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CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0044-1787757
Original Article

Physical Activity Level and Sleep Quality in Community-Dwelling Older Adults. A Cross-Sectional Study

Ygor Matos Luciano 
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
,
Rafael Zambelli Pinto
2   Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
,
Cynthia Gobbi
3   Department of Physiotherapy, Centro Universitário de Ensino Superior (UNICESUMAR), Maringá, Brazil
,
Guilherme Luiz Fernandes
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
,
Vinicius Dokkedal-Silva
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
,
Ítalo R. Lemos
2   Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
,
Gabriel Natan Pires
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
,
Monica Levy Andersen
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
,
Sergio Tufik
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
,
Priscila Kalil Morelhão
1   Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
› Author Affiliations Funding Our studies are supported by grants from the Associacão Fundo de Incentivo à Pesquisa (AFIP). GLF are supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES) – Finance Code 001. GLF is supported by the National Council for Scientific and Technological Development (CNPq - 141445/2021-1) RZP, MLA and ST are National Council for Scientific and Technological Development (CNPq) fellowship recipients.
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Abstract

The worldwide increase in life expectancy has resulted in a significant aging of the population. The physiological and functional changes that result from the aging process, changes in sleep patterns, and the prevalence of chronic diseases affect the health and well-being of individuals aged over 60.

Objective The aim of this study was to investigate the relationship between levels of physical activity (PA) and sleep quality in community-dwelling older adults.

Methods This is a cross-sectional study, with the participants randomly recruited according to the region and street in which they live. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep quality, the Modified Baecke Questionnaire for the Elderly (MBQ-E) to assess PA levels, as well as questionnaires to obtain social, demographic and anthropometric data. Multivariable regression analyses were conducted with PA activity as the independent variable and sleep quality as the dependent variable of interest, while also considering all potential covariates.

Results A total of 503 older adults were analyzed, of whom 377 (75%) were classified as inactive and only 126 (25%) as active. Among the participants, 344 (68.4%) had poor sleep quality, 86 (17.1%) had symptoms of insomnia, and 57 (11.5%) reported complaints of excessive daytime sleepiness. We found that 128 participants (25.4%) consumed alcohol and 41 (8.2%) were current smokers. Multivariate regression results showed an inverse association between PA levels and sleep (Beta coefficient = −0.67 ([95% confidence interval = −1.29 to −0.04]).

Conclusions The results of the study indicate that being physically inactive is associated with poor sleep quality.

Keywords

sleep - physical activity - older adults

Data Availability Statement

The raw data was stored at REDCap. Derived data supporting the findings of this study are available from the corresponding author PKM upon request.




Publication History

Received: 16 November 2023

Accepted: 28 May 2024

Article published online:
25 June 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Sciubba JD. Population Aging as a Global Issue. Oxford University Press; 2020
    CrossrefGoogle Scholar
  • 2 Barnes JN. Exercise, cognitive function, and aging. Adv Physiol Educ 2015; 39 (02) 55-62
    CrossrefPubMedGoogle Scholar
  • 3 Morin CM, Stone J, Trinkle D, Mercer J, Remsberg S. Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychol Aging 1993; 8 (03) 463-467
    CrossrefPubMedGoogle Scholar
  • 4 Phillips B, Ancoli-Israel S. Sleep disorders in the elderly. Sleep Med 2001; 2 (02) 99-114
    CrossrefPubMedGoogle Scholar
  • 5 Scullin MK, Bliwise DL. Sleep, cognition, and normal aging: integrating a half century of multidisciplinary research. Perspect Psychol Sci 2015; 10 (01) 97-137
    CrossrefPubMedGoogle Scholar
  • 6 Oliveira SD, Pinto RZ, Gobbi C. et al. Sleep Quality Predicts Functional Disability in Older Adults with Low Back Pain: A Longitudinal Study. J Appl Gerontol 2022; 41 (11) 2374-2381
    CrossrefPubMedGoogle Scholar
  • 7 Lichstein KL, Means MK, Noe SL, Aguillard RN. Fatigue and sleep disorders. Behav Res Ther 1997; 35 (08) 733-740
    CrossrefPubMedGoogle Scholar
  • 8 Vaz Fragoso CA, Gill TM. Sleep complaints in community-living older persons: a multifactorial geriatric syndrome. J Am Geriatr Soc 2007; 55 (11) 1853-1866
    PubMedGoogle Scholar
  • 9 Morelhão PK, Gobbi C, Christofaro DGD. et al. Bidirectional Association Between Sleep Quality and Low Back Pain in Older Adults: A Longitudinal Observational Study. Arch Phys Med Rehabil 2022; 103 (08) 1558-1564
    CrossrefPubMedGoogle Scholar
  • 10 Morelhão PK, Fernandes GL, Dokkedal-Silva V, Pires GN, Tufik S, Andersen ML. Musculoskeletal pain during the night and its relationship to sleep quality and poor sleep perception among older adults. Sleep Epidemiol 2021; 1: 100006
    CrossrefGoogle Scholar
  • 11 Li J, Vitiello MV, Gooneratne NS. Sleep in Normal Aging. Sleep Med Clin 2018; 13 (01) 1-11
    CrossrefPubMedGoogle Scholar
  • 12 Zheng D, Yuan X, Ma C. et al. Alcohol consumption and sleep quality: a community-based study. Public Health Nutr 2021; 24 (15) 4851-4858
    CrossrefPubMedGoogle Scholar
  • 13 Park SY, Oh MK, Lee BS. et al. The Effects of Alcohol on Quality of Sleep. Korean J Fam Med 2015; 36 (06) 294-299
    CrossrefPubMedGoogle Scholar
  • 14 Sabanayagam C, Shankar A. The association between active smoking, smokeless tobacco, second-hand smoke exposure and insufficient sleep. Sleep Med 2011; 12 (01) 7-11
    CrossrefPubMedGoogle Scholar
  • 15 da Silva e Silva WC. Costa NL, Rodrigues DdS, da Silva ML, Cunha KdC. Sleep quality of adult tobacco users: A systematic review of literature and meta-analysis. Sleep Epidemiol 2022; 2: 100028
    CrossrefGoogle Scholar
  • 16 Chasens ER, Sereika SM, Weaver TE, Umlauf MG. Daytime sleepiness, exercise, and physical function in older adults. J Sleep Res 2007; 16 (01) 60-65
    CrossrefPubMedGoogle Scholar
  • 17 World Health O. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018 2018
    Google Scholar
  • 18 Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U. Lancet Physical Activity Series Working Group. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet 2012; 380 (9838): 247-257
    CrossrefPubMedGoogle Scholar
  • 19 Franco MR, Tong A, Howard K. et al. Older people's perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature. Br J Sports Med 2015; 49 (19) 1268-1276
    CrossrefPubMedGoogle Scholar
  • 20 Chennaoui M, Arnal PJ, Sauvet F, Léger D. Sleep and exercise: a reciprocal issue?. Sleep Med Rev 2015; 20: 59-72
    CrossrefPubMedGoogle Scholar
  • 21 Arakaki FH, De Angelis K, Hachul H, Morelhão PK, Tufik S, Andersen ML. Is physical inactivity or sitting time associated with insomnia in older men? A cross-sectional study. Sleep Epidemiol 2022; 2: 100023
    CrossrefGoogle Scholar
  • 22 Delbari A, Ghavidel F, Bidkhori M. et al. Evaluation of Sleep Quality and Related Factors in Community-Dwelling Adults: Ardakan Cohort Study on Aging (ACSA). J Res Health Sci 2023; 23 (03) e00591
    CrossrefPubMedGoogle Scholar
  • 23 Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. [The Mini-Mental State Examination in a general population: impact of educational status]. Arq Neuropsiquiatr 1994; 52 (01) 1-7
    CrossrefPubMedGoogle Scholar
  • 24 Austin PC, Steyerberg EW. The number of subjects per variable required in linear regression analyses. J Clin Epidemiol 2015; 68 (06) 627-636
    CrossrefPubMedGoogle Scholar
  • 25 Bujang MA, Sa'at N, Sidik TMITAB. Determination of minimum sample size requirement for multiple linear regression and analysis of covariance based on experimental and non-experimental studies. Epidemiol Biostat Public Health 2017; 14 (03) e12117-1-e12117-9
    Google Scholar
  • 26 Beaudreau SA, Spira AP, Stewart A. et al; Study of Osteoporotic Fractures. Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women. Sleep Med 2012; 13 (01) 36-42
    CrossrefPubMedGoogle Scholar
  • 27 Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28 (02) 193-213
    CrossrefPubMedGoogle Scholar
  • 28 Bertolazi AN, Fagondes SC, Hoff LS. et al. Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med 2011; 12 (01) 70-75
    CrossrefPubMedGoogle Scholar
  • 29 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14 (06) 540-545
    CrossrefPubMedGoogle Scholar
  • 30 Bertolazi AN, Fagondes SC, Hoff LS, Pedro VD, Menna Barreto SS, Johns MW. Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil. J Bras Pneumol 2009; 35 (09) 877-883
    CrossrefPubMedGoogle Scholar
  • 31 Lemes ÍR, Pinto RZ, Turi Lynch BC. et al. The Association Between Leisure-time Physical Activity, Sedentary Behavior, and Low Back Pain: A Cross-sectional Analysis in Primary Care Settings. Spine 2021; 46 (09) 596-602
    CrossrefPubMedGoogle Scholar
  • 32 Hertogh EM, Monninkhof EM, Schouten EG, Peeters PH, Schuit AJ. Validity of the modified Baecke questionnaire: comparison with energy expenditure according to the doubly labeled water method. Int J Behav Nutr Phys Act 2008; 5: 30
    CrossrefPubMedGoogle Scholar
  • 33 Silva FG, Oliveira CB, Hisamatsu TM. et al. Critical evaluation of physical activity questionnaires translated to Brazilian-Portuguese: a systematic review on cross-cultural adaptation and measurements properties. Braz J Phys Ther 2020; 24 (03) 187-218
    CrossrefPubMedGoogle Scholar
  • 34 Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 2003; 49 (02) 156-163
    CrossrefPubMedGoogle Scholar
  • 35 Harrell Jr FE, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med 1996; 15 (04) 361-387
    CrossrefPubMedGoogle Scholar
  • 36 Mander BA, Winer JR, Walker MP. Sleep and Human Aging. Neuron 2017; 94 (01) 19-36
    CrossrefPubMedGoogle Scholar
  • 37 Eckstrom E, Neukam S, Kalin L, Wright J. Physical Activity and Healthy Aging. Clin Geriatr Med 2020; 36 (04) 671-683
    CrossrefPubMedGoogle Scholar
  • 38 Park H, Suh B. Association between sleep quality and physical activity according to gender and shift work. J Sleep Res 2020; 29 (06) e12924
    CrossrefPubMedGoogle Scholar
  • 39 Britton A, Fat LN, Neligan A. The association between alcohol consumption and sleep disorders among older people in the general population. Sci Rep 2020; 10 (01) 5275
    CrossrefPubMedGoogle Scholar
  • 40 Purani H, Friedrichsen S, Allen AM. Sleep quality in cigarette smokers: Associations with smoking-related outcomes and exercise. Addict Behav 2019; 90: 71-76
    CrossrefPubMedGoogle Scholar
  • 41 McClain JJ, Lewin DS, Laposky AD, Kahle L, Berrigan D. Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults. Prev Med 2014; 66: 68-73
    CrossrefPubMedGoogle Scholar
  • 42 Gao C, Scullin MK. Longitudinal trajectories of spectral power during sleep in middle-aged and older adults. Aging Brain 2022; 3: 100058
    CrossrefPubMedGoogle Scholar
  • 43 Bublitz M, Adra N, Hijazi L, Shaib F, Attarian H, Bourjeily G. A Narrative Review of Sex and Gender Differences in Sleep Disordered Breathing: Gaps and Opportunities. Life (Basel) 2022; 12 (12) 2003
    Google Scholar
  • 44 Krishnan V, Collop NA. Gender differences in sleep disorders. Curr Opin Pulm Med 2006; 12 (06) 383-389
    CrossrefPubMedGoogle Scholar
  • 45 Hirshkowitz M. Normal human sleep: an overview. Med Clin North Am 2004; 88 (03) 551-565 , viivii.
    CrossrefPubMedGoogle Scholar
  • 46 Faramarzi M, Cheraghi M, Zamani M, Kheirkhah F, Bijani A, Hosseini SR. Gender-Specific Predictors of Depressive Symptoms among Community Elderly. J Res Health Sci 2017; 17 (02) e00377
    Google Scholar
  • 47 Dzierzewski JM, Buman MP, Giacobbi Jr PR. et al. Exercise and sleep in community-dwelling older adults: evidence for a reciprocal relationship. J Sleep Res 2014; 23 (01) 61-68
    CrossrefPubMedGoogle Scholar
  • 48 Kline CE, Irish LA, Krafty RT. et al. Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study. Sleep 2013; 36 (09) 1279-1288
    CrossrefPubMedGoogle Scholar
  • 49 Montgomery P, Dennis J. Physical exercise for sleep problems in adults aged 60+. Cochrane Database Syst Rev 2002; 2002 (04) CD003404
    PubMedGoogle Scholar
  • 50 Seol J, Lee J, Park I. et al. Bidirectional associations between physical activity and sleep in older adults: a multilevel analysis using polysomnography. Sci Rep 2022; 12 (01) 15399
    CrossrefPubMedGoogle Scholar
  • 51 Stutz J, Eiholzer R, Spengler CM. Effects of Evening Exercise on Sleep in Healthy Participants: A Systematic Review and Meta-Analysis. Sports Med 2019; 49 (02) 269-287
    CrossrefPubMedGoogle Scholar
  • 52 St-Onge MP. The role of sleep duration in the regulation of energy balance: effects on energy intakes and expenditure. J Clin Sleep Med 2013; 9 (01) 73-80
    CrossrefPubMedGoogle Scholar
  • 53 Taylor AH, Cable NT, Faulkner G, Hillsdon M, Narici M, Van Der Bij AK. Physical activity and older adults: a review of health benefits and the effectiveness of interventions. J Sports Sci 2004; 22 (08) 703-725
    CrossrefPubMedGoogle Scholar
  • 54 Ramos V, Carraça EV, Paiva T, Baptista F. Sedentary Time, Physical Activity, Fitness, and Physical Function in Older Adults: What Best Predicts Sleep Quality?. J Aging Phys Act 2019; 27 (04) 538-544
    CrossrefPubMedGoogle Scholar
  • 55 Atkinson G, Davenne D. Relationships between sleep, physical activity and human health. Physiol Behav 2007; 90 (2-3): 229-235
    CrossrefPubMedGoogle Scholar
  • 56 Teixeira PJ, Carraça EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Act 2012; 9 (01) 78
    CrossrefPubMedGoogle Scholar