Abstract
BackgroundModerate sleep complaints are major gerontological issue affecting as many as 80% of older adults. More intriguing findings have indicated that moderate sleep complaints were associated with cognitive decline, functional deterioration, clinical depression, and even morbidity and mortality among older adults. The aim of this study is to evaluate the effects of an activity-based lifestyle intervention on moderate sleep complaint among community-dwelling older adults.Methods/DesignThis sequential quantitative–qualitative mixed method study will randomly allocate 224 individuals to receive either the 16-week group-based moderate-intensity stepping exercise or 16-week health education. The exercise group receives three 60-min stepping exercises per week, whereas the education group receives weekly educative talks on health topics other than sleep. The primary outcomes are sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) and sleep pattern as measured by the actiwatch. Physical fitness and mood status are measured as mediating variables by using the Rockport walking test and Profile of Mood States. The qualitative part will invite 30 individuals from the exercise group who have different sleep-related treatment responses to participate in individual interviews to explore their overall perception of using stepping exercise as a lifestyle intervention to improve sleep. Mixed effects model with intention-to-treat analysis will be used for quantitative data. Inductive thematic analysis with a prior coding framework will be used for the qualitative data.DiscussionBy investigating the effects and the mediating mechanism of a moderate-intensity exercise program on moderate sleep complaints among older adults, this study will generate evidence of high scientific value and important public health implication. Understanding the sleep-promoting effects and acceptability of exercise informs how to apply lifestyle promotion as a public health practice to improve late-life moderate sleep complaints and forestall its progression to level of clinical severity.Trial registrationClinical Trial Registry Team, Center for Clinical Research and Biostatistics CUHK, CCRB00491. Registered on 1 December 2015.
Highlights
Moderate sleep complaints are major gerontological issue affecting as many as 80% of older adults
Research aims and hypotheses The primary aim of this study is to investigate the effects of moderate-intensity endurance exercise training on the sleep pattern and sleep quality of older adults who have moderate sleep complaints
As this study focuses on moderate sleep complaints, individuals who have reached insomnia of clinical severity according to DSMV will be excluded
Summary
Moderate sleep complaints are major gerontological issue affecting as many as 80% of older adults. More intriguing findings have indicated that moderate sleep complaints were associated with cognitive decline, functional deterioration, clinical depression, and even morbidity and mortality among older adults. Detrimental health impact of moderate sleep complaint Sleep problems are a major issue in gerontological care, with as many as 80% of older adults reporting one or more sleep complaints, such as difficulty in falling asleep and nocturnal awakening [1]. More intriguing findings have indicated that moderate sleep complaints were associated with an increased risk of clinical depression, chronic diseases including dementia, healthcare utilization, and mortality [4, 6, 7]
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