Do you throw it and spin it every night? While more physical activity throughout the week is a known way to improve sleep, new research shows that you don’t have to run a marathon or visit the gym to enjoy the benefits.
The low-intensity low impact exercise can improve sleep and alleviate symptoms of insomnia, according to a new meta-analysis of 22 randomized clinical trials published in the BMJ evidence-based medical journal on Tuesday..
The trial included 13 non-pharmaceutical insomnia treatments, including seven fitness regimens, acupuncture, massage and cognitive behavioral therapy.
Of the exercises investigated, yoga, tai chi, walking or jogging provided the most promising evidence to help participants fall asleep faster and stay asleep longer.
“The growing evidence suggests that regular physical activity not only improves physical health, but also improves sleep quality,” said Zhi-Jun Bu, the first author of the study and a doctoral student in clinical medicine at Nanjing Medical University. “However, most existing studies focus on one type of exercise and do not have a comprehensive comparison.”
The study points to potential cost-effective, drug-free alternatives to traditional insomnia treatment, and further understanding the unique benefits of each exercise could be the next step, BU said he conducted the study while earning his master’s degree from Beijing Medical University.
What causes insomnia and how is it treated?
It is not uncommon to struggle with frequent seizures of restlessness. A 2020 survey by the Centers for Disease Control and Prevention in the US found that about 14.5% of adults have reported falling asleep for the past few days or every day.
In a clinical setting, insomnia is commonly diagnosed when someone struggles to fall asleep and experiences sleep disruptions that are frequently elicited more than three times a week.
Long-term insomnia can be attributed to a wide range of environmental and hereditary causes, including stress, poor sleep habits, chronic pain, medication, or other sleep disorders such as sleep apnea, Paruthi said.
Typically, the initial line of treatment for insomnia involves CBT, a psychological approach aimed at regulating patients’ thoughts, feelings, and behaviors regarding sleep.
“It is common to expect (insomnia patients) to lose hope for sleep at night and lie in bed in the heart of lace,” Parti said. “CBT allows them to rethink how they are approaching and think about sleep.”
Unlike other story-oriented treatments, CBT does not need to delve into a patient’s past experiences or traumatic events, Paruthi said. Rather, this approach helps patients develop techniques to relax their minds and move to sleep.
“There is very strong evidence that CBT can work just as well as medications and can last longer as people are creating new habits,” Paruthi added that insomnia patients usually see improvement in symptoms after 2-6 weeks of treatment.
On the other hand, exercise is not considered first-line treatment for insomnia in the clinical teaching literature. Still, Paruthi said he frequently recommends that moderate-intensive physical activity, along with other methods, be highly recommended for 150 minutes a week.
Important Note: Consult your doctor before starting a new exercise program. If you feel pain, stop immediately.
Of the randomized clinical trials analyzed by the BU team, these three physical activities had the best evidence behind their effectiveness as a standalone treatment for insomnia.
Yoga: Sessions of two to six 45-60-minute yoga sessions over a week to four months increased the duration of sleep for nearly two hours per night, reducing the number of cases of awakening after falling asleep for an hour.
“Yoga can promote better sleep by promoting deep breathing, body awareness and a calm mental state. This helps reduce stress and anxiety.
Tai Chi: Over three to four months, 45-60-minute sessions a week increased sleep duration for over 50 minutes, and waking up for over 30 minutes to shorten the time.
Chinese martial arts involve combining a series of flowing, low-impact movements with deep, slow breathing that help reduce stress and calm the body, Bu said.
Walking or Jogging: Three to five 30-75 minute sessions were shown to reduce symptoms of insomnia based on a standardized scoring system used in clinical settings.
“Walking or jogging improves sleep through both physical and emotional pathways. It increases energy expenditure, lowers stress hormones such as cortisol, boosts mood, enhances melatonin production (hormone that regulates sleep), and promotes deeper, more recovery sleep.
Further research is needed to develop standardized regimens and understand the benefits of other exercises, Bu said. This information will help providers adjust recommendations to suit the sleep challenges of individual patients with insomnia.
Paruthi said the evidence from the meta-analysis was a compelling case of exercise as a complementary treatment, but she said it would not routinely recommend it as the only treatment.
“If a patient tries to exercise more, I start slowly and accumulate that strength and frequency over time, but say I listen to your body and observe how it improves your sleep,” Parti said.
The timing of your physical activity is also important, she said. Exercising early in the day can make you feel wary, but intense workouts just before going to bed can make it difficult to fall asleep.
“The most important thing is to choose something sustainable… Sometimes it’s easy to set lofty goals,” says Paruthi. “(with the patients) we discuss some of the exercises they can do on a daily basis and what they really stick to.”
If your lifestyle isn’t changing on its own, it may be time to visit a sleep expert, she said.
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