Intervention Review

Physical exercise for sleep problems in adults aged 60+

  1. Paul Montgomery1,*,
  2. Jane A Dennis2

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 21 OCT 2002

Assessed as up-to-date: 2 FEB 2002

DOI: 10.1002/14651858.CD003404


How to Cite

Montgomery P, Dennis JA. Physical exercise for sleep problems in adults aged 60+. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD003404. DOI: 10.1002/14651858.CD003404.

Author Information

  1. 1

    University of Oxford, The Centre for Evidence-Based Intervention, Oxford, UK

  2. 2

    University of Bristol, School for Policy Studies, Bristol, UK

*Paul Montgomery, The Centre for Evidence-Based Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. paul.montgomery@socres.ox.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 OCT 2002

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The prevalence of sleep problems in adulthood increases with age. While not all sleep changes are pathological in later life, severe disturbances may lead to depression, cognitive impairments, deterioration of quality of life, significant stresses for carers and increased healthcare costs. The most common treatment for sleep disorders (particularly insomnia) is pharmacological. The efficacy of non-drug interventions has been suggested to be slower than pharmacological methods, but with no risk of drug-related tolerance or dependency. Physical exercise, taken regularly, may promote relaxation and raise core body temperature in ways that are beneficial to initiating and maintaining sleep.

Objectives

To assess the efficacy of physical exercise amongst older adults (aged 60 and above).

Search methods

We searched: The Cochrane Library (Issue 1, 2002); MEDLINE (1966 to January 2002); EMBASE (1980 to January 2002); CINAHL (1982 to January 2002); PsycINFO (1887 to January 2002); National Research Register (Issue1, 2002). Bibliographies of existing reviews in the area, as well as of all trial reports obtained, were searched. Experts in the field were consulted.

Selection criteria

Randomised controlled trials of physical exercise for primary insomnia where 80% or more of participants were over the age of 60. Participants must have been screened to exclude those with dementia and/or depression.

Data collection and analysis

Abstracts of studies identified in searches of electronic databases were read and assessed to determine whether they might meet the inclusion criteria. Data were analysed separately depending on whether results had been obtained subjectively or objectively.

Main results

One trial, including 43 participants with insomnia, examined the effectiveness of exercise in a population within an elderly population. At post-treatment, sleep onset latency improved slightly for both men and women. Total sleep duration, sleep onset latency and scores on a scale of global sleep quality showed significant improvement. Improvements in sleep efficiency were not significant. In some cases improvements indicated falls to below what are usually considered pathological levels but the wide confidence intervals and small sample size indicate that these findings must be interpreted with caution.

Authors' conclusions

When the possible side-effects of standard treatment (hypnotics) are considered, there is an argument to be made for clinical use of alternative treatments in the elderly. Exercise, though not appropriate for all in this population, may enhance sleep and contribute to an increased quality of life. Research involving exercise programmes designed with the elderly in mind is needed.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Physical exercise as a treatment for sleep problems in older people

Sleep problems become more common with age, affect quality of life for individuals and their families, and can increase healthcare costs. Older people are often prescribed a range of drugs for their health problems (including with sleep) many of which have side effects. This review considered the effectiveness of a programme of physical exercise involving brisk walking and moderate resistance training tailored for the needs of the older adult. These reviewers report that evidence from one small trial is encouraging, and further research is needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

以運動治療60歲以上成年人的睡眠問題

睡眠問題在成年人的盛行率,隨著年齡增加.雖不是所有中年後的睡眠變化都是病態的,然而嚴重惡化可能引起憂鬱,認知障礙,對照顧者亦是種壓力和增加醫療支出.最常見的睡眠障礙 (尤其是失眠) 治療是藥物.非藥物治療的療效一般認為比藥物慢,但沒有藥物耐受性或依賴性的風險.規律運動可能可以促進放鬆和提高身體基礎溫度,這些都有助導眠和維持睡眠狀態.

目標

評估老人 (60歲以上) 運動的療效

搜尋策略

搜尋MEDLINE (1966  October 2001); EMBASE (1980  January 2002), CINAHL (1982  January 2002; PsychINFO 1887 to 2002; The Cochrane Library (Issue 1, 2002); National Research Register (NRR [2002]), 搜尋本領域現有參考資料和所有得到的試驗報告.也有諮詢本領域專家.

選擇標準

隨機及對照組試驗,以運動治療原發性失眠,受試者80% 以上都超過60歲.有痴呆或憂鬱的受試者會被排除.

資料收集與分析

閱讀由電子資料庫中挑出的試驗摘要,以評估是否符合納入條件.資料依照客觀的或主觀的試驗結果而分開分析.

主要結論

個有43位失眠受試者的試驗,檢視運動對老年人的療效.治療後,進入睡眠狀態需要的時間包括男性及女性有輕微的改善和以整體睡眠品質指數及總睡眠時數,都有顯著進步.睡眠改進效率方面,則沒有顯著改善.某些個案進步的程度超過病理學層面,但信賴區間太大和小樣本數,使的解釋這些研究結果時要小心.

作者結論

因標準治療 (安眠藥) 的可能副作用,故可以討論臨床上對老人是否該使用其他治療.運動,雖然不適用此族群所有人,可增進睡眠和生活品質.需要研究為老人設計的運動計畫.

翻譯人

本摘要由成功大學附設醫院尹子真翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

以運動治療老年人睡眠問題.睡眠問題隨年老而常見,可能影響個人和家庭生活品質,增加醫療花費.老年人常被處方一些藥物治療健康問題 (包含睡眠問題), 其中很多有副作用.本回顧研究評估為老年人量身訂做的運動療程 (快走和中度訓練) 的療效.回顧研究由一個小試驗中,發現一個正面的證據,需要更進一步的研究.