Randomized, Controlled Trial of Exercise on Objective and Subjective Sleep in Parkinson's Disease

Abstract

A BS TRACT: Background: Sleep dysfunction is common and disabling in persons with Parkinson's Disease (PD). Exercise improves motor symptoms and subjective sleep quality in PD, but there are no published studies evaluating the impact of exercise on objective sleep outcomes. The goal of this study was to to determine if high-intensity exercise rehabilitation combining resistance training and bodyweight interval training, compared with a sleep hygiene control improved objective sleep outcomes in PD. Methods: Persons with PD (Hoehn & Yahr stages 2-3; aged ≥45 years, not in a regular exercise program) were randomized to exercise (supervised 3 times a week for 16 weeks; n = 27) or a sleep hygiene, no-exercise control (in-person discussion and monthly phone calls; n = 28). Participants underwent polysomnography at baseline and post-intervention. Change in sleep efficiency was the primary outcome, measured from baseline to postintervention. Intervention effects were evaluated with general linear models with measurement of group × time interaction. As secondary outcomes, we evaluated changes in other aspects of sleep architecture and compared the effects of acute and chronic training on objective sleep outcomes. Results: The exercise group showed significant improvement in sleep efficiency compared with the sleep hygiene group (group × time interaction: F = 16.0, P < 0.001, d = 1.08). Other parameters of sleep architecture also improved in exercise compared with sleep hygiene, including total sleep time, wake after sleep onset, and slow-wave sleep. Chronic but not acute exercise improved sleep efficiency compared with baseline. Conclusions: High-intensity exercise rehabilitation improves objective sleep outcomes in PD. Exercise is an effective nonpharmacological intervention to improve this disabling nonmotor symptom in PD.

Fat mass loss correlates with faster disease progression in amyotrophic lateral sclerosis patients: Exploring the utility of dual-energy x-ray absorptiometry in a prospective study

“…Whole body DEXA scans were obtained at enrollment (baseline), 6-month, and 12-month follow ups. Data for the PD cohort were obtained from a no-exercise control group in our recently completed, randomized controlled trial of persons with PD [ 14 ]. All PD subjects underwent whole body DEXA scan at enrollment and at 4 months.…”

A Short Overview of Changes in Inflammatory Cytokines and Oxidative Stress in Response to Physical Activity and Antioxidant Supplementation

“…Regular physical activity of light to moderate intensity supplies a multitude of health benefits, including decrements in the risk of various diseases such as cardiovascular disease, diabetes, cancer, dementia and Alzheimer's disease [10], adverse blood lipid profile [11], and improved non-alcoholic fatty liver disease (NAFLD) [12] and disabling non-motor symptom in Parkinson's disease (PD) [13]. In addition, these types of activities relieve antioxidant defense incrementally and diminish oxidative stress (OS), which ultimately leads to a reduction in mortality [9,[13][14][15]. It should be noted that free radicals and reactive oxygen species (ROS) were discovered in 1970 [16].…”

The Treatment of Sleep Dysfunction in Neurodegenerative Disorders

“…Akin to bright light therapy, there is a relative paucity of high-quality studies in Parkinson's specific cohorts, with most studies employing subjective outcomes suggesting benefit [193][194][195], whereas objective measures have tended to be negative [105,196]. Nonetheless, daytime physical exercise has been found to improve nocturnal actigraphy [197] and polysomnographic outcomes [198] in Parkinson's.…”