体育活动干预对睡眠质量的长期影响：一项整群随机对照试验的二次分析

Longer-term effect of physical activity intervention on sleep quality: a secondary analysis of cluster randomized controlled trial.

作者信息

Li Xianlan, Ye Qin, Liu Qianqian, Peng Jie, Li Nanyan, Deng Qian, Hu Julinling, Yong Chan, Li Shiyi, Wang Yufei, Zhu Jingjie, Zhao Xing, Zhou Junmin

机构信息

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

School of Public Health, Georgia State University, Atlanta, GA, USA.

出版信息

Sleep. 2024 Dec 11;47(12). doi: 10.1093/sleep/zsae165.

DOI:10.1093/sleep/zsae165

PMID:39041369

Abstract

STUDY OBJECTIVES

To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers.

METHODS

This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months.

RESULTS

The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; p = .002), and the effect diminished at 24 months (-0.64; p = .06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; p = .01 vs. -1.27; p = .05), 12 months (-0.86; p = .03 vs. -0.84; p = .21), and 24 months (-0.80; p = .04 vs. -0.14; p = .84), although these improvements were below the minimum detectible level of the PSQI which is 1 point.

CONCLUSIONS

The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g. focusing on multiple behavioral interventions such as PA and a healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.

TRIAL REGISTRATION

Conceptualizing a physical activity intervention model among rural older adults in China: a socio-ecological model-based approach, https://www.chictr.org.cn/showprojEN.html?proj=123704, registered at Chinese Clinical Trial Registry on April 20, 2021 (identifier: ChiCTR2100045653).

摘要

研究目的

探讨体育活动（PA）干预对睡眠质量的长期影响，以及这种影响在日间小睡者和非小睡者之间是否存在异质性。

方法

本研究是对中国一项整群随机对照试验的二次分析。8个村庄按1:1随机分为干预组或对照组。干预组接受为期8周的PA干预，而对照组未接受。本研究的主要结局是24个月时匹兹堡睡眠质量指数（PSQI）全球评分的变化。

结果

511名参与者的平均年龄为70.94岁（标准差5.73），55.6%为女性。干预在8周时使PSQI全球评分得到改善（调整后平均差值-1.05；p = 0.002），而在24个月时效果减弱（-0.64；p = 0.06）。日间小睡者的PSQI全球评分在8周（调整后平均差值-0.98；p = 0.01 vs -1.27；p = 0.05）、12个月（-0.86；p = 0.03 vs -0.84；p = 0.21）和24个月（-0.80；p = 0.04 vs -0.14；p = 0.84）时有统计学意义的改善，尽管这些改善低于PSQI的最小可检测水平1分。

结论

为期8周的PA干预可有效改善睡眠质量，但在24个月后效果减弱且低于PSQI的最小可检测水平1分。PA干预对睡眠质量的影响在日间小睡者中更为明显。需要额外的干预措施（如关注多种行为干预，如体育活动和健康饮食）来维持体育活动对一般老年人群睡眠质量的有益影响。需要进一步的研究来确认小睡影响的机制并制定针对性的干预措施。