EXERCISE AND SLEEP

Question 1

PHYSICAL ACTIVITY DEFINITION?

Answer 1

ANY BODILY MOVEMENT PRODUCED BY SKELETAL MUSCLES THAT REQUIRE ENERGY EXPENDITURE

Question 2

EXERCISE DEFINITION?

Answer 2

A SUBSET OF PHYSICAL ACTIVITY THAT IS PLANNED, STRUCTURED AND REPETITIVE AND HAS A FINAL OR AN INTERMEDIATE OBJECTIVE OF THE IMPROVEMENT OR MAINTENANCE OF PHYSICAL FITNESS

Question 3

PHYSICAL FITNESS DEFINITION?

Answer 3

SET OF ATTRIBUTES THAT ARE EITHER HEALTH- OR SKILL-RELATED

THE DEGREE TO WHICH PEOPLE HAVE THESE ATTRIBUTES CAN BE MEASURED WITH SPECIFIC TESTS

Question 4

SLEEP DISORDERS?

Answer 4

A COLLECTIVE TERM THAT REFERS TO CONDITIONS THAT AFFECT SLEEP QUALITY, TIMING, OR DURATION AND IMPACT A PERSON’S ABILITY TO PROPERLY FUNCTION WHILE THEY ARE AWAKE

Question 5

IN SLEEP APNEA, HOW LONG DOES BREATHING STOP DURING SLEEP?

Answer 5

10 OR MORE SECONDS

Question 6

THE MOST COMMON SLEEP DISORDER

Answer 6

INSOMNIA

Question 7

ACTIGRAPHY?

Answer 7

Actigraphy is a non-invasive method of monitoring human rest/activity cycles. A small actigraph unit, also called an actimetry sensor, is worn for a week or more to measure gross motor activity. The unit is usually in a wristwatch-like package worn on the wrist.

Question 8

TOTAL SLEEP TIME?

Answer 8

The total sleep time is the total amount of sleep time scored during the total recording time. This includes time from sleep onset to sleep offset and is distributed throughout the sleep time as minutes of Stage N1 sleep, Stage N2 sleep, Stage N3, and rapid eye movement (REM) sleep.

• DETERMINED THROUGH MEASURING OF SLEEP QUANTITY

Question 9

SLEEP ONSET LATENCY (SOL)?

Answer 9

THE TIME NEEDED FROM GETTING INTO THE BED/BEING FULLY AWAKE TO FALLING ASLEEP

Question 10

SLEEP EFFICIENCY?

Answer 10

THE AMOUNT OF TIME SPENT ACTUALLY SLEEPING WHILE IN BED

Question 11

WAKE AFTER SLEEP ONSET (WASO)?

Answer 11

THE AMOUNT OF TIME AN INDIVIDUAL SPENDS AWAKE AFTER THEY HAVE FALLEN ASLEEP AND BEFORE THEY FULLY WAKE UP (USUALLY MEASURED IN MINUTES)

Question 12

WAKEFULNESS AND AMOUNT OF TIMES AWAKE (SLEEP DISTURBANCES)?

Answer 12

MEASUREMENTS REFERRING TO HOW MANY MINUTES ARE SPENT AWAKE DURING NIGHT OR HOW MANY TIMES WAKINGS OCCUR DURING THE NIGHT

Question 13

PITTSBURGH SLEEP QUALITY INDEX (PSQI)?

Answer 13

• VALIDATED PATIENT REPORTED SLEEP QUALITY QUESTIONNAIRE
• A SERIES OF QUESTIONS ABOUT SLEEP-RELATED BEHAVIOURS
• USED IN BOTH CLINICAL AND RESEARCH SETTINGS
• QUESTIONS IN 7 CATEGORIES, INCLUDING SLEEP QUALITY, SLEEPING DISTURBANCES, AND DAYTIME DYSFUNCTION

Question 14

RELATIONSHIP BETWEEN EXERCISE AND SLEEP IS:

Answer 14

BIDIRECTIONAL (INACTIVITY CAN LEAD TO POORER SLEEP, BUT INSUFFICIENT SLEEP CAN LEAD TO LOWER ACTIVITY LEVELS)

Question 15

EFFECTS OF EVENING EXERCISE ON SLEEP?

Answer 15

A SYSTEMATIC REVIEW AND META-ANALYSIS (STUTZ ET AL, 2019) FOUND THAT THERE IS NO SUPPORT FOR THE HYPOTHESIS THAT EVENING EXERCISE NEGATIVELY AFFECTS SLEEP, IN FACT RATHER THE OPPOSITE (CAN IMPROVE SLOW WAVE SLEEP)

• HOWEVER, SLEEP-ONSET LATENCY, TOTAL SLEEP TIME AND SLEEP EFFICIENCY MIGHT BE IMPAIRED AFTER VIGOROUS EXERCISE ENDING 1 HOUR OR LESS BEFORE BEDTIME!

Question 16

LONG TERM EFFECTS OF EXERCISE, I.E. CHRONIC ADAPTATIONS OF EXERCISE?

Answer 16

• LARGELY DEPENDENT ON EXERCISE TYPE
• A CONTINUUM RATHER THAN ISOLATED EFFECTS (THERE IS ALWAYS OVERLAP, CANNOT DO EXERCISES FOR JUSTONE PURPOSE/MUSCLE GROUP AND AVOID OTHERS)
• SKELETAL MUSCLE ADAPTATIONS
• LIGAMENT AND TENDON ADAPTATIONS
• METABOLIC ADAPTATIONS
• LONG TERM CARDIAC ADAPTATION ((VENTRICULAR ENLARGEMENT, LOWER RESTING HEART RATE, HIGHER CARDIAC OUTPUT..)
• LONG TERM RESPIRATORY ADAPTATIONS

Question 17

WHY MIGHT IT BE HELPFUL FOR SLEEP QUALITY TO BE PHYSICALLY FITTER?

Answer 17

• EFFECTS OF EXERCISE ON CARDIAC AND AUTONOMIC FUNCTION DURING SLEEP (INCREASE PARAS. AND DECREASE SYMPATHETIC ACTIVITY, ESP IMPORTANT DURING SLOW WAVE SLEEP)
• EXERCISE AND MELATONIN (MELATONIN INCREASES DURING SLEEP, AND DURINGE EXERCISE?)
• EFFECTS OF EXERCISE ON MOOD DURING THE NIGHT (IMPROVES MOOD, DECREASES REM SLEEP - PROBABLY ATTRIBUTABLE TO BRAIN-DERIVED NEUROTROPIC FACTOR, HAS ANTIDEPRESSANT PROPERTIES)
• EFFECTS OF EXERCISE ON ENDOCRINE, METABOLIC AND IMMUNE FUNCTION DURING SLEEP REMAINS TOPICS FOR RESEARCH

Question 18

EFFECTS OF EXERCISE ON SLEEP AMONG CANCER PATIENTS?

Answer 18

• MOST CANCER PATIENTS REPORT SLEEP DISTURBANCES
• EXERCISE INTERVENTION CAN REDUCE SLEEP DISTURBANCES IN PATIENTS WITH CANCER
• NO SIGNIFICANT IMPROVEMENT IN SLEEP QUALITY AFTER AN EXERCISE INTERVENTIONS

Question 19

EXERCISE INDUCED MUSCLE DAMAGE (EIMD)?

Answer 19

A TRANSIENT PHENOMENON CAUSED BY UNACCUSTOMED, DAMAGING EXERCISE AND IS CHARACTERISED BY STRUCTURAL DAMAGE TO MYOFIBERS AND SECONDARY INFLAMMATION RESULTING FROM LEUKOCYTE INFILTRATION INTO THE DAMAGED TISSUES

Question 20

HOW CAN LONGER/BETTER QUALITY SLEEP IMPACT PAIN AND EXERCISE?

Answer 20

• SLEEP CAN SUPPORT MUSCLE RECOVERY AFTER EXERCISE (RANGING FROM SIMPLE PHYSICAL ACTIVITY TO EIMD; EXERCISE INDUCED MUSCLE DAMAGE
• THE CONCEPT OF SLEEP EXTENSION COULD LEAD TO BETTER REGENERATION OF MUSCLE GIVEN THE INCREASE IN IGF-1 LEVELS AND POSSIBLY THE CONTROL OF LOCAL INFLAMMATION
• IN HUMANS, THE POTENTIAL VALUE OF SLEEP INTERVENTIONS TO PROMOTE AN ANABOLIC HORMONAL PROFILE HAS BEEN DEMONSTRATED BY SLEEP EXTENSION
• INCREASING DAILY TOTAL SLEEP TIME BY LESS THAN 1 HOUR DURING 7 DAYS INCREASES CIRCULATING CONCETRATION OF IGF-1 BEFORE AND DURING TOTAL SLEEP DEPRIVATION

Question 21

IMPACT OF INSUFFICIENT SLEEP ON PHYSICAL ACTIVITY?

Answer 21

• CORRELATION BETWEEN LOW LEVELS OF PA AND POOR SLEEP
• SLEEP DEPRIVATION KNOWN TO SUPPRESS CIRCULATING TROPHIC FACTORS SUCH AS INSULIN-LIKE GROWTH FACTOR (IGF-I) AND BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) –> THIS NEGATIVELY IMPACTS MUSCLE RECOVERY FROM EXERCISE
• TOTAL SLEEP DEPRIVATION OR RESTRICTION IS KNOWN TO ALTER NOT ONLY BLOOD
  HORMONES BUT ALSO CYTOKINES THAT MIGHT BE RELATED TO SKELETAL MUSCLE RECOVERY
• SOME RESEARCH SHOWED SLEEP DEPRIVATION CAUSES A LOSS OF MUSCLE MASS (DUE TO TYPE IIB MUSCLE FIBRE ATROPHY; fast twitch muscle fiber) AND REDUCES MUSCLE REGENERATION AFTER DAMAGE (INDUCED BY CRYOLESIONS)
• OTHER DATA SUGGESTS JUST ONE NIGHT OF PARTIAL SLEEP DEPRIVATION IMPAIRS RECOVERY FROM A SINGLE EXERCISE SESSION

Question 22

EXERCISE AND INSOMNIA?

Answer 22

• AEROBIC EXERCISE IMPROVES SELF-REPORTED SLEEP AND QUALITY OF LIFE IN OLDER ADULTS WITH INSOMNIA (REDUCTION OF DEPRESSIVE SYMPTOMS AND DAYTIME SLEEPINESS + IMPROVEMENTS IN VITALITY), IMPROVES TIME NEEDED TO FALL ASLEEP, TOTAL SLEEPING TIME, SLEEP EFFICACY…
• EXERCISE COULD BE CONSIDERED AS A NON PHARMACOLOGICAL TREATMENT FOR INSOMNIA

Question 23

EXERCISE AND OBSTRUCTIVE SLEEP APNOEA SYNROME (OSAS)?

Answer 23

• META ANALYSIS ON THE TOPIC CONDUCTED IN 2021

‘EXERCISE PREVENTS A DYSREGULATION OF BOTH DAYTIME AND NIGHT-TIME CARDIOVASCULAR AUTONOMIC FUNCTION, REDUCES BODY WEIGHT, HALTS THE ONSET AND PROGRESS OF INSULIN RESISTANCE, WHILE IT AMELIORATES EXCESSIVE DAYTIME SLEEPINESS, COGNITIVE DECLINE, AND MOOD DISTURBANCES, CONTRIBUTING TO AN OVERALL GREATER SLEEP QUALITY AND QUALITY OF LIFE’

RECOMMENDED EXERCISE PROGRAMME FOR PATIENTS WITH OSAS:
- 3-9 MONTHS, 3-5 WEEKLY SESSIONS, LASTING 45-60 MINS, 60% OF EACH SESSION SHOULD BE ALLOCATED TO AEROBIC EXERCISES

Question 24

SLEEP AND ATHLETIC PERFORMANCE?

Answer 24

• NOT MUCH CONVINCING EVIDENCE YET, MORE RESEARCH NEEDED TO MAKE CONCERETE ASSOCIATIONS
• INSUFFICIENT SLEEP MAY ENHANCE PERCEPTION OF EXERTION
• POSSIBLE INCREASED LAPSING, COGNITIVE SLOWING, MEMORY IMPAIRMENT, DECREASED VIGILANCE AND SUSTAINED ATTENTION, SHIFTS IN OPTIMUM RESPONSE CAPABILITIES AND EMOTIONAL REGULATION

MORE KNOWN ABOUT REOVERY AND SLEEP:

• ACUTE AND CHRONIC SUBOPTIMAL SLEEP IS ASSOCIATED WITH INCREASED RISK OF MUSCULOSKELETAL PAIN AND SPORTS INJURY (UKNOWN OF SLEEP LOSS PREDISPOSES THE ATHLETE TO SPECIFIC TYPES OF MUSCULOSKELETAL INJURIES)
• ACUTE SLEEP DEPRIVATION INCREASES THE RISK OF ‘OVER-STRAIN’ INJURIES LINKED TO THE DECREASE OF PROPRIOCEPTION, POSTURAL CONTROL, AND REACTION TIME
• IN CONTACT SPORTS, THERE IS AN ASSOCIATION BETWEEN ‘POOR’ SLEEP AND CONCUSSION
• SLEEP PROBLEMS ARE ALSO ASSOCIATED WITH AN INCREASED RISK OF CHRONIC PAIN IN THE LOWER BACK, NECK AND SHOULDERS + PROBLEMS WITH TEMP REGULATION (IN BOTH HOT AND COLD ENVIRONMENTS)

Question 25

POPULATIONS OF KEY INTEREST IN TERMS OF IMPROVING SLEEP?

Answer 25

• EMERGING ADULTS (POOR SLEEP DISPROPORTIONATELY NEGATIVELY IMPACTS THOSE IN LATE ADOLESCENCE THROUGH THEIR EARLY 20s BECAUSE THE RELATIONSHIP BETWEEN SLEEP DURATION AND CARDIOMETABOLIC RISK AND NEUROCOGNITIVE DYSFUNCTION IS ESPECIALLY PRONUNCED AMONG YOUNG ADULTS)
• OLDER ADULTS

Question 26

SLEEP HYGIENE ADVICE?

Answer 26

• MAY BE GENERAL, BUT IS OFTEN AIMED AT UNIVERSITY STUDENTS
  E.G.
• MAINTAIN A REGULAR SLEEP SCHEDULE
• SEEK BRIGHT LIGHT DURING THE DAY, AND AVOID IT AT NIGHT
• THE BEDROOM SHOULD BE KEPT COOL, DARK AND COMFORTABLE
• AVOID CAFFEINE AT LEAST 6 HRS BEFORE BEDTIME
• AVOID NICOTINE AS IT IS A STIMULANT
• ALCOHOL MIGHT HELP FALLING ASLEEP FASTER, BUT SHOULD BE AVOIDED CLOSE TO SLEEP TIME AS IT CAN ADVERSLY AFFECT SLEEP QUALITY
• AVOID CONSUMING EXCESSIVE FOOD AND LIQUIDS AT NIGHT
• AVOID OBSSESSIVE CLOCK WATCHING
• AVOID NAPS IF YOU HAVE DIFFICULTY FALLING ASLEEP (HOWEVER, ATHLETES MIGHT FIND NAPS HELPFUL)
• USE BEDS FOR SLEEP ONLY (OTHER ACTIVITIES SHOULD BE DONE OUTSIDE YOUR BED, IF YOU CAN’T FALL ASLEEP, GET UP AND TRY LATER)

Question 27

UK PHYSICAL ACTIVITY GUIDELINES FOR OLDER ADULTS (65+)?

Answer 27

• HAVE A RENEWED FOCUS ON RESISTANCE EXERCISE (BUILDING STRENGTH)
• AT LEAST 150 MINUTES OF MODERATE INTENSITY ACTIVITY PER WEEK OR 75 MINUTES OF VIGOROUS INTENSITY ACTIVITY PER WEEK OR A COMBINATION OF BOTH