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A Randomized Controlled Trial

Abby C. King, PhD; Roy F. Oman, PhD; Glenn S. Brassington, MA; Donald L. Bliwise, PhD; William L. Haskell, PhD

JAMA. 1997;277(1):32-37.

Abstract
Objective.
—To determine the effects of moderate-intensity exercise training on self-rated (subjective) sleep quality among healthy, sedentary older adults reporting moderate sleep complaints.

Design.
—Randomized controlled trial of 16 weeks' duration.

Setting.
—General community.

Participants.
—Volunteer sample of 29 women and 14 men (of 67 eligible subjects) aged 50 to 76 years who were sedentary, free of cardiovascular disease, and reported moderate sleep complaints. No participant was withdrawn for adverse effects.

Intervention.
—Randomized to 16 weeks of community-based, moderate-intensity exercise training or to a wait-listed control condition. Exercise consisted primarily of four 30- to 40-minute endurance training sessions (low-impact aerobics; brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate.

Main Outcome Measure.
—Pittsburgh Sleep Quality Index (PSQI).

Results.
—Compared with controls (C), subjects in the exercise training condition (E) showed significant improvement in the PSQI global sleep score at 16 weeks (baseline and posttest values in mean [SD] for C=8.93 [3.1] and 8.8 [2.6]; baseline and posttest values for E=8.7 [3.0] and 5.4 [2.8]; mean posttest difference between conditions=3.4; P<.001; 95% confidence interval, 1.9-5.4), as well as in the sleep parameters of rated sleep quality, sleep-onset latency (baseline and posttest values for C=26.1 [20.0] and 23.8 [15.3]; for E=28.4 [20.2] and 14.6 [13.0]; net improvement=11.5 minutes), and sleep duration baseline and posttest scores for C=5.8 [1.1] and 6.0 [1.0]; for E=6.0 [1.1] and 6.8 [1.2]; net improvement=42 minutes) assessed via PSQI and sleep diaries (P=.05).

Conclusions.
—Older adults with moderate sleep complaints can improve selfrated sleep quality by initiating a regular moderate-intensity exercise program.

Author Affiliations
From the Division of Epidemiology, Department of Health Research and Policy (Dr King) and the Division of Cardiovascular Medicine (Dr Haskell), and Stanford Center for Research in Disease Prevention, Department of Medicine, Stanford University School of Medicine, Stanford, Calif (Drs King and Haskell and Mr Brassington; Department of Health Promotion Sciences, College of Public Health, University of Oklahoma, Oklahoma City (Dr Oman); Department of Neurology, Emory University School of Medicine, Atlanta, Ga (Dr Bliwise).

Footnotes
Reprints: Abby C. King, PhD, Stanford University School of Medicine, 730 Welch Rd, Suite B, Palo Alto, CA 94304-1583.

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