Forget counting sheep or a mug of warm milk. It appears that a few push ups might be a better approach to keeping insomnia at bay. A new systematic review has shown that regular physical exercise can make a huge difference in the sleep quality of older adults while offering a welcome drug-free insomnia treatment.
This research, appearing in Family Medicine and Community Health, analyzed more than two dozen randomized controlled trials (RCTs). The data revealed that aerobic and combination exercises proved to be exceedingly effective in boosting sleep quality.
“Exercise, particularly strengthening exercise and aerobic exercise, is beneficial for enhancing subjective sleep quality at a clinically significant level compared with normal activities,” the Mahidol University researchers wrote in their paper.
Sleep Suffers As We Age
As we get older, the quality of our sleep is usually one of the first things to suffer. Up to 48 percent of seniors admit to suffering excessive sleepiness while 20 percent of them saying it’s so bad that they’d go so far as to call it insomnia.
Primary care providers see an estimated 5.5 million patients for insomnia every year. Multiple studies have exposed links between a lack of sleep and disorders such as anxiety, depression, heart disease, hypertension, and overall cognitive decline. The growing economic burden on both healthcare and workplace productivity illustrates why the need persists for better care management.
Most medical experts prefer non-drug treatment options for older adults because of the risks inherent in prescribing sedatives. Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the standard treatment protocol. But, even so, many fail to implement it because of a persistent lack of resources and a shortage of trained specialists.
Consequently, many clinicians are embracing exercise as a practical alternative that not only helps with insomnia, but also offers additional health benefits such as improved muscle strength, reduced anxiety, and better cardiovascular health.
Evaluating Exercise as a Solution to Insomnia
The systematic review analyzed studies conducted between 1996 and 2021 and spanned multiple continents, including Asia, North America, South America, and Europe. The more than 2,100 participants, whose average age hovered around 70, engaged in various forms of exercise, including aerobic activities like jogging and swimming, strength training, balance exercises, flexibility routines, and combination workouts integrating multiple exercise types.
The researchers concluded that combination exercise regimens showed the most dramatic boost to Global Pittsburgh Sleep Quality Index (PSQI) scores, especially when the participants performed them at lower intensity levels.
Notably, aerobic exercise alone also showed strong benefits, especially when the participants exercise more than an hour per session – and at least 100 minutes weekly for 10 weeks or more.
Among the different exercise types that the researchers studied, strengthening workouts proved to be the most effective in boosting overall sleep quality. The authors cited the higher intensity levels found in strengthening routines, as opposed to other workouts. While combination exercises also produced significant improvements, strengthening exercises consistently outperformed others in slashing PSQI scores.
Insights and Recommendations
The review emphasized that low to moderate-intensity exercises yielded the best outcomes. Participants engaged in such exercises for an average of 150 minutes per week over a span of 14 weeks. They reported noteworthy advances in sleep patterns.
It’s worth noting that the review discovered that participants who followed their exercise plans faithfully, with compliance rates exceeding 70 percent, enjoyed the most benefits.
That being said, the researchers warned that variation in the data, as well as an elevated risk of bias in come studies could sway some of the numbers. The inclusion of non-standardized treatments, such as tai chi and pilates, for example, in combination exercise groups also added to inconsistent data.
Based on this comprehensive review, the authors argue that:
- Seniors who want to sleep better (and longer) should adopt a combination of aerobic and strength-building exercises – with an emphasis on moderate intensity and consistency.
- Healthcare providers should prescribe exercise regimens tailored to individual fitness levels and preferences to encourage better adherence and long-term success.
As insomnia continues to plague aging populations, physical exercise presents a valuable, accessible, and cost-effective solution to improve sleep quality and overall well-being.
Further Reading
A 2023 Update on Managing Insomnia in Primary Care
