Resistance Training Emerges as Optimal Approach for Insomnia in Seniors

Recent research indicates that resistance training may be the most effective form of exercise for addressing insomnia among older adults. A comprehensive data analysis published in the journal Family Medicine and Community Health presents findings that highlight the benefits of muscle-strengthening exercises utilizing weights or body weight.

In addition to resistance training, the analysis suggests that aerobic exercises, as well as a combination of strength, aerobic, balance, and flexibility routines, also contribute positively to sleep quality among the elderly. As people age, the quality of sleep often deteriorates, with up to 20% of older adults experiencing insomnia. Poor sleep is associated not only with a variety of serious health issues and cognitive decline but also with increased risk of workplace underperformance and absenteeism.

Previous studies have established that exercise can alleviate insomnia symptoms, but the specific types of exercise that are most beneficial have remained unclear. To clarify this, researchers conducted a thorough review of clinical trials published until October 2022, which compared various forms of exercise against routine activities, standard care, or health education in individuals diagnosed with insomnia. The assessment utilized the Global Pittsburgh Sleep Quality Index (GPSQI) to measure sleep quality.

The reviewed studies encompassed several types of exercises, including aerobic activities like cycling, dancing, swimming, brisk walking, and gardening; resistance exercises such as weight lifting, push-ups, and planks; balance exercises including step-ups and heel-to-toe walking; flexibility exercises like yoga and Pilates; and mixed exercise programs.

A total of 24 studies involving 2,045 adults aged 60 and above (average age 70) were included in the pooled analysis. The majority of these studies were conducted in Asia (56%), followed by North America (16%), South America (16%), and Europe (12%). Notably, 20% of the studies took place in nursing homes.

The intensity of the exercises reported was primarily mild to moderate, with the average session lasting just over 50 minutes, executed two to three times a week over a duration of approximately 14 weeks. The pooled data analysis focused on combination and aerobic exercises, as there were insufficient studies on other types.

The analysis revealed that combined exercise significantly enhanced the GPSQI score by an average of 2.35 points, while aerobic exercise yielded an average improvement of 4.35 points. The network meta-analysis--a statistical method that aggregates multiple treatment effects--indicated that resistance training was the most effective, with an improvement of 5.75 points on the GPSQI. In comparison, aerobic exercises improved scores by 3.76 points, and combination exercises led to an enhancement of 2.54 points.

Among the comparison groups, sleep education showed the highest effectiveness, though its precise components were not clearly defined in the studies. However, it still fell short of the benefits provided by muscle-strengthening exercises.

The researchers acknowledged variability in the design and methodologies of the included studies, with many lacking detailed information on exercise intensity. Some exercises may pose challenges for older adults due to physical limitations. Nevertheless, the researchers concluded that both strength training and aerobic exercises offer significant benefits for improving subjective sleep quality when compared to ordinary activities.

For further details, refer to the study titled Impact of different types of physical exercise on sleep quality in older population with insomnia: a systematic review and network meta-analysis of randomised controlled trials published in Family Medicine and Community Health.