Can Exercise Help with Sleep Problems as We Get Older

Vol.1, Issue 3, March 2021

Sleep problems among Canadian older adults, along with the use of sleeping pills, have been in the news recently.
The number of recommended hours of sleep each night varies depending on age. Teens, for example, need 8 to 10 hours. For adults over the age of 65, the recommendation is 7 to 8 hours of good-quality sleep.¹

However, for many, the ability to fall asleep or stay asleep decreases with age. This causes daytime sleepiness, which impairs quality of life. According to Statistics Canada, 26% of older Canadians report nighttime insomnia, also called sleep disorder.²

What is a sleep disorder?

Some sleeping problems are temporary. But if a sleep problem occurs regularly and interferes with daily life, it may be a sleep disorder. There are four types of sleep problems:

Sleep latency means the amount of time it takes to fall asleep.
Sleep efficiency refers to the amount of time a person actually spends sleeping while lying in bed.
Waking often at night is a problem for some people.
A person’s perception of sleep quality can also be a problem – feeling tired rather than rested on waking and throughout the day.

Although there are effective medications for insomnia, they may have side effects, including falls. Researchers are looking at lifestyle factors, such as exercise, for alternative ways to manage sleep problems.

Research for the whole population shows that exercise is associated with shorter sleep onset time, less time awake after sleep onset, and longer total sleep time.³ For older adults with sleep problems, exercise may decrease both time to fall asleep and use of sleep medication.⁴

What kind of exercise helps with sleep?

Some may think that a very intense workout will tire them out and they will have better sleep. In fact, regular, moderate-intensity physical activity seems to be the most beneficial. High-intensity activity may even have a negative impact on getting to sleep.^5,6

A recent study of older adults in Japan showed that accumulating more than 5000 steps a day had sleep benefits. They included better sleep efficiency, awakening less at night, and reduced daytime napping.⁷

Regular, strength-training exercise may also improve all aspects of sleep, especially sleep quality. The benefits may be even greater if combined with aerobic exercise.⁸

What time of day is best to exercise for better sleep?

We are not sure. Each person’s internal clock is different. It may take some trial and error to find the time of day that works best for you. What we do know is that exercising right before bed is not a good idea. That is because exercise increases endorphins and raises body temperature -- the body’s signals to be awake. As such, a general guideline is not to exercise in the 2 hours before bedtime.

Sleep is an important part of healthy aging. Although an optimal exercise prescription for improving sleep quality is not known, being physically active could be an alternative or complementary approach to existing therapies for sleep problems and may help to achieve a good night’s sleep.

Learn more about managing sleep as you get older from the Healthy Ageing and Geriatrics Program, Sinai Health System and University Health Network:
https://sinaigeriatrics.ca/patient-resources/managing-sleep-in-older-adults/

References:

Hirshkowitz M et al. National Sleep Foundation’s updated sleep duration recommendations: Final report. Sleep Health 2015; 1: 233-43.
Chaput JP et al. Statistics Canada. Health Reports. Prevalence of insomnia for Canadians aged 6 to 79. Health Reports. Catalogue no. 82-003-X ISSN 1209-1367. December 2018.
Bushman B. Exercise and Sleep. ACSM’s Health & Fitness Journal. Vol. 17/ No. 5. 2013
Yang et al. Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. J Physiother. 2012;58(3):157-63.
Bullock A, et al. Optimizing Sleep in Older Adults: Where Does High-Intensity Interval Training. Front Psychol. October | Volume 11 | Article 576316. 2020.
Tsai et al. Associations between objectively measured physical activity, sedentary behaviour and time in bed among 75+ community-dwelling Danish older adults. BMC Geriatrics 21:53. 2021.
Kimura et al. Association between objectively measured walking steps and sleep in community-dwelling older adults: A prospective cohort study. PLoS ONE 15(12): e0243910.
Kovacevic et al. The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep Med Rev. Jun; 39:52-68. 2018

Liza Stathokostas, PhD
Research Director
Active Aging Canada

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