Background: Physical activity is known to influence sleep efficiency. Relatively little is known about the relationship between physical activity and sleep efficiency in young and older humans and the impact of exercise training on sleep efficiency in healthy older individuals. Objectives: To determine the relationship between physical fitness and daily energy expenditure with sleep efficiency in young and older subjects, and assess the effect of 12-month exercise training on sleep efficiency in healthy older participants. Methods: The relationship between physical fitness (maximal cycling test) and daily energy expenditure (accelerometry) with sleep efficiency (accelerometry) was examined cross-sectionally in 12 healthy young adults (27 ± 5 years) and 21 healthy older participants (69 ± 3 years). Subsequently, the effect of 12-month exercise training (n = 11) or control period (n = 10) on sleep efficiency in older participants was examined using a randomized controlled trial. Results: Daily energy expenditure and sleep efficiency did not differ between young and older subjects. A significant correlation was found between energy expenditure and sleep efficiency (r = 0.627, p = 0.029) in young adults, but not in older participants (r = –0.158, p = 0.49). Physical fitness did not correlate with sleep efficiency in either group. Exercise training significantly improved physical fitness (15.0%, p < 0.001), but failed to alter sleep characteristics such as sleep efficiency, sleep onset latency and awakenings. Conclusions: We found that young adults with higher daily energy expenditure have greater sleep efficiency, whilst this relationship is diminished with advanced age. In contrast, we found no correlation between physical fitness and sleep characteristics in healthy young or older participants, which may explain the lack of improvement in sleep characteristics in older participants with 12-month exercise training. Exercise training may be more successful in subjects with existing sleep disturbances to improve sleep characteristics rather than in healthy older subjects.

Shochat T, Umphress J, Israel AG, Ancoli-Israel S: Insomnia in primary care patients. Sleep 1999;22(suppl 2):S359–S365.
Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV: Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004;27:1255–1273.
Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG: Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18:425–432.
Maggi S, Langlois JA, Minicuci N, Grigoletto F, Pavan M, Foley DJ, Enzi G: Sleep complaints in community-dwelling older persons: prevalence, associated factors, and reported causes. J Am Geriatr Soc 1998;46:161–168.
Hohagen F, Kappler C, Schramm E, Rink K, Weyerer S, Riemann D, Berger M: Prevalence of insomnia in elderly general practice attenders and the current treatment modalities. Acta Psychiatr Scand 1994;90:102–108.
Morin CM, Wooten V: Psychological and pharmacological approaches to treating insomnia: critical issues in assessing their separate and combined effects. Clin Psychol Rev 1996;16:521–542.
Buscemi N, Vandermeer B, Friesen C, Bialy L, Tubman M, Ospina M, Klassen TP, Witmans M: The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of rcts. J Gen Intern Med 2007;22:1335–1350.
Nowell PD, Mazumdar S, Buysse DJ, Dew MA, Reynolds CF, 3rd, Kupfer DJ: Benzodiazepines and zolpidem for chronic insomnia: a meta-analysis of treatment efficacy. JAMA 1997;278:2170–2177.
Englert S, Linden M: Differences in self-reported sleep complaints in elderly persons living in the community who do or do not take sleep medication. J Clin Psychiatry 1998;59:137–144, quiz 145.
van der Hooft CS, Schoofs MW, Ziere G, Hofman A, Pols HA, Sturkenboom MC, Stricker BH: Inappropriate benzodiazepine use in older adults and the risk of fracture. Br J Clin Pharmacol 2008;66:276–282.
Adam K, Oswald I: Protein synthesis, bodily renewal and the sleep-wake cycle. Clin Sci (Lond) 1983;65:561–567.
Berger RJ, Phillips NH: Comparative aspects of energy metabolism, body temperature and sleep. Acta Physiol Scand Suppl 1988;574:21–27.
Driver HS, Taylor SR: Exercise and sleep. Sleep Med Rev 2000;4:387–402.
Youngstedt SD, O’Connor PJ, Dishman RK: The effects of acute exercise on sleep: a quantitative synthesis. Sleep 1997;20:203–214.
O’Connor PJ, Youngstedt SD: Influence of exercise on human sleep. Exerc Sport Sci Rev 1995;23:105–134.
Kubitz KA, Landers DM, Petruzzello SJ, Han M: The effects of acute and chronic exercise on sleep. A meta-analytic review. Sports Med 1996;21:277–291.
Sherrill DL, Kotchou K, Quan SF: Association of physical activity and human sleep disorders. Arch Intern Med 1998;158:1894–1898.
Vuori I, Urponen H, Hasan J, Partinen M: Epidemiology of exercise effects on sleep. Acta Physiol Scand Suppl 1988;574:3–7.
King AC, Oman RF, Brassington GS, Bliwise DL, Haskell WL: Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. JAMA 1997;277:32–37.
King AC, Pruitt LA, Woo S, Castro CM, Ahn DK, Vitiello MV, Woodward SH, Bliwise DL: Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J Gerontol A Biol Sci Med Sci 2008;63:997–1004.
Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC: Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med 2010;11:934–940.
Youngstedt SD: Ceiling and floor effects in sleep research. Sleep Med Rev 2003;7:351–365.
Youngstedt SD, Perlis ML, O’Brien PM, Palmer CR, Smith MT, Orff HJ, Kripke DF: No association of sleep with total daily physical activity in normal sleepers. Physiol Behav 2003;78:395–401.
Buysse DJ, Ancoli-Israel S, Edinger JD, Lichstein KL, Morin CM: Recommendations for a standard research assessment of insomnia. Sleep 2006;29:1155–1173.
Fruin ML, Rankin JW: Validity of a multi-sensor armband in estimating rest and exercise energy expenditure. Med Sci Sports Exerc 2004;36:1063–1069.
Balady GJ, Arena R, Sietsema K, Myers J, Coke L, Fletcher GF, Forman D, Franklin B, Guazzi M, Gulati M, Keteyian SJ, Lavie CJ, Macko R, Mancini D, Milani RV: Clinician’s guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association. Circulation 2010;122:191–225.
Germain A, Buysse DJ, Kupfer DJ: Preliminary validation of a new device for studying sleep. Sleep 2006;29:A351.
O’Driscoll DM, Turton AR, Copland JM, Strauss BJ, Hamilton GS: Energy expenditure in obstructive sleep apnea: validation of a multiple physiological sensor for determination of sleep and wake. Sleep Breath, DOI 10.1007/s11325–012–0662–x.
Jones H, George K, Edwards B, Atkinson G: Exercise intensity and blood pressure during sleep. Int J Sports Med 2009;30:94–99.
Leary AC, Struthers AD, Donnan PT, MacDonald TM, Murphy MB: The morning surge in blood pressure and heart rate is dependent on levels of physical activity after waking. J Hypertens 2002;20:865–870.
Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak CP: The role of actigraphy in the study of sleep and circadian rhythms. Sleep 2003;26:342–392.
Sadeh A: The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev 2011;15:259–267.
Jean-Louis G, Kripke DF, Ancoli-Israel S, Klauber MR, Sepulveda RS, Mowen MA, Assmus JD, Langer RD: Circadian sleep, illumination, and activity patterns in women: Influences of aging and time reference. Physiol Behav 2000;68:347–352.
Huang YL, Liu RY, Wang QS, Van Someren EJ, Xu H, Zhou JN: Age-associated difference in circadian sleep-wake and rest-activity rhythms. Physiol Behav 2002;76:597–603.
Wilson KG, Watson ST, Currie SR: Daily diary and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain. Pain 1998;75:75–84.
Meadows R, Luff R, Eyers I, Venn S, Cope E, Arber S: An actigraphic study comparing community dwelling poor sleepers with non-demented care home residents. Chronobiol Int 2010;27:842–854.
Kramer CJ, Kerkhof GA, Hofman WF: Age differences in sleep-wake behavior under natural conditions. Pers Individ Dif 1999;27:853–860.
Krystal AD, Edinger JD: Measuring sleep quality. Sleep Med 2008;9(suppl 1):S10–S17.
Eijsvogels T, George K, Shave R, Gaze D, Levine BD, Hopman MT, Thijssen DH: Effect of prolonged walking on cardiac troponin levels. Am J Cardiol 2010;105:267–272.
Eijsvogels TM, Veltmeijer MT, Schreuder TH, Poelkens F, Thijssen DH, Hopman MT: The impact of obesity on physiological responses during prolonged exercise. I Int J Obes (Lond) 2011;35:1404–1412.
Jones H, George K, Edwards B, Atkinson G: Is the magnitude of acute post-exercise hypotension mediated by exercise intensity or total work done? Eur J Appl Physiol 2007;102:33–40.
Horne JA, Moore VJ: Sleep EEG effects of exercise with and without additional body cooling. Electroencephalogr Clin Neurophysiol 1985;60:33–38.
Krauchi K: The human sleep-wake cycle reconsidered from a thermoregulatory point of view. Physiol Behav 2007;90:236–245.
Waterhouse J, Drust B, Weinert D, Edwards B, Gregson W, Atkinson G, Kao S, Aizawa S, Reilly T: The circadian rhythm of core temperature: origin and some implications for exercise performance. Chronobiol Int 2005;22:207–225.
Koopman R, van Loon LJ: Aging, exercise, and muscle protein metabolism. J Appl Physiol 2009;106:2040–2048.
Koopman R, Saris WH, Wagenmakers AJ, van Loon LJ: Nutritional interventions to promote post-exercise muscle protein synthesis. Sports Med 2007;37:895–906.
Meintjes AF, Driver HS, Shapiro CM: Improved physical fitness failed to alter the eeg patterns of sleep in young women. Eur J Appl Physiol Occup Physiol 1989;59:123–127.
Paxton SJ, Trinder J, Shapiro CM, Adam K, Oswald I, Graf KJ: Effect of physical fitness and body composition on sleep and sleep-related hormone concentrations. Sleep 1984;7:339–346.
Lee AJ, Lin WH: Association between sleep quality and physical fitness in female young adults. J Sports Med Phys Fitness 2007;47:462–467.
Lefevre J, Philippaerts R, Delvaux K, Thomis M, Claessens AL, Lysens R, Renson R, Vanden Eynde B, Vanreusel B, Beunen G: Relation between cardiovascular risk factors at adult age, and physical activity during youth and adulthood: the Leuven Longitudinal Study on Lifestyle, Fitness and Health. Int J Sports Med 2002;23(suppl 1):S32–S38.
Blair SN, Kohl HW 3rd, Barlow CE, Paffenbarger RS Jr, Gibbons LW, Macera CA: Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA 1995;273:1093–1098.
Alessi CA, Schnelle JF, MacRae PG, Ouslander JG, al-Samarrai N, Simmons SF, Traub S: Does physical activity improve sleep in impaired nursing home residents? J Am Geriatr Soc 1995;43:1098–1102.
Benloucif S, Orbeta L, Ortiz R, Janssen I, Finkel SI, Bleiberg J, Zee PC: Morning or evening activity improves neuropsychological performance and subjective sleep quality in older adults. Sleep 2004;27:1542–1551.
Guilleminault C, Clerk A, Black J, Labanowski M, Pelayo R, Claman D: Nondrug treatment trials in psychophysiologic insomnia. Arch Intern Med 1995;155:838–844.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.