Exercise to Improve Sleep in People with Parkinson’s Disease

#022-Exercise to Improve Sleep in People with Parkinson’s Disease

ByAl-Jallad

Estimated reading time: 1 minute, 57 seconds

Exercise can Improve Sleep Quality in Person with Parkinson’s Disease

??‍?What we know

64% to 98% of persons with Parkinson’s disease (PD) experience sleep disorders, these can be rapid eye movement (REM) sleep behavior disorder (30-46%), insomnia (20-80%), restless leg syndrome (3-22%), sleep-related breathing disorder (15-76%) and excessive daytime sleepiness (20-60%).

Sleep disorders can be due the nocturnal motor symptoms of the disease, the side-effects of medications, and the progressive neurodegeneration of sleep-regulatory brain structure. In some studies, physical exercise has been shown to improve aspects of sleep in healthy population.

?Aim

This systematic review and meta-analysis evaluate the evidence in support of the use of exercise to improve sleep quality in PD.

10 RCTs and 2 non-RCTs with 690 participant.

Type of exercises used by the included studies (in experimental groups):

  • Multimodal training combining different types of exercise used by 3 studies.
  • Cardiovascular training used by 3 studies.
  • Strength training, a combination of strength and muscle endurance training, Yoga, Qigong, Tai-chi and Brazilian samba. (1 study each)
?Doses:

Mild to moderate intensity (4 studies), moderate to maximal intensity (4 studies).

20 to 60 minutes sessions, 2 to 5 sessions/week for 4 weeks to 6 months.

?Results

  • The exercise group significantly improved subjective sleep quality compared to control group. (Moderate effect, data pooled from 12 studies)
  • Only 1 study used objectively measured sleep quality using polysomnography, exercise significantly improved sleep efficiency, reduced wake time after sleep onset and increased total sleep time.
  • No significant difference between groups regarding sleep latency.

Sub-group meta-analysis results

  • Mild to moderate exercise showed no effect.
  • Moderate to maximal intensities showed significant effect.
  • The largest effect of exercise types was Multimodal interventions combining different types of exercise and, to a lesser extent, interventions using exclusively cardiovascular exercise.
  • Non-significant effect was shown by resistance training or meditative movement exercise interventions (Yoga, Qigong, Tai-chi).
  • High-intensity resistance training demonstrated to have large effects on different measures of objective sleep quality in the only study that implemented these measures.

?In conclusion

  • Physical exercise has a positive impact on subjective sleep quality in persons with PD.
  • Multimodal training programs performed at vigorous intensities appear to be the most effective exercise intervention to improve subjective sleep quality.

The studies had limited methodological quality, with a mean SD score of PEDro scale was 5.8.

?️Recommended reads:

References

*Calculation is based on the average reading speed that around 200 words per minute (wpm).

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