 March 2018. Available from https://www.youtube.com/watch?v=BHY0FxzoKZE</ref>


== References  ==
== References  ==
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[[Category:Interventions]]
[[Category:Interventions]]
[[Category:Sleep]]
[[Category:Sleep]]
[[Category:Insomnia]]
[[Category:Mental Health]]
[[Category:Mental health]]
[[Category:Mental Health - Interventions]]

Latest revision as of 23:05, 31 March 2024

Original Editor - Sai Kripa

Top Contributors - Sai Kripa, Pacifique Dusabeyezu, Kim Jackson and Sehriban Ozmen  

Introduction[edit | edit source]

Sleep

Sleep is defined as a reversible state where your responsiveness to external environmental stimuli is reduced[1]. We can divide sleep into two sleep states, namely rapid eye movement (REM) sleep, and non-rapid eye movement (NREM) sleep. While sleeping at night there is a sequential rotation occurs quite a lot of times (5 to 6 times) among these two sleep states[2]. According to the American Sleep Association, there are many sleep disorders that humans suffer from; including dyssomnias such as Sleep Apnea, Hypersomnia, and Insomnia; Bruxism; parasomnias such as REM Behavior Disorder and sleepwalking, and circadian rhythm sleep disorders. Furthermore, sleep disorders are so common among individuals and it could lead to chronic sleep deprivation which is completely dangerous. There are numerous pharmacological interventions available to treat these sleep disorders, however, one of the best non-pharmacological interventions approved by the American Sleep Disorders Association regarding improving your sleep is considered to be Exercise. Wide epidemiological studies indicate the therapeutic advantages of moderate to regular physical activity regarding sleep[3]. Also, researchers can conduct various studies among the population to identify the effects of exercise on sleep quality and quantity[4]. Since shreds of evidence can find the physiological and psychological calming effects of exercise that are well known, which it could be obvious to assume that exercise can promote sleep[5].

[6]

Does Exercise Reduce Sleeplessness?[edit | edit source]

Exercise is a variety of physical fitness that mainly withstand physiological stress. Many would have told us that exercising regularly is good for your mind and body. However, preferences of choosing for exercises extremely vary among individuals. Some individuals might prefer doing exercises regularly, while others might prefer to avoid exercises fully. Here, our actual concern is to understand the relationship between exercise and sleeplessness and whether exercise should be a part of the prescription for people suffering from sleeplessness. To identify the effect of exercise among insomniacs, two types of research have been performed which mainly showed improvement among individuals and encouraged them to sleep.

Sleep plays a crucial role in promoting memory consolidation and learning as well as allowing the body to recover and restore itself. Unfortunately, many people face issues such as insomnia, sleep apnea, and restless legs syndrome that disrupt their sleep. However, physical activity can be a helpful strategy to enhance sleep quality and decrease the risk of sleep disorders, as it has a positive impact on sleep quality.[7]

Regular physical activity can improve your sleep quality in several ways. Firstly, it boosts the production of melatonin, a hormone that regulates the sleep-wake cycle of the body. This helps you fall asleep faster and enjoy better quality sleep. Secondly, physical activity helps reduce stress levels, which is a common barrier to falling and staying asleep. Thirdly, engaging in physical activity improves your mood, leading to increased enthusiasm for exercise and creating a positive feedback loop. Research shows that physically active individuals have higher levels of positive emotions and tranquility during exercise, and lower levels of negative emotions and tiredness. Finally, physical activity helps regulate body temperature, which is necessary for falling asleep. An increase in body temperature during exercise aids in the eventual drop 30-90 minutes post-exercises, facilitating easier sleepiness.[7]

According to studies, engaging in regular physical activity can enhance the quality and duration of sleep. Scientific literature suggests that adults who exercise for at least 30 minutes a day tend to sleep for an average of 15 minutes longer than those who do not exercise.[7]

By looking into the above-proved evidence, we can say that exercise can help improve the sleep quality of people suffering from sleeplessness and exercise should be a part of the daily routine for every individual for healthy benefits

Impact of Acute & Chronic Exercise on Sleep Disorders[edit | edit source]

There are numerous non-pharmacological interventions available to treat sleeplessness, such as relaxation therapy, sleep hygiene techniques, and sleep restriction therapy. However, some researchers suggest that acute morning exercise can effectively improve sleep quality among individuals. The relationship between exercise and sleep has been extensively studied, with many people relying on exercise as an alternative or adjunct to traditional sleep-related therapies. Exercise has been shown to reduce the risk of cardiovascular diseases, promote overall fitness, reduce mortality rates, and improve mental health. By identifying the potential effects of exercise on sleep, individuals can make informed decisions about managing sleep-related disorders without relying on medication, which can have negative side effects.[8].

A study investigates the effect of acute exercise on good sleepers and they can use Polysomnography to assess sleep. The parameters that are focused for examination include sleep onset latency (SOL), stage 2 sleep, SWS, rapid eye movement (REM) sleep, REM latency (REM-L), total sleep time (TST), and wakefulness after sleep onset (WASO). We can observe little to moderate effects on SWS, REM, REM-L, and TST. Nevertheless, the research has focused completely on good sleepers; as even sleeping pills could bring a difference to good sleepers, we are unable to identify the variation in the magnitude of effects of exercise on sleep among people suffering from sleep disorders due to lack of evidence[5].

In a pilot study, researchers investigated the impact of acute aerobic exercise on 17 young females. They were instructed to use the treadmill for 30 minutes, maintaining a heart rate reserve of 65%-88%. The study used worry, anxiety, feelings of energy, and fatigue as outcome measures. The results showed a moderate to large decrease in anxiety and fatigue levels, as well as an improvement in feelings of energy. This provides evidence supporting the positive effects of acute aerobic exercise on individuals with generalized anxiety disorder.[9]

Similarly, looking for the evidence regarding chronic exercise on sleep, there is an absolute increase in parameters such as TST, and SWS and a decrease in sleep onset latency, REM sleep, and WASO. Chronic exercise provides extreme benefits to older people suffering from sleep disorders. Besides, controlled studies prove that individuals who are suffering from sleeplessness and anxiety can see improvement post-chronic exercise. However, these studies are limited to self-reported measures and further researches are required to find the benefits of chronic exercise on sleep[10].

Theories behind Exercise Influencing Sleep[edit | edit source]

There are numerous findings regarding the positive effects of exercise towards good sleepers however, there is less evidence to prove the efficacy of exercise on sleep sufferers. Furthermore, future research is required to identify the role of acute and chronic exercise on sleep. On the other hand, we could be able to see some misconceptions & predicted positive hypotheses towards the effects of exercise here, which will help us to gain knowledge regarding the exact working mechanism behind exercise promoting sleep among the population.

Thermoregulation[edit | edit source]

When an individual performs exercise or intense physical training, their body experiences vasodilation resulting in increased blood flow to the skin, which in turn increases body temperature and promotes sleep. The Anterior hypothalamus plays a crucial role in regulating the body temperature and promoting sleep before bedtime. After exercise, when the body temperature rises, sweating increases, and metabolic rate decreases, resulting in a decrease in body temperature during sleep. According to the thermoregulatory hypothesis, exercise needs to be intense enough to raise the body temperature for it to have a positive effect on sleep. Low-intensity exercise doesn't provide any benefits to sleep. Besides active exercises, research also suggests that passive methods such as sauna baths or hot tubs can also promote SWS. Therefore, evidence suggests that there is a clear connection between temperature regulation and increased sleep.[5].

Exercise before bedtime[edit | edit source]

Time of exercise is the most important parameter here that could have an acute effect on sleep. There are common questions that usually arise among individuals regarding the perfect time for performing the exercise. Individuals believe that performing exercise before going to sleep can hurt their sleep. However, observing the findings from research has proved doing exercises 2 hours before going to sleep can improve the quality of sleep among individuals or have no effect on others. Another recent evidence shows that performing a 1-hour session of exercise at 60% VO2 max or a 3-hour session of exercise at 70% VO2 max by aerobically fit individuals 30 minutes before going to sleep did not affect the sleep quality[5].

Exercise Duration[edit | edit source]

It is necessary to know the duration of exercise before commencing with any exercise protocol. When talking about the effect of exercise on sleep, it is required to know whether performing exercises for how long may perhaps bring a reliable effect among individuals. A meta-analytical study shows that exercise increases SWS, reduces REM sleep, and delays REM latency in already fit individuals. We can see the effects of an actual increase in sleep changes when individuals perform exercise longer than 1 hour a day. However, further research is required to know, if performing exercise for longer periods will bring an improvement in sleep quality in individuals[5].

Exercise and Fitness[edit | edit source]

We can say that physical fitness is achieved when we consume appropriate nutrition, perform moderate to vigorous exercises, and have adequate rest. If an individual is not able to fulfill these criteria, he/she is falling sick, has a low energy level, suffering from disease and hopelessness we consider them unfit. There are a few researches suggest that a vigorous level of exercise can help in improving sleep quality. However, there is a misconception that fit individuals can only perform vigorous intensity exercises, rather unfit individuals and they can be able to benefit from such exercise for sleep. An experimental study proved this statement wrong, and suggests, that there is no role of fitness with regards to exercise & sleep and such findings indicate that exercise encourages sleep in a wide range of the population[5].

Exposure to Outdoor light[edit | edit source]

Appropriately, timely exposure to bright light can enhance sleep quality among the population. Individuals going out and receiving bright light for more than 2,500 lux for almost 20 minutes, 3 times a day could help in increasing the sleep as much as possible more than exercise[5].

Anti-Depressant effects[edit | edit source]

Sleep disturbance is one of the most common characteristic features among individuals suffering from anxiety. According to evidence, the findings can prove that anxiolytic therapeutic therapies are effective in treating patients suffering from sleeplessness.  Moreover, speaking about exercise, researchers are also able to show that exercises are effective in reducing anxiety by providing psychophysiological treatment effects. It promotes better control between the mind and body and helps in improving the conditions and symptoms of patients suffering from anxiety. Possibly, exercise could promote better sleep by reducing anxiety symptoms. Apart from that, evidence also suggests that individuals suffering from sleeplessness are more prone to developing depression. Thus, findings support that chronic exercise can encourage sleep by promoting anti-depressant effects and reducing depression. There is an observable reduction in REM sleep due to acute exercise and such reductions can be found in anti-depressant treatments[5].

Conclusion[edit | edit source]

Regular exercise is beneficial for those with sleep disorders as it reduces worry, anxiety, and depressive symptoms, leading to improved sleep quality. Moderate-intensity physical activities are effective in managing sleep disorders like insomnia, while high-intensity activities, especially in the evening, may lead to difficulty sleeping. Factors affecting the effectiveness of physical activities include gender, age, activity type, timing, duration, and consistency. Promoting regular physical activity can improve sleep health and overall well-being.[7]

References[edit | edit source]

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  2. Moser D, Anderer P, Gruber G, Parapatics S, Loretz E, Boeck M, Kloesch G, Heller E, Schmidt A, Danker-Hopfe H, Saletu B. Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters. Sleep. 2009 Feb 1;32(2):139-49.
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  4. Horne JA. The effects of exercise upon sleep: a critical review. Biological psychology. 1981 Jun 1;12(4):241-90.
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  6. PictureFit. Can Exercise Improve Your Sleep. Published 30 September 2016. Available from https://www.youtube.com/watch?v=LNjxw-00_rM
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  9. Herring MP, Hallgren M, Campbell MJ. Acute exercise effects on worry, state anxiety, and feelings of energy and fatigue among young women with probable generalized anxiety disorder: a pilot study. Psychology of Sport and Exercise. 2017 Nov 1;33:31-6.
  10. Driver HS, Taylor SR. Exercise and sleep. Sleep medicine reviews. 2000 Aug 1;4(4):387-402.