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Matthew P. Buman , Ph.D.

Exercise Effects on Night-to-Night Fluctuations in Self-rated Sleep among Older Adults with Sleep Complaints. Matthew P. Buman , Ph.D. Co-authors Eric B. Hekler, Ph.D. 1* Donald L. Bliwise, Ph.D. 2 Abby C. King, Ph.D. 1,3.

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Matthew P. Buman , Ph.D.

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  1. Exercise Effects on Night-to-Night Fluctuations in Self-rated Sleep among Older Adults with Sleep Complaints Matthew P. Buman, Ph.D.

  2. Co-authors Eric B. Hekler, Ph.D.1* Donald L. Bliwise, Ph.D.2 Abby C. King, Ph.D.1,3 1 Stanford Prevention Research Center, Stanford University School of Medicine 2Department of Neurology, Emory University School of Medicine 3Department of Health Research and Policy, Stanford University School of Medicine *Supported by Public Health Service Training Grant No. 5 T32 HL 007034 from the National Heart, Lung, and Blood Institute. This study was supported by Public Health Service Grant No. R01MH58853 (PI: Dr. King) from the National Institute of Mental Health.

  3. Background • Sleep complaints highly prevalent • Chronic insomnia - 10% of US population • Long-term pharmacological treatments are not recommended • Behavioral sleep treatments are more effective but expensive to deliver

  4. Exercise and Sleep Quality • Modest mean-level improvements in sleep • Subjective • sleep quality • sleep-onset latency • Objective • Stage 1 • Stage 2 • No. of awakenings

  5. Exercise and Sleep Quality • Effects stronger among poorer sleepers, older adults • No data on exercise effects of night-to-night fluctuations in sleep

  6. Night-to-Night Sleep Fluctuations:Intra-individual Variability (IIV) “Low IIV” Mean = 4.92 SD = 0.84 “High IIV” Mean = 4.92 SD = 3.44

  7. Sleep IIV and Health Outcomes • Elevated sleep IIV is highly prevalent • Older adults and insomniacs more likely to display high IIV • Elevated sleep IIV is associated with: • ↓Mood states • ↓Cognitive function • ↑Physical health complaints

  8. Why Exercise? • Impacts other sleep parameters • Ease of delivery in the community • May increase consistencies in daytime and nighttime behaviors and routines

  9. Primary Research Question • Does 12mos of moderate-intensity exercise reduce IIV in self-rated sleep?

  10. Secondary Research Questions • Are these changes associated with… • mean-level changes in the same measures? • changes in other subjective and objective sleep parameters? • Changes in sleep-wake schedules?

  11. Recruitment Eligibility Participants N=66; 66% women 36 intervention, 30 control 89% completion rate Equal dropout by group • 55 years or older • Underactive • BMI ≤ 35 • No diagnosed sleep disorder • Mild to moderate sleep complaints

  12. Intervention

  13. Data Collection Schedule

  14. Analyses • Primary Research Question • Baseline-adjusted ANCOVA for 6mos and 12mos outcomes (intent-to-treat)

  15. Analyses • Secondary research questions • Residualized change correlational analyses • Mean-level parameters • PSQI: global sleep quality, sleep disturbance • PSG: Stage 1, Stage 2, no. of awakenings • Changes in sleep-wake schedules • Bed time, Wake time

  16. Primary Research Question6- and 12-month changes in IIV

  17. Secondary Research QuestionCorrelations among IIV and mean-level changes

  18. Exercise group • Direction similar • Magnitude different • Control group • Magnitude and direction similar

  19. Secondary Research QuestionCorrelations among IIV and other sleep outcomes

  20. Secondary Research QuestionChanges in sleep-wake schedules • No significant change in wake time and bedtime by group

  21. Summary of Findings • 12mos of moderate intensity exercise reduced IIV in sleep-onset latency (SOL) • Changes largely independent of… • mean-level changes in SOL • changes in other subjective and objective sleep parameters • changes in sleep-wake schedules

  22. Significance of SOL-based IIV • SOL-based IIV is consistently high in the literature of older adults and poor sleepers • SOL-based IIV is temporally linked with mood states • Appears to respond independently to treatment from mean-level sleep parameters

  23. Potential Mechanisms of Exercise-Induced Effects of Sleep IIV • Sleep-wake schedule consistency • Body temperature regulation • acute vs. chronic effects

  24. Strengths & Limitations • Population under study • Light exposure • Limited power

  25. Contact Information Matthew P. Buman, PhD Postdoctoral Research Fellow Stanford Prevention Research Center Stanford University School of Medicine Medical School Office Building 251 Campus Drive Stanford, CA 94305-5411 Office # (650) 723-3342 Fax # (650) 725-6247 Email mbuman@stanford.edu Web http://med.stanford.edu/profiles/Matthew_Buman/ THANK YOU!

  26. Results: Mean-level variability and IIV in sleep outcomes

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