Effects of Strength Training on Sleep Parameters of Adolescents: A Randomized Controlled Trial

Physical Fitness and Sleep-Related Problems Among Adolescents: Findings From the EHDLA Study

Physical fitness, particularly cardiorespiratory fitness, has been shown to positively impact sleep quality. However, the relationship between overall physical fitness and sleep-related problems in adolescents remains underexplored. Therefore, the aim of this study was to analyze the association between overall physical fitness and sleep-related problems in adolescents. This cross-sectional study included 812 adolescents (median age: 14 years [interquartile range = 12-17]; 54.9% girls) from the Eating Healthy and Daily Life Activities (EHDLA) data. Physical fitness was measured objectively using the Assessing the Levels of PHysical Activity and fitness (ALPHA-Fit) battery for children and adolescents and a flexibility test, while sleep-related problems were evaluated using the BEARS sleep screening tool (B = Bedtime problems, E = Excessive daytime sleepiness, A = Awakenings during the night, R = Regularity and duration of sleep, S = Snoring). Generalized linear models were used to examine the association of overall physical fitness with the different components of sleep-related problems. The odds of experiencing sleep-related problems decreased significantly with each kilogram increase in handgrip strength (odds ratio [OR] = 0.97, 95% confidence interval [CI] 0.94-0.99), and with each standard deviation increase in overall physical fitness (OR = 0.76, 95% CI 0.59-0.99). In contrast, despite not statistically significant, an increase in long jump appeared to reduce the sleep-related problems (OR = 0.91; 95% CI 0.82-1.02), while a longer time in the 4×10-m shuttle run test might increase sleep problems (OR = 1.12; 95% CI 0.98-1.28). In conclusion, greater levels of physical fitness, particularly muscular strength, may be key for reducing sleep-related problems, emphasizing the importance of personalized training programs.

Effects of a school-based physical activity intervention on mental health indicators in a sample of Brazilian adolescents: a cluster randomized controlled trial

PURPOSE

To test the effects of a physical activity intervention program on symptoms of mental disorders among adolescents.

METHODS

This study is a 12-week cluster randomized controlled trial. The sample consisted of 306 adolescents (45,8% male, age: 13,6 [0,72] years; 54.2% female, age: 13.5 [0.69] years), randomized into an intervention group (N = 165) and a control group (N = 141). The physical activity program involved sessions including muscle strengthening and cardiorespiratory exercises and lifestyle guidance. The mental health indicators analyzed were: anxiety, depression, sleep, and psychological well-being. Intervention effects were analyzed by generalized estimating equations.

RESULTS

After 12 weeks, no significant improvements were observed in the intervention group for sleep; anxiety; depression, and psychological well-being. In the subgroup analysis, significant group×time interactions were observed for adolescents who were classified with moderate symptoms of depression (mean difference: -0.97, p = 0.002) and anxiety (mean difference: -3.03, p = 0.01) with favorable effects for intervention group.

CONCLUSION

After the 12-week intervention period, it can be concluded that 12 weeks of school-based physical activity intervention significantly reduced symptoms of anxiety and depression in adolescents with moderate/severe symptoms. Furthermore, the intervention contributed to the maintenance of psychological well-being, since the control group showed a significant reduction in this mental health indicator.

Effects of exercise on sleep quality in general population: Meta-analysis and systematic review

PURPOSE

Sleep is the foundation of human physiological health and psychological health, as well as one of the basic needs for human survival. Sleep quality problems are prevalent in the population, and poor sleep quality is often closely related to the occurrence of many diseases, which seriously affects the quality of life and may even result in a shortened lifespan, so that improving sleep health has become a real problem that needs to be solved urgently. Exercise, as an important non-pharmacological tool, has been widely used for sleep quality enhancement, while the efficacy of exercise on subjective and objective sleep with respect to individual sleep quality remains controversial. Therefore, the aim of this meta-analysis was to compare the effects of exercise on subjective sleep quality and objective sleep efficiency in a non-athlete population, and to further rank the effectiveness of exercise types to provide appropriate means of exercise to improve sleep.

METHODS

This study was evaluated by literature search in five databases, PubMed, Embase, Web of Science, Cochrane, and EBSCO, and paired meta-analysis and network meta-analysis were performed using Review Manager 5.3 and stata16.0.

RESULTS

A total of 7494 studies were retrieved, and 81 eligible randomized controlled trials involving 6193 subjects were finally included. The primary outcome metrics included subjective sleep quality (PSQI), and the secondary outcome was objective sleep efficiency (SE), of which 65 reported PSQI and 23 reported SE. The results of paired meta-analysis showed that exercise significantly decreased PSQI [MD = -1.77, (95 % CI = -2.28,-1.25),P < 0.05] and increased SE [MD = 4.81, (95 % CI = 2.89,6.73),P < 0.05]. The results of the network meta-analysis showed that body and mind exercise [MD = -2.28, (95 % CI = -3.19,-1.36),P < 0.05, SUCRA = 85.6] may be the best exercise to improve PSQI, and aerobic exercise [MD = 5.02, (95 % CI = 2.52,7.52),P < 0.05, SUCRA = 75.1] is most likely to be the best type of exercise to improve SE. In regression analyses, there was a moderating effect of exercise cycle (β = -0.25 [0.40, 0.46], SE = 0.10 [P = 0.015, R2 = 0.24]) and age (β = -0.20 [-0.04, -0.01, SE = -2.06 [P = 0.039,R2 = 0.16]) as moderators of objective sleep efficiency.

CONCLUSION

Exercise is effective in improving both subjective and objective sleep quality. Body and mind exercise, aerobic exercise, and aerobic combined with resistance exercise may be the preferred way to improve sleep, and the longer the exercise cycle, the more obvious the improvement in sleep effect, the improvement effect will gradually decrease with age.

Classifying intervention components used in sleep duration interventions for children: A systematic review and meta-analysis

The Multiphase Optimization Strategy (MOST) is a three-phase iterative framework that could accelerate the development of behavioral interventions. This systematic review and meta-analysis was conducted within the MOST preparation phase and aimed to classify components included in pediatric sleep duration interventions, using the Behavior Change Technique (BCT) Taxonomy. Across 37 interventions, 46 out of 93 BCTs have been used, with an average of 8 techniques used per study. The most common BCTs used were instruction on how to perform the behavior (N = 29; code 4.1), practical social support (N = 22; code: 3.2), and behavioral practice/rehearsal (N = 22; code: 8.1). A latent class analysis identified two classes of interventions, distinguished by the presence of BCTs falling within the following behavior change groups: shaping knowledge, natural consequences, comparison of behavior, and repetition and substitution. Our meta-analysis revealed that interventions belonging to the latent class with these behavior change groups (N = 15) had a pooled positive intervention effect of 14 min (95 % CI: 8-21) versus 8 min (95 % CI: 1-15) for interventions without these behavior change groups (N = 19). This systematic review and meta-analysis will enhance the development of sleep promotion interventions and guide the selection of candidate intervention components for future optimization and randomized control trials.

The effect of exercise on daytime sleepiness in healthy individuals

The effects of exercise on daytime sleepiness remain unclear, with conflicting findings in the literature. We reviewed the existing literature on the relationship between exercise and daytime sleepiness in healthy individuals. We conducted a systematic search of PubMed and Google Scholar (1991 to present) for interventional studies that used the Epworth Sleepiness Scale (ESS) to measure change in self-reported degree of sleepiness before and after an exercise regimen. Seven studies were included in the review. Exercise significantly improved self-reported sleepiness after the intervention, as measured by ESS, in 4 of the 7 studies; the other studies indicated no significant difference. Additionally, exercise interventions enhanced sleep quality, evident in lower Pittsburgh Sleep Quality Index scores in 4 of 5 studies, thus indirectly alleviating daytime sleepiness. Results were variable and influenced by exercise type, intensity, and timing, as well as participant adherence. Factors that may contribute to the effect of exercise on daytime sleepiness include improved sleep quality, regulation of circadian rhythms, neurotransmitter release, stress reduction, increased energy levels, and weight reduction. This review suggests benefits of exercise for reducing daytime sleepiness and improving sleep quality. Future research is essential for assessing the mechanisms of these effects.

The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials

The prevalence of locomotive syndrome naturally increases with age, but approximately half of nonelderly individuals also meet the criteria for locomotive syndrome, suggesting that even younger people need to pay attention to their own health status. Sleep is important for physical, cognitive, and psychological health. Some individuals with poor sleep quality may be at risk of developing negative health status. Although the effects of sleep hygiene strategies for elderly individuals have been well investigated, optimal nonpharmacological sleep hygiene strategies for improving sleep quality in nonelderly individuals has not been identified. We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials aimed to elucidate the effects of various nonpharmacological interventions on sleep quality in nonelderly individuals and to identify the optimal intervention. Cochrane Central Register of Controlled Trials, Medline, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Scopus were comprehensively searched. We identified 27 studies focusing on the effects of various nonpharmacological sleep hygiene strategies in nonelderly individuals, and 24 studies were applied into NMA. The present results showed that resistance training was the most effective intervention for improving sleep quality in nonelderly individuals. In addition, this study revealed the effects of nonpharmacological interventions, such as physical activity, nutritional intervention, as well as exercise interventions. This is the first report that utilized NMA to compare the effects of various nonpharmacological interventions on sleep quality in nonelderly individuals.

Examining the Effects of Strength Training with Load Progression on Sleep Parameters and Mental Health in College Students

Objective  To compare the effects of strength training with load progression after 4 weeks on sleep parameters and mental health in college students. Methods  A total of 17 university students (11 women, 6 men), ranging from 18 to 21 years old, were randomized into a strength training group (STG) and a control group (CG). The Pittsburgh sleep quality index (PSQI), insomnia severity questionnaire, hospital anxiety and depression (HAD) scale, profile of mood states (POMS), and chronotype were used to evaluate the main outcomes. Training consisted of 60 minute·d -1 (2 times/week, for 4-weeks), with 3 sets of 10 to 12 repetitions, and a 1-minute rest interval between sets and exercises. Baseline and postintervention differences were analyzed using generalized estimating equations (GEE). Results  After 4 weeks of ST, a significant time effect on the chronotype (β: 1.33; p  < 0.05) was observed in the STG. Additionally, there was a significant time and group effect in the reduction of tension (β: 5.00; p  < 0.05), depression (β: 15.41; p  < 0.05), anger (β: 8.00; p  < 0.05), and confusion (β: 6.50; p  < 0.05). For fatigue (β: 2.66; p  < 0.05), there was a significant time effect difference in its reduction. Vigor was meaningfully increased in the STG group (β: -1.75; p  < 0.05). Furthermore, a significant positive relationship was observed between sleep quality and anxiety (r = 0.54; p  = 0.03). Finally, insomnia was positively related with an increase in confusion (r = 0.70; p  = 0.04) and anxiety (r = 0.52; p  = 0.04), as well as with a decrease in vigor (r = -0.71; p  = 0.03). Discussion  Short-term strength training for 4 weeks was effective for improving mental health, helping achieve characteristics of a positive mood profile, that is, low values for negative factors and a high value for the positive factor.

Effect of Strengthening Exercises on Sleep Quality among Females Suffering from Polycystic Ovarian Syndrome: A Randomized Controlled Trial

Background

Sleep problems also occur in women with polycystic ovarian syndrome (PCOS) of normal weight. Furthermore, PCOS and sleep disturbances are linked with worsening of cardiometabolic health in the long term.

Objective

The study aimed to determine the effect of strengthening exercises on sleep quality among females suffering from PCOS.

Materials and Methods

Twenty-four female participants aged 20-45 years suffering from PCOS from at least 1 year with body mass index of 18.5-29.9 kg/m2 and Pittsburgh Sleep Quality Index (PSQI) score ≥5 were randomized into experimental (n = 12) and control (n = 12) groups; allocation (1:1). The participants were blinded. Experimental group received strengthening exercises thrice per week for 4 weeks, and no intervention was given in control group. Sleep quality was assessed using PSQI.

Results

The Wilcoxon signed-rank test showed significant improvements (P < 0.05) in sleep quality, sleep latency, sleep efficiency, sleep disturbances, and global score with strengthening exercises. Mann-Whitney U-test revealed significant improvements (P < 0.05) in use of medication (P = 0.016) and global score (P = 0.045).

Conclusion

Four weeks of strengthening exercises has significant benefits in improving the sleep quality among females with PCOS.

Nonpharmacological Interventions to Lengthen Sleep Duration in Healthy Children: A Systematic Review and Meta-analysis

Importance

Adequate sleep duration is necessary for many aspects of child health, development, and well-being, yet sleep durations for children are declining, and effective strategies to increase sleep in healthy children remain to be elucidated.

Objective

To determine whether nonpharmaceutical interventions to improve sleep duration in healthy children are effective and to identify the key components of these interventions.

Data Sources

CENTRAL, MEDLINE, Embase, PsycINFO, Web of Science Core collection, ClinicalTrials.gov, and WHO trials databases were searched from inception to November 15, 2021.

Study Selection

Randomized clinical trials of interventions to improve sleep duration in healthy children were independently screened by 2 researchers. A total of 28 478 studies were identified.

Data Extraction and Synthesis

Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline. Random-effects meta-analytic models were used to estimate pooled effect sizes.

Main Outcomes and Measures

Difference in sleep duration, measured in minutes.

Results

A total of 13 539 child participants from 45 randomized clinical trials were included. Of these, 6897 (50.9%) were in the intervention group and 6642 (49.1%) in the control group, and the mean age ranged from 18 months to 19 years. Pooled results indicate that sleep interventions were associated with 10.5 minutes (95% CI, 5.6-15.4) longer nocturnal sleep duration. There was substantial variation between trials. Sources of variation that were not associated with the study effect size included age group, whether the population was identified as having a sleep problem or being at a socioeconomic disadvantage (eg, coming from a low-income family or area), method of assessment of sleep duration (objective vs subjective), location of intervention delivery (home vs school), whether interventions were delivered in person or used parental involvement, whether behavioral theory was used, environmental change, or had greater or lower intensity. Interventions that included earlier bedtimes were associated with a 47-minute sleep extension (95% CI, 18.9-75.0; 3 trials) compared with remaining studies (7.4 minutes; 95% CI, 2.9-11.8; 42 trials) (P = .006 for group difference). Trials of shorter duration (6 months or less) had larger effects.

Conclusions and Relevance

Interventions focused on earlier bedtimes may offer a simple, pragmatic, effective way to meaningfully increase sleep duration that could have important benefits for child health.