Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK.
Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK.
Psychoneuroendocrinology. 2022 Sep;143:105843. doi: 10.1016/j.psyneuen.2022.105843. Epub 2022 Jun 24.
Managing stress and having good quality sleep are inter-related factors that are essential for health, and both factors seem to be affected by physical activity. Although there is an established bidirectional relationship between stress and sleep, remarkably few studies have been designed to examine the effects of physical activity on cortisol, a key biomarker for stress, and sleep. Research is particularly scarce in older people despite both sleep and cortisol changing with age. This systematic literature review addresses this gap.
A systematic review was conducted following the PRISMA guidelines. Original, peer-reviewed records of intervention studies such as randomized controlled trials (RCTs) and non-RCTs with relevant control groups were eligible for inclusion. The Participant, Intervention, Comparison, Outcome (PICO) characteristics were (1) adults or older adults (2) physical activity programmes of any duration, (3) controls receiving no intervention or controls included in a different programme, (4) cortisol measurement, and subjective or objective measures of sleep.
Ten original studies with low-to-moderate risk of bias were included. Findings from this review indicated with moderate- and low-certainty evidence, respectively, that physical activity was an effective strategy for lowering cortisol levels (SMD [95% CI] = -0.37 [-0.52, -0.21] p < .001) and improving sleep quality (SMD [95% CI] = -0.30 [-0.56, -0.04], p = .02). Caution is needed to generalize these findings to the general population, as included trials were predominantly participants with breast cancer, included few males and no older adults.
Cortisol regulation and sleep quality are intertwined, and physical activity programmes could improve both in several ways. Further, physical activity may benefit adults with long term conditions or current poor (mental) health states the most, although more research is needed to support this claim fully. Few intervention studies have examined the inter-relationship between cortisol and sleep outcomes in males or older adults, indicating fruitful enquiry for future research.
管理压力和拥有高质量的睡眠是相互关联的健康因素，这两个因素似乎都受到身体活动的影响。尽管压力和睡眠之间存在着既定的双向关系，但很少有研究旨在检查身体活动对皮质醇（一种应激的关键生物标志物）和睡眠的影响。尽管睡眠和皮质醇随年龄增长而变化，但研究在老年人中尤其稀缺。本系统文献综述旨在填补这一空白。
按照 PRISMA 指南进行系统综述。原始的、经过同行评审的干预研究记录，如随机对照试验（RCT）和非 RCT 与相关对照组，符合纳入标准。参与者、干预、比较、结局（PICO）特征为：（1）成年人或老年人；（2）任何时长的身体活动方案；（3）对照组不接受干预或对照组纳入不同的方案；（4）皮质醇测量和主观或客观的睡眠测量。
纳入了 10 项原始研究，这些研究的偏倚风险为低至中度。本综述的结果表明，具有中等到低确定性证据，身体活动分别是降低皮质醇水平的有效策略（SMD [95% CI] = -0.37 [-0.52, -0.21]，p < 0.001）和改善睡眠质量（SMD [95% CI] = -0.30 [-0.56, -0.04]，p = 0.02）。需要谨慎地将这些发现推广到一般人群，因为纳入的试验主要是乳腺癌患者，男性参与者较少，没有老年人。
皮质醇调节和睡眠质量是相互交织的，身体活动方案可以通过多种方式改善这两者。此外，身体活动可能对患有长期疾病或当前（精神）健康状况不佳的成年人最有益，尽管需要更多的研究来充分支持这一说法。很少有干预研究检查过男性或老年人皮质醇和睡眠结果之间的相互关系，这表明未来的研究有很大的探索空间。
