Randomized, Controlled Trial of Exercise on Objective and Subjective Sleep in Parkinson's Disease - PubMed (original) (raw)

Randomized Controlled Trial

. 2020 Jun;35(6):947-958.

doi: 10.1002/mds.28009. Epub 2020 Feb 24.

Kimberly H Wood 1 2 3, Allen Joop 1, Raima A Memon 1 4, Jennifer Pilkington 1, S Craig Tuggle 2 5, John Reams 2 5, Matthew J Barrett 6, David A Edwards 7, Arthur L Weltman 7, Christopher P Hurt 2 8, Gary Cutter 2 9, Marcas M Bamman 1 2 4 10

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Randomized Controlled Trial

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

Amy W Amara et al. Mov Disord. 2020 Jun.

Abstract

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 body-weight 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 post-intervention. 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. © 2020 International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease; exercise; polysomnography; rehabilitation; sleep.

© 2020 International Parkinson and Movement Disorder Society.

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Conflict of interest statement

Financial Disclosure/Conflicts of Interests: none

Figures

FIG. 1.

FIG. 1.

Consort Flow Diagram

FIG. 2.

FIG. 2.

Objective Sleep Outcomes in Exercise and Sleep Hygiene Participants. In order to show improvement as a positive change, outcomes for which a lower score is better (wake after sleep onset and sleep latency) were multiplied by −1 for this figure. *Significant group x time interaction (p < 0.01).

FIG. 3.

FIG. 3.

Objective sleep outcomes on PSGs recorded at baseline, in the trained state on an exercise night (AEX), and in the trained state on a nonexercised night (CEX). A: Sleep Efficiency; B: Total Sleep Time; C: Wake after Sleep Onset; D: Time spent inN3. *Significant difference from Baseline based on Tukey’s HSD multiple comparisons procedure; +Significantly different from AEX based on Tukey’s HSD multiple comparisons procedure.

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