BEDFORD, MA – An often recommended lifestyle intervention for insomnia is physical activity (PA). It is not clear, however, that more activity benefits patients across the range of insomnia severity.
A new study led by the Bedford, MA, VAMC, examined the relationship between daily PA (steps) and sleep (duration, efficiency, and quality) at different levels of insomnia severity.
The report in the Journal of Behavioral Medicine used multilevel models to estimate day-to-night relationships between PA and sleep, and if insomnia severity moderated these relationships. 1
Researchers determined that days with greater PA were associated with nights with longer sleep duration, but that was moderated by insomnia severity;
“PA was associated with longer sleep that night in participants with mild insomnia and associated with less sleep in those with severe insomnia,” the authors wrote. “PA was not associated with sleep efficiency or quality. PA is potentially an easily accessible and impactful intervention to promote sleep duration in participants who are experiencing less severe sleep disturbance. More complex, resource-intensive interventions may be needed as insomnia severity increases.”
Background information in the article noted that insomnia affects approximately 6 – 10% of adults and 24 – 54% of post-9/11 veterans (e.g., those returning from Operations Iraqi Freedom, Enduring Freedom or New Dawn). “Sleep disturbances can be the consequence of various physiological (e.g., high BMI), psychological (e.g., PTSD), and/or behavioral factors (e.g., poor sleep hygiene), which are often more common in veterans than civilians,” the authors noted.
With a need for more easily accessible behavioral interventions for sleep improvement, physical activity could be a solution, according to the researchers, who added, “While cognitive behavioral therapy for insomnia (CBTI) is the first-line treatment for chronic insomnia, it can be time- and resource-intensive. To augment therapist-delivered CBTI, patient-facing mobile applications, such as the VA’s CBT-i Coach, have been developed to guide users through the process of learning about sleep, developing positive sleep routines and improving their sleep environments, and providing a structured program that teaches evidence-based strategies to improve sleep and help alleviate symptoms of insomnia.”
They cautioned that CBT-i Coach is not intended to replace traditional CBTI for those who need it, “but rather to provide options for self-reported sleep assessments (e.g., daily sleep diaries, use of the Insomnia Severity Index), sleep hygiene education, and opportunities for making behavioral changes that may enhance sleep even outside co-use of the app during insomnia treatment by a sleep clinician.”
- Robinson SA, Reilly ED, Petrakis BA, Wiener RS, Castaneda-Sceppa C, Quigley KS. Daily physical activity and sleep in veterans: the role of insomnia severity. J Behav Med. 2022 Apr;45(2):318-323. doi: 10.1007/s10865-021-00260-8. Epub 2021 Oct 30. PMID: 34718912; PMCID: PMC8957495.