Sleep Duration and Sleep Quality Are Associated with Physical Activity in Elderly People Living in Nursing Homes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. PA Assessment
2.3. Sleep Duration
2.4. Sleep Quality
2.5. Covariates
2.6. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
95% CI | 95 percent confidence interval |
IPAQ | International Physical Activity Questionnaire |
OR | odds ratio |
PA | physical activity |
PSQI | Pittsburgh Sleep Quality Index |
WHO | World Health Organization |
References
- Division of Ageing and Seniors: Physical Activity and Older Adults from Canada. 2011. Available online: http://www.phac-aspc.gc.ca/seniors-aines/indexeng.php (accessed on 22 September 2018).
- Rimmer, J.H. Fitness and Rehabilitation Programs for Special Populations; Brown Benchmark: Madison, WI, USA, 1994. [Google Scholar]
- Bauman, A.; Craig, C. The place of physical activity in the WHO Global Strategy on Diet and physical activity. Int. J. Behav. Nutr. Phys. Act. 2005, 2, 10. [Google Scholar] [CrossRef] [PubMed]
- Ministry of Health. Guidelines on Physical Activity for Older People (Aged 65 Years and over); Ministry of Health: Wellington, New Zealand, 2013. [Google Scholar]
- World Health Organization. Global Recommendations on Physical Activity for Health; World Health Organization: Geneva, Switzerland, 2010. [Google Scholar]
- Warburton, D.E.; Nicol, C.W.; Bredin, S.S. Health benefits of physical activity: The evidence. CMAJ 2006, 74, 801–809. [Google Scholar] [CrossRef] [PubMed]
- Bauman, A.E.; Reis, R.S.; Sallis, J.F.; Wells, J.C.; Loos, J.F.; Martin, B.W. Correlates of physical activity: Why are some people physically active and others not? Lancet 2012, 380, 258–271. [Google Scholar] [CrossRef]
- Wolkove, N.; Elkholy, O.; Baltzan, M.; Palayew, M. Sleep and aging: 1. Sleep disorders commonly found in older people. CMAJ 2007, 176, 1299–1304. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tsou, M.-T. Association between sleep duration and health outcome in elderly Taiwanese. Int. J. Gerontol. 2011, 5, 200–205. [Google Scholar] [CrossRef]
- Fu, L.; Jia, L.; Zhang, W.; Han, P.; Kang, L.; Ma, Y.; Yu, H.; Zhai, T.; Chen, X.; Guo, Q. The association between sleep duration and physical performance in Chinese community-dwelling elderly. PLoS ONE 2017, 12, e0174832. [Google Scholar] [CrossRef] [PubMed]
- Lentino, C.V.; Purvis, D.L.; Murphy, K.J.; Deuster, P.A. Sleep as a component of the performance triad: The importance of sleep in a military population. US Army Med. Dep. J. 2013, 98–108. [Google Scholar]
- Štefan, L.; Sporiš, G.; Krističević, T.; Knjaz, D. Associations between sleep quality and its domains and insufficient physical activity in a large sample of Croatian young adults: A cross-sectional study. BMJ Open 2018, 8, e021902. [Google Scholar] [CrossRef] [PubMed]
- Holfeld, B.; Ruthig, J.C. A longitudinal examination of sleep quality and physical activity in older adults. J. Appl. Gerontol. 2014, 33, 791–807. [Google Scholar] [CrossRef] [PubMed]
- Chennaoui, M.; Arnal, P.J.; Sauvet, F.; Léger, D. Sleep and exercise: A reciprocal issue? Sleep Med. Rev. 2015, 20, 59–72. [Google Scholar] [CrossRef] [PubMed]
- Jurakić, D.; Pedišić, Ž.; Andrijašević, M. Physical activity of Croatian population: Cross-sectional study using International Physical Activity Questionnaire. Croat. Med. J. 2009, 50, 165–173. [Google Scholar] [CrossRef] [PubMed]
- McGuire, L.C.; Ahluwalia, I.B.; Strine, T.W. Chronic disease-related behaviors in U.S. older women: Behavioral Risk Factor Surveillance System, 2003. J. Women Health 2006, 15, 3–7. [Google Scholar] [CrossRef] [PubMed]
- Ohayon, M.M. Epidemiology of insomnia: What we know and what we still need to learn. Sleep. Med. Rev. 2002, 6, 97–111. [Google Scholar] [CrossRef] [PubMed]
- Rao, V.; Spiro, J.R.; Samus, Q.M.; Rosenblatt, A.; Steele, C.; Baker, A.; Harper, M.; Brandt, J.; Mayer, L.; Rabins, P.V.; Lyketsos, C.G. Sleep disturbances in the elderly residing in assisted living: Findings from the Maryland Assisted Living Study. Int. J. Geriatr. Psychiatry 2005, 20, 956–966. [Google Scholar] [CrossRef] [PubMed]
- Brand, S.; Kalak, N.; Gerber, M.; Kirov, R.; Pühse, U.; Holsboer-Trachsler, E. High self-perceived exercise exertion before bedtime is associated with greater objectively assessed sleep efficiency. Sleep Med. 2014, 15, 1031–1036. [Google Scholar] [CrossRef] [PubMed]
- Buman, M.P.; Phillips, B.A.; Youngstedt, S.D.; Kline, C.E.; Hirshkowitz, M. Does nighttime exercise really disturb sleep? Results from the 2013 National Sleep Foundation Sleep in America Poll. Sleep Med. 2014, 15, 755–761. [Google Scholar] [CrossRef] [PubMed]
- Hurtig-Wehnlöf, A.; Hagströmer, M.; Olsson, L.A. The International Physical Activity Questionnaire modified for the elderly: Aspects of validity and feasibility. Public Health Nutr. 2010, 13, 1847–1854. [Google Scholar] [CrossRef] [PubMed]
- Buysse, D.J.; Reynolds, C.F.; Monk, T.H., 3rd; Monk, T.H.; Berman, S.R.; Kupfer, D.J. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Rev. 1989, 28, 193–213. [Google Scholar] [CrossRef]
- Shankar, A.; Charumathi, S.; Kalidindi, S. Sleep Duration and self-rated health: The National Health Interview Survey 2008. Sleep 2011, 34, 1173–1177. [Google Scholar] [CrossRef] [PubMed]
- Kessler, R.C.; Barker, P.R.; Colpe, L.J.; Epstein, J.F.; Gfroerer, J.C.; Hiripi, E.; Howes, M.J.; Normand, S.L.; Manderscheid, R.W.; Walters, E.E.; et al. Screening for serious mental illness in the general population. Arch. Gen. Psychiatry 2003, 60, 184–189. [Google Scholar] [CrossRef] [PubMed]
- Garfield, V.; Llewellyn, C.H.; Kumari, M. The relationship between physical activity, sleep duration and depressive symptoms in older adults: The English Longitudinal Study of Ageing (ELSA). Prev. Med. Rep. 2016, 4, 512–516. [Google Scholar] [CrossRef] [PubMed]
- Chen, H.I. Effects of 30-h sleep loss on cardiorespiratory functions at rest and in exercise. Med. Sci. Sports Exerc. 1991, 23, 193–198. [Google Scholar] [CrossRef] [PubMed]
- Dattilo, M.; Antunes, H.K.; Medeiros, A.; Mônico Neto, M.; Souza, H.S.; Tufik, S.; de Mello, M.T. Sleep and muscle recovery: Endocrinological and molecular basis for a new and promising hypothesis. Med. Hypotheses 2011, 77, 220–222. [Google Scholar] [CrossRef] [PubMed]
- Taheri, S. The link between short sleep duration and obesity: We should recommend more sleep to prevent obesity. Arch. Dis. Child. 2006, 91, 881–884. [Google Scholar] [CrossRef] [PubMed]
- Kredlow, M.A.; Capozzoli, M.C.; Hearon, B.A.; Calkins, A.W.; Otto, M.W. The effects of physical activity on sleep: A meta-analytic review. J. Behav. Med. 2015, 38, 427–449. [Google Scholar] [CrossRef] [PubMed]
- Şahįn, G. The importance of physical activity level and exercise characteristics on sleep quality in older adults. Act. Adapt. Aging 2017, 42, 250–259. [Google Scholar] [CrossRef]
- Li, J.; Yang, B.; Varrasse, M.; Ji, X.; Wu, M.; Li, M.; Li, K. Physical activity in relation to sleep among community-dwelling older adults in China. J. Aging Phys. Act. 2018, 26, 647–654. [Google Scholar] [CrossRef] [PubMed]
- King, A.C.; Pruitt, L.A.; Woo, S.; Castro, C.M.; Ahn, D.K.; Vitiello, M.V.; Woodward, S.H.; Bliwise, D.L. Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J. Gerontol. A. Biol. Sci. Med. Sci. 2008, 63, 997–1004. [Google Scholar] [CrossRef] [PubMed]
- Bin, Y.S. Is sleep quality more important than sleep duration for public health? Sleep 2016, 39, 1626–1630. [Google Scholar] [CrossRef] [PubMed]
- Shephard, R.J. Limits to the measurement of habitual physical activity by questionnaires. Br. J. Sports Med. 2003, 37, 197–206. [Google Scholar] [CrossRef] [PubMed]
- Youngstedt, S.D.; Freelove-Charton, J.D. Exercise and Sleep. In Exercise, Health and Mental Health; Faulkner, G.E.J., Taylor, A.H., Eds.; Routledge: London, UK, 2005. [Google Scholar]
Study Variables | Total (N = 894) | ‘Sufficiently’ Active (N = 389) | ‘Insufficiently’ Active (N = 505) | p-Value * |
---|---|---|---|---|
N (%) | N (%) | N (%) | ||
Sleep duration | ||||
<6 | 76 (8.5) | 20 (5.1) | 56 (11.1) | |
6–7 | 150 (16.8) | 55 (14.1) | 95 (18.8) | |
7–8 | 486 (54.4) | 223 (57.3) | 263 (52.1) | |
8–9 | 132 (14.8) | 59 (15.2) | 73 (14.5) | |
>9 | 50 (5.6) | 32 (8.2) | 18 (3.6) | <0.001 |
Sleep quality | ||||
Poor | 487 (54.5) | 184 (47.3) | 303 (60.0) | |
Good | 407 (45.5) | 205 (52.7) | 202 (40.0) | <0.001 |
Sex | ||||
Men | 393 (44.0) | 229 (58.9) | 164 (32.5) | |
Women | 501 (56.0) | 160 (41.1) | 341 (67.5) | <0.001 |
Self-rated health | ||||
Poor | 132 14.8) | 35 (9.0) | 97 (19.2) | |
Good | 762 (85.2) | 354 (91.0) | 408 (80.8) | <0.001 |
Smoking consumption | ||||
Yes | 281 (31.4) | 113 (29.0) | 168 (33.3) | |
No | 613 (68.6) | 276 (71.0) | 337 (66.7) | 0.191 |
Alcohol consumption | ||||
Yes | 227 (25.4) | 81 (20.8) | 146 (28.9) | |
No | 667 (74.6) | 308 (79.2) | 359 (71.1) | 0.007 |
Psychological distress | ||||
High | 124 (13.9) | 29 (7.5) | 95 (18.8) | |
Low | 770 (86.1) | 360 (92.5) | 410 (81.2) | <0.001 |
Socioeconomic status | ||||
Low | 33 (3.7) | 15 (3.9) | 18 (3.6) | |
Middle/high | 861 (96.3) | 374 (96.1) | 487 (96.4) | 0.859 |
Chronic Disease/s | ||||
Yes | 115 (12.9) | 39 (10.0) | 76 (15.0) | |
No | 779 (87.1) | 350 (90.0) | 429 (85.0) | 0.027 |
Study Variables | Model 1 (N = 894) | Model 2 (N = 894) | Model 3 (N = 894) |
---|---|---|---|
OR (95% CI; p-Value) | OR (95% CI; p-Value) | OR (95% CI; p-Value) | |
Sleep duration | |||
<6 | 0.50 (0.27 to 0.83; 0.007) | 0.52 (0.30 to 0.91; 0.025) | |
6–7 | 0.79 (0.51 to 1.18; 0.310) | 0.93 (0.61 to 1.40; 0.671) | |
7–8 | Ref. | Ref. | |
8–9 | 1.25 (0.83 to 1.90; 0.335) | 1.22 (0.79 to 1.85; 0.320) | |
>9 | 2.64 (1.40 to 5.06; <0.001) | 2.58 (1.35 to 4.92; <0.001) | |
Sleep quality | |||
Poor | Ref. | Ref. | |
Good | 1.61 (1.23 to 2.11; <0.001) | 1.47 (1.10 to 1.97; 0.021) | |
Sex | |||
Men | Ref. | Ref. | Ref. |
Women | 0.31 (0.22 to 0.43; <0.001) | 0.34 (0.25 to 0.43; <0.001) | 0.33 (0.27 to 0.45; <0.001) |
Self-rated health | |||
Poor | Ref. | Ref. | Ref. |
Good | 1.80 (1.14 to 2.88; 0.017) | 1.64 (1.05 to 2.58; 0.043) | 1.68 (1.07 to 2.60; 0.034) |
Smoking consumption | |||
Yes | Ref. | Ref. | Ref. |
No | 1.06 (0.76 to 1.46; 0.649) | 1.05 (0.77 to 1.44; 0.825) | 1.06 (0.77 to 1.46; 0.705) |
Alcohol consumption | |||
Yes | Ref. | Ref. | Ref. |
No | 1.39 (1.00 to 1.94; 0.048) | 1.45 (1.05 to 2.00; 0.024) | 1.43 (1.05 to 2.07; 0.031) |
Psychological distress | |||
High | Ref. | Ref. | Ref. |
Low | 2.15 (1.33 to 3.44; <0.001) | 2.00 (1.23 to 3.22; <.001) | 1.94 (1.20 to 3.15; <0.001) |
Socioeconomic status | |||
Low | Ref. | Ref. | Ref. |
Middle/high | 0.71 (0.32 to 1.54; 0.421) | 0.74 (0.35 to 1.60; 0.451) | 0.73 (0.34 to 1.59; 0.436) |
Chronic disease/s | |||
Yes | Ref. | Ref. | Ref. |
No | 1.10 (0.71 to 1.72; 0.628) | 1.11 (0.71 to 1.75; 0.676) | 1.10 (0.70 to 1.74; 0.664) |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Štefan, L.; Vrgoč, G.; Rupčić, T.; Sporiš, G.; Sekulić, D. Sleep Duration and Sleep Quality Are Associated with Physical Activity in Elderly People Living in Nursing Homes. Int. J. Environ. Res. Public Health 2018, 15, 2512. https://doi.org/10.3390/ijerph15112512
Štefan L, Vrgoč G, Rupčić T, Sporiš G, Sekulić D. Sleep Duration and Sleep Quality Are Associated with Physical Activity in Elderly People Living in Nursing Homes. International Journal of Environmental Research and Public Health. 2018; 15(11):2512. https://doi.org/10.3390/ijerph15112512
Chicago/Turabian StyleŠtefan, Lovro, Goran Vrgoč, Tomislav Rupčić, Goran Sporiš, and Damir Sekulić. 2018. "Sleep Duration and Sleep Quality Are Associated with Physical Activity in Elderly People Living in Nursing Homes" International Journal of Environmental Research and Public Health 15, no. 11: 2512. https://doi.org/10.3390/ijerph15112512