Effects of aerobic exercise on home-based sleep among overweight and obese men with chronic insomnia symptoms : a randomized controlled trial

Objective To determine the effect of a six-month aerobic exercise program on home-based sleep quality among overweight and obese men with chronic insomnia symptoms. Methods Participants were 45 Finnish men (93% had body mass index ≥25) aged 30–65 years, with chronic (≥3 months) insomnia symptoms as classified by the DSM-IV criteria. Participants were randomized into an exercise (n = 24) or control group (n = 21). The exercise group received six-month aerobic exercise intervention with one to five sessions per week of 30–60 minutes duration. The control group was instructed to maintain habitual lifestyle behaviors during the study period. Seven-night home sleep was measured with a piezoelectric bed sensor and sleep diary. Other assessments included the modified Basic Nordic Sleep Questionnaire, a health and behavior questionnaire, physical activity and diet diaries, anthropometry, fat mass, and physical fitness. Analysis of covariance controlling for baseline values, and repeated-measures analysis of variance were implemented for time-by-group comparisons and within-group comparisons, respectively. Results At six months, the exercise group showed reduced objective sleep onset latency (p = 0.010) and lowered frequency of difficulty initiating sleep (p = 0.021) than controls. Although a time-by-group difference was not significant, exercisers showed shorter objective wake after sleep onset (p = 0.004), reduced subjective nocturnal awakenings (p = 0.010), improved objective sleep efficiency (p < 0.001), and improved morning-rated subjective sleep quality (p = 0.042) at six months than baseline. Conclusions A six-month aerobic exercise can improve sleep, mainly by mitigating difficulty of initiating sleep among overweight and obese men with chronic insomnia symptoms.peerReviewe