Regular physical activity and insomnia: An international perspective

Abstract

Both very low and very high levels of regular physical activity have been associated with degraded sleep quality. Cross-national variations in habitual physical activity levels, therefore, may contribute to cross-national differences in insomnia prevalence. The present study assesses and compares the extent to which weekly durations of moderate-intensity physical activity contribute to insomnia risk. Demographic, sleep, physical activity and general health profiles were obtained from a convenience sample of 9,238 adults drawn from five countries (South Africa, Australia, China, South Korea and the UK) using social media. Insomnia prevalence, using DSM-5 criteria, ranged from 4.1% (China) to 14.8% (UK). Evaluating risk using logistic regression adjusted only for age and gender, the lowest level of activity (<10 continuous min per week) was associated with significant insomnia risk (odds ratio = 1.37; 95% confidence interval = 1.05-1.79; p < 0.05). However, when adjusted for all covariates except country, only the highest level of physical activity (>300 min per week) was associated with significantly increased insomnia risk (odds ratio = 1.30; 95% confidence interval = 1.03-2.51; p < 0.05). Risk associated with high activity remained after the addition of "country" to the model (odds ratio = 1.31; 95% confidence interval = 1.02-1.69; p < 0.05). Across all models, female gender, low-rated health, low education and older age consistently increased insomnia risk. These cross-national data indicate that extremes of inactivity/activity can significantly influence insomnia risk independent of country. Insomnia risk associated with very low levels of activity may be mediated by poorer health and disadvantageous social status. However, while very high levels of activity increase insomnia risk independent of health and demographic factors, they may also confound with personally and occupationally demanding lifestyles.

Effects of Occupational and Leisure-Time Physical Activities on Insomnia in Korean Firefighters

“…Previous studies have suggested that gender, levels of education or socioeconomic status, marital status, smoking and alcohol consumption, caffeine intake, and psychiatric comorbidities, such as depression and anxiety, are associated with insomnia. More specifically, these past studies indicate that being female, having a lower level of education and socioeconomic status, greater alcohol consumption and caffeine intake, and simultaneously suffering from other psychological disorders are strongly associated with insomnia [ 2 , 3 , 4 , 5 ].…”

“…Furthermore, a previous study suggested that PA itself can be used as a non-pharmacological treatment for sleep disorders [ 9 ]. Although the effects of PA on sleep and insomnia symptoms are controversial as it depends on the type, time, or intensity of the specific PA [ 3 , 10 ]; in general, PA seems to have a more positive effect on sleep.…”

Validation of insomnia questionnaires in the general population: The Nord‐Trøndelag Health Study (HUNT)

“…Insomnia is the most common sleep disorder (Chung et al., 2015; Ohayon, 2002; Uhlig et al., 2014). Estimates range between 8% and 25% (Bayard et al., 2017; Chung et al., 2015; Hartescu & Morgan, 2019; Ohayon, 2002; Uhlig et al., 2014) depending on the criteria used (Buysse et al., 2006; Chung et al., 2015; Edinger et al., 2004). Prevalence is higher in women (Zhang & Wing, 2006), while the relation to age is less clear (Ohayon, 2002; Uhlig et al., 2014).…”

“…While insomnia is most accurately diagnosed by an insomnia expert through a face‐to‐face interview, large prevalence studies most often evaluate insomnia with sleep questionnaires or telephone interviews for efficiency (Chung et al., 2015; Hartescu & Morgan, 2019; Kalmbach et al., 2016; Sivertsen et al., 2012, 2014; Uhlig et al., 2014). Validation of questionnaire‐based diagnoses is therefore key to their interpretation.…”

Old and new methods in sleep research/sleep medicine and insomnia

“…Hartescu and Morgan () assessed and compared the extent to which weekly durations of moderate‐intensity physical activity contribute to risk of insomnia using a convenience sample of almost 10 000 adults drawn from South Africa, Australia, China, South Korea and the UK using social media. With a sophisticated analysis the authors were able to show that across all models, female gender, low‐rated health, low education and older age consistently increased risk of insomnia, which is not surprising.…”