Effects of resistance exercise training and stretching on chronic insomnia

D’Aurea, Carolina V.R.; Poyares, Dalva; Passos, Giselle S.; Santana, Marcos G.; Youngstedt, Shawn D.; Souza, Altay A.; Bicudo, Juliana; Tufik, Sergio; de Mello, Marco T.

doi:10.1590/1516-4446-2018-0030

Acessibilidade / Reportar erro

Brasil

Brazilian Journal of Psychiatry

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Braz. J. Psychiatry 41 (1) • Jan-Feb 2019 • https://doi.org/10.1590/1516-4446-2018-0030 copy

Effects of resistance exercise training and stretching on chronic insomnia

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients.

Methods:

Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively.

Results:

There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group.

Conclusion:

Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia.

Clinical trial registration:

NCT01571115

Sleep; physical activity; mood; flexibility; strength exercise

	Control (n=8)	Stretching (n=10)	Resistance (n=10)
Age (years)	40.3±2.7	45.5±2.5	44.5±2.2
Weight (kg)	76.8±5.5	68.2±4.8	70.6±3.2
Height (cm)	166.5±4.1	162.5±2.4	163.6±2.5
BMI (kg/m²)	27.9±2.0	25.9±1.7	26.7±1.6
Insomnia duration (years)	8.4±3.1	6.5±2.7	5.4±1.4

	Control (n=8)		Stretching (n=10)		Resistance (n=10)
	Baseline	Change (Δ)	Baseline	Change (Δ)	Baseline	Change (Δ)
ISI (0-28)	16.8±2.6	2.3±1.8	18.7±1.2	-8.1±2.0^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	21.3±1.0	-10.5±2.3^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.
Wrist actigraphy
TST (min)	395.4±14.8	-21.4±18.7	392.4±13.1	23.5±19.3	363.5±17.9	31.6±9.9
SOL (min)	16.2±3.0	2.2±2.1	17.0±2.1	-5.2±1.9^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	19.6±5.1	-7.1±4.6^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.
WASO (min)	34.8±5.0	3.6±4.2	30.1±4.0	-7.1±3.0^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	34.9±6.3	-9.3±2.8^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.
SE (%)	86.3±2.2	-2.3±2.0	89.1±0.8	5.0±0.8^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	86.8±1.7	4.4±1.8^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.
Polysomnography
SOL (min)	32.2±12.1	-4.3±10.1	22.9±7.0	4.6±9.1	28.4±6.6	-6.4±6.5
REM latency (min)	86.1±19.5	24.5±21.7	133.9±23.2	-41.0±23.1	85.5±11.9	21.5±24.0
TST (min)	301.3±31.0	26.9±19.5	333.5±23.3	39.2±20.3	317.2±18.6	-12.7±20.8
SE (%)	74.1±6.5	1.4±4.5	78.8±4.3	4.5±4.3	78.4±5.1	-1.9±4.5
WASO (min)	72.4±24.1	-1.0±17.2	65.3±14.2	-14.5±14.4	62.3±20.8	-5.5±9.7
Stage 1 sleep (%)	16.0±5.1	-3.2±1.3	8.5±1.7	1.0±2.0	10.9±2.4	0.4±1.6
Stage 2 sleep (%)	42.7±2.4	6.1±3.0	48.9±2.5	0.2±2.4	45.5±1.7	0.7±4.5
Stage 3 sleep (%)	24.3±3.4	-3.7±2.1	23.5±3.2	-2.5±2.1	24.2±2.7	-1.9±3.5
REM sleep (%)	17.0±3.3	0.6±2.0	19.1±2.0	1.3±2.4	19.4±2.7	0.9±1.4
PSQI
Global score (0-21)	12.8±0.9	-0.1±0.8	12.0±0.7	-3.9±1.5^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	12.7±0.4	-5.3±0.8^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.
Sleep latency (min)	78.1±20.7	-15.6±18.4	67.3±23.4	-37.9±25.3	75.0±15.9	-47.5±15.0
SE (%)	59.8±7.7	2.1±4.3	64.9±6.0	13.3±6.3	69.8±3.7	19.5±3.9^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.
Sleep duration (h)	4.3±0.5	-0.1±0.2	4.3±0.3	1.6±0.6^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	4.6±0.3	1.2±0.3^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.

	Control (n=8)		Stretching (n=10)		Resistance (n=10)
	Baseline	Change (Δ)	Baseline	Change (Δ)	Baseline	Change (Δ)
POMS (score)
Tension-anxiety	11.6±3.2	0.9±2.4	14.8±2.1	-6.8±1.3^* * Analysis of covariance (ANCOVA): p < 0.05 statistically significant compared with control.	8.0±2.5	-1.8±1.6
Depression	10.3±4.2	-1.2±1.4	15.9±4.7	-5.9±2.7	8.8±3.1	-3.5±2.8
Anger-hostility	10.8±3.8	3.4±6.1	13.5±3.5	-5.2±1.8	11.2±4.1	-1.5±1.5
Vigor-activity	16.5±1.3	0.8±1.0	12.7±2.1	3.9±2.2	19.3±2.2	0.4±3.3
Fatigue	9.9±2.6	-0.4±1.5	13.7±2.4	-4.8±1.4	11.7±2.2	-4.9±2.2
Confusion bewilderment	3.4±1.4	-1.4±1.0	6.8±2.1	-3.6±1.5	3.6±1.4	-1.8±1.1
SF-36 (0-100)
Physical functioning	79.8±8.2	-1.9±1.9	69.5±8.7	8.5±5.6	92.5±3.0	2.5±1.7
Role-physical	62.5±14.2	9.4±17.6	47.5±13.1	23.8±12.7	52.5±9.5	15.0±9.3
Body pain	70.0±11.7	-0.1±9.4	57.2±8.4	8.0±7.8	58.9±7.6	13.4±11.1
General health perception	63.1±9.3	13.4±6.4	56.9±6.6	11.9±5.4	77.8±4.8	0.8±6.1
Vitality	52.5±6.9	3.7±4.3	33.5±7.6	25.5±8.9	45.0±7.6	23.0±8.2
Social functioning	67.2±11.1	5.9±5.7	52.5±9.1	29.0±9.5	67.5±10.1	17.5±11.2
Role-emotional	66.7±12.6	16.7±8.9	30.0±13.6	26.7±20.4	36.7±10.5	33.3±15.7
Mental health	64.0±7.0	-2.5±4.9	47.6±7.9	21.2±8.2	57.4±8.1	20.2±7.3

	Baseline	2 months	Post with
1RM exercises (lb)	Resistance exercise (n=10)
Leg extension	116.5±2.5	123.7±2.3	143.5±2.7^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month.
Leg curl	89.5±2.1	103.3±2.2	122.3±2.0^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Abductor	119.0±2.7	128.2±2.7	144.8±2.4^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Abductor	103.5±2.7	116.7±2.4	137.3±2.6^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Vertical Traction	98.0±2.3	110.1±2.2	122.8±2.6^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month.
Chest press	71.0±1.9	77.0±2.0	89.5±2.2^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Arm Curl	26.0±1.0	39.8±1.7	50.8±1.7^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Arm extension	76.5±1.8	89.0±2.4	102.5±2.3^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Lower back	85.0±2.6	102.3±2.5	119.2±2.5^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
Abdominal crunch	57.5±1.9	69.5±2.4	83.8±2.9^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡
	Stretching (n=10)
Sit and reach test (cm)	22.2±26.4	27.3±19.7	31.1±15.2^* * Baseline vs. post-treatment. ^† † 2-month vs. 4-month; ‡ baseline vs. 2-month. ^‡

Associação Brasileira de Psiquiatria Rua Pedro de Toledo, 967 - casa 1, 04039-032 São Paulo SP Brazil, Tel.: +55 11 5081-6799, Fax: +55 11 3384-6799, Fax: +55 11 5579-6210 - São Paulo - SP - Brazil
E-mail: editorial@abp.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Giselle Soares Passos, Universidade Federal de Goiás, Regional Jatai, Cidade Universitária, BR 364, km 195, 3800, CEP 75801-615, Jataí, GO, Brazil. E-mail: passos.gs@gmail.com