Comparison of the Effects of Morning and Evening Walks on Nighttime Sleep Quality Among Elderly People: A Randomized, Crossover, Clinical Trial

Abstract

Background and Aim: Sleep disorder is one of the most prevalent health problems among elderly people. Regular physical exercise can promote calmness. The current study aimed at comparing the effects of morning and evening walks on nighttime sleep quality among elderly people. Methods: The current 2-group randomized, crossover trial was conducted on 50 eligible elderly people. Participants were randomly assigned to morning-evening and evening-morning walk groups. In the first phase of the study, cases in the groups went on morning and evening walks, respectively, for 4 weeks. After a 4-week washout period and in the second phase of the study, cases in the groups went on 4-week evening and morning walks, respectively. Sleep quality was measured using the Pittsburg sleep quality index (PSQI) at 4 assessment time points, namely before the intervention, immediately after the first intervention, immediately after the washout period (i e, immediately before the second intervention), and immediately after the second intervention. The SPSS software version 18.0 was employed to analyze the data by the paired- and the independent-samples t tests and the intergroup repeated-measures analysis of variance (ANOVA). Significance level for all statistical tests was 0.05. Results: At both baseline assessments (i e, before the first and the second interventions), groups did not differ significantly regarding the mean scores of sleep quality (P >0.05).However, after both morning and evening walks, the mean score of sleep quality decreased significantly compared with the baseline readings (P < 0.05). Crossover analysis showed that the effects of morning walk on sleep quality did not significantly differ from the effects of evening walk (P = 0.873). Conclusions: The findings of the current study showed that morning and evening walks similarly improved sleep quality. Thus, elderly people can be recommended to include walking exercise in their daily schedule in order to improve their sleep quality.