Effects on Sleep Quality of Physical Exercise Programs in Older Adults: A Systematic Review and Meta-Analysis

Round 1

Reviewer 1 Report

It a very well designed study. I have no criticism regarding any of the components of this work. I fully appraciate the quality of the methodology, that is rarely at such a high level of presentation. Congratulations.

Author Response

Thank you very much for your review. In the attached document are our responses.

 

Best wishes

Lilian Solis Navarro

Author Response File: Author Response.docx

Reviewer 2 Report

Dear authors,

Thank you for the possibility of reviewing this interesting review aiming at assessing the effectiveness of physical activity interventions on sleep quality in the elderly.

I listed my concerns and suggestions:

 

1.       Line 112: what do you mean by “abstract review?”

2.       2.5: did you include only RCTs? If not, you should use the ROBINS-I toll for the no-RCT studies.

3.       Chapter 3 in line 148 should probably be titled Results rather than Discussion.

4.       In chapter 3.1, what do you mean by the “wrong study design, wrong intervention, etc.? the word wrong does not seem the most suitable.

5.       Were the subjects all healthy or sub-healthy participants? If not, how did you manage the differences between studies including healthy or unhealthy participants and which inclusion criteria did you use?

6.       In your analysis, did you account for the following:

a.       Sex differences?

b.       Age differences, since the age ranged between 65 and 85?

c.       Pathologies?

7.       What is healthy beat acupunch? Is it considered a physical activity?

8.       In line 211, you reported that only one study used an accelerometer, which is an objective sleep assessment method. However, in line 252, you wrote that objective sleep efficiency was assessed in two studies.

9.       Line 238, what do you mean by “type of patient?”

10.   In my opinion, you should evaluate the 12-month study deeper. Indeed, in such long studies, intermediate evaluations should be practised during the study protocol, which could have highlighted sleep improvements. Indeed, suppose the physical activity intensity does not increase properly during the intervention. In that case, sleep improvement could be traceable in the intermediate evaluations and not at the end of the study protocols, since the body and all the physiological processes could have adapted to the physical activity intervention.

11.   Lines 303-308: how are these sentences useful for the discussion and the interpretation of the results?

 

12.   In line 76, among citations 20-23, I also suggest the following article: https://doi.org/10.1007/s11332-019-00573-x

Author Response

Thank you very much for your review. In the attached document are our responses.

 

Best wishes

Lilian Solis Navarro

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Dear authors,

Thank you for accepting my suggestions and the explanations you gave about my concerns.

The manuscript is now more apparent; however, I still have some suggestions:

1. (previously point 6), you did not explain why you did not consider age in the analyses.

2. please explain in the text what healthy beat acupunch is.

3. it would be interesting and valuable reading some physiological or cause-effect hypotheses about how physical activity could influence/improve sleep duration/quality and vice-versa. In the way the manuscript is now, there is only the results explanation without any explication of the related mechanisms.

Author Response

Dear reviewer

Thank you for your comments. In the attached file our responses.

Best wishes

Rodrigo Torres

Author Response File: Author Response.docx