title: Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations.
abstract: OBJECTIVE
  To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations.
  
  
  METHODS
  Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30 months.
  
  
  METHODS
  Lifestyle Interventions and Independence for Elders Study.
  
  
  METHODS
  Community-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N = 1,635).
  
  
  METHODS
  Sleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30 months.
  
  
  RESULTS
  The randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5 = 0.80, 95% confidence interval (CI) = 0.68-0.94), including fewer new cases (aOR for PSQI >5 = 0.70, 95% CI = 0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI ≤5 = 1.13, 95% CI = 0.90-1.43). No significant intervention effects were observed for the ISI or ESS.
  
  
  CONCLUSIONS
  Structured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI.
authors.affiliation: Clinical Epidemiology Research Center, Veterans Affairs Connecticut, West Haven, Connecticut.|Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Vaz Fragoso
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Miller
authors.affiliation: Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California.|Health Research and Policy Department, School of Medicine, Stanford University, Stanford, California.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
authors.affiliation: Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
authors.affiliation: Department of Medicine, School of Medicine, Boston University, Boston, Massachusetts.
authors.forename: Christine K
authors.initials: CK
authors.lastname: Liu
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana.|Klein Buendel, Inc., Golden, Colorado.
authors.forename: Valerie H
authors.initials: VH
authors.lastname: Myers
authors.affiliation: Department of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Neelesh K
authors.initials: NK
authors.lastname: Nadkarni
authors.affiliation: Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida.
authors.forename: Marco
authors.initials: M
authors.lastname: Pahor
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Spring
authors.affiliation: Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Gill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology; D015444:Exercise; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D015995:Prevalence; D057185:Sedentary Behavior; D016037:Single-Blind Method; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: daytime drowsiness; insomnia; physical activity; poor sleep quality; sleep-wake behaviors