A Pilot Randomized Controlled Trial of Interval Training and Sleep Hygiene for Improving Sleep in Older Adults

in Journal of Aging and Physical Activity
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The primary objective of this pilot randomized controlled trial was to study the feasibility (recruitment and retention rates) for interval training and sleep hygiene (SH) in adults aged above 60 years. Thirteen out of 46 screened individuals from a home for older adults in Shirdi (Maharashtra, India) were randomly assigned by permuted block randomization to either an interval training with SH group (n = 6) or an SH alone group (n = 7). The authors measured sleep with the S+ sleep monitor manufactured by ResMed (USA) Pittsburgh Sleep Quality Index and quality of life with Short Form-12 health survey version 2. Interval training consisted of 8 weeks of stationary cycling, whereas SH consisted of lecture and handouts. Recruitment was 38.2%, retention was >80% for both the interventions, and there was one loss to follow-up in SH. Interval training and SH were feasible for older adults and supported a full-scale randomized controlled trial.

A. Mahajan is with the Dr. A.P.J. Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences, Loni, India. S. Mahajan is with the Rural Medical College, Pravara Institute of Medical Sciences, Loni, India. Tilekar is with the Center for Social Medicine, Pravara Institute of Medical Sciences, Loni, India.

A. Mahajan (aashirwad.mahajan@gmail.com) is corresponding author.
  • Almeida, P., & Neves, R. (2014). Physical activity—The attitude of the institutionalised elderly. Journal of Physical Education and Sport, 14(1), 1215. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • American Academy of Sleep Medicine. (2017, February 9). Healthy sleep habits. Retrieved from http://sleepeducation.org/essentials-in-sleep/healthy-sleep-habits

    • Search Google Scholar
    • Export Citation
  • Attride-Stirling, J. (2001). Thematic networks: An analytic tool for qualitative research. Qualitative Research, 1(3), 385405. doi:

  • Backhaus, J., Junghanns, K., Broocks, A., Riemann, D., & Hohagen, F. (2002). Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research, 53(3), 737740. PubMed ID: 12217446 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bethancourt, H.J., Rosenberg, D.E., Beatty, T., & Arterburn, D.E. (2014). Barriers to and facilitators of physical activity program use among older adults. Clinical Medicine & Research, 12(1–2), 1020. PubMed ID: 24415748 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bouaziz, W., Malgoyre, A., Schmitt, E., Lang, P.O., Vogel, T., & Kanagaratnam, L. (2020). Effect of high‐intensity interval training and continuous endurance training on peak oxygen uptake among seniors aged 65 or older: A meta‐analysis of randomized controlled trials. International Journal of Clinical Practice, 74(6), e13490. PubMed ID: 32083390 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chen, Y.M. (2010). Perceived barriers to physical activity among older adults residing in long‐term care institutions. Journal of Clinical Nursing, 19(3–4), 432439. PubMed ID: 20500283 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cooke, J.R., & Ancoli-Israel, S. (2011). Normal and abnormal sleep in the elderly. Handbook of Clinical Neurology, 98, 653665. PubMed ID: 21056216

    • Crossref
    • Search Google Scholar
    • Export Citation
  • De Chazal, P., Fox, N., O’Hare, E.M.E.R., Heneghan, C., Zaffaroni, A., Boyle, P., … McNicholas, W.T. (2011). Sleep/wake measurement using a non‐contact biomotion sensor. Journal of Sleep Research, 20(2), 356366. PubMed ID: 20704645 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Driscoll, H.C., Serody, L., Patrick, S., Maurer, J., Bensasi, S., Houck, P.R., … Miller, M.D. (2008). Sleeping well, aging well: A descriptive and cross-sectional study of sleep in “successful agers” 75 and older. The American Journal of Geriatric Psychiatry, 16(1), 7482. PubMed ID: 18070833 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Eldridge, S.M., Chan, C.L., Campbell, M.J., Bond, C.M., Hopewell, S., Thabane, L., & Lancaster, G.A. (2016). CONSORT 2010 statement: Extension to randomised pilot and feasibility trials. BMJ, 355, i5239. PubMed ID: 27777223 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fisher, G. (2016). A role for High Intensity Interval Training (HIIT) for improving cardiometabolic health outcomes. Obes Open Access, 2(2). doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gambhir, I.S., Chakrabarti, S.S., Sharma, A.R., & Saran, D.P. (2014). Insomnia in the elderly—A hospital-based study from North India. Journal of Clinical Gerontology and Geriatrics, 5(4), 117121. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harris, T.J., Carey, I.M., Victor, C.R., Adams, R., & Cook, D.G. (2008). Optimising recruitment into a study of physical activity in older people: A randomised controlled trial of different approaches. Age and Ageing, 37(6), 659665. PubMed ID: 18718924 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Herbert, E., Julious, S.A., & Goodacre, S. (2019). Progression criteria in trials with an internal pilot: An audit of publicly funded randomised controlled trials. Trials, 20(1), 493. PubMed ID: 31399148 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hughes, C.M., McCullough, C.A., Bradbury, I., Boyde, C., Hume, D., Yuan, J., … McDonough, S.M. (2009). Acupuncture and reflexology for insomnia: A feasibility study. Acupuncture in Medicine, 27(4), 163168. PubMed ID: 19942722 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Irandoust, K., & Taheri, M. (2019). Effect of a High Intensity Interval Training (HIIT) on serotonin and cortisol levels in obese women with sleep disorders. Women’s Health Bulletin, 6(1), 1–5. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Joshi, S. (2008). Nonpharmacologic therapy for insomnia in the elderly. Clinics in Geriatric Medicine, 24(1), 107119. PubMed ID: 18035235 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kate, N.S., Pawar, S.S., Parkar, S.R., & Sawant, N.S. (2015). Adverse drug reactions due to antipsychotics and sedative-hypnotics in the elderly. Journal of Geriatric Mental Health, 2(1), 16. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • King, A.C., Pruitt, L.A., Woo, S., Castro, C.M., Ahn, D.K., Vitiello, M.V., … Bliwise, D.L. (2008). Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 63(9), 9971004. PubMed ID: 18840807 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kong, Z., Fan, X., Sun, S., Song, L., Shi, Q., & Nie, J. (2016). Comparison of high-intensity interval training and moderate-to-vigorous continuous training for cardiometabolic health and exercise enjoyment in obese young women: A randomized controlled trial. PLoS One, 11(7), e0158589. PubMed ID: 27368057 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leger, D., & Poursain, B. (2005). An international survey of insomnia: Under-recognition and under-treatment of a polysymptomatic condition. Current Medical Research and Opinion, 21(11), 17851792. PubMed ID: 16307699 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Liu, H., Byles, J.E., Xu, X., Zhang, M., Wu, X., & Hall, J.J. (2016). Association between nighttime sleep and successful aging among older Chinese people. Sleep Medicine, 22, 1824. PubMed ID: 27544831 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Løppenthin, K., Esbensen, B.A., Jennum, P., Østergaard, M., Christensen, J.F., Thomsen, T., … Midtgaard, J. (2014). Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis—Design of a randomized controlled trial. BMC Musculoskeletal Disorders, 15(1), 49. PubMed ID: 24559487 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Milanović, Z., Sporiš, G., & Weston, M. (2015). Effectiveness of high-intensity interval training (HIT) and continuous endurance training for VO2max improvements: A systematic review and meta-analysis of controlled trials. Sports Medicine, 45(10), 14691481. PubMed ID: 26243014 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Montazeri, A., Vahdaninia, M., Mousavi, S.J., Asadi-Lari, M., Omidvari, S., & Tavousi, M. (2011). The 12-item medical outcomes study short form health survey version 2.0 (SF-12v2): A population-based validation study from Tehran, Iran. Health and Quality of Life Outcomes, 9(1), 12. PubMed ID: 21385359 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Montgomery, P., & Dennis, J.A. (2002). Physical exercise for sleep problems in adults aged 60+. Cochrane Database of Systematic Reviews, 4, CD003404. PubMed ID: 12519595 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morin, C.M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: A randomized controlled trial. JAMA, 281(11), 991999. PubMed ID: 10086433 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Osuka, Y., Matsubara, M., Hamasaki, A., Hiramatsu, Y., Ohshima, H., & Tanaka, K. (2017). Development of low-volume, high-intensity, aerobic-type interval training for elderly Japanese men: A feasibility study. European Review of Aging and Physical Activity, 14(1), 14. PubMed ID: 28855969 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Patel, D., Steinberg, J., & Patel, P. (2018). Insomnia in the elderly: A review. Journal of Clinical Sleep Medicine, 14(6), 10171024. PubMed ID: 29852897 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Petit, L., Azad, N., Byszewski, A., Sarazan, F.F.A., & Power, B. (2003). Non‐pharmacological management of primary and secondary insomnia among older people: Review of assessment tools and treatments. Age and Ageing, 32(1), 1925. PubMed ID: 12540343 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pichot, V., Roche, F., Denis, C., Garet, M., Duverney, D., Costes, F., & Barthélémy, J.C. (2005). Interval training in elderly men increases both heart rate variability and baroreflex activity. Clinical Autonomic Research, 15(2), 107115. PubMed ID: 15834767 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ramocha, L.M., Louw, Q.A., & Tshabalala, M.D. (2017). Quality of life and physical activity among older adults living in institutions ` the community. The South African Journal of Physiotherapy, 73(1), 342. PubMed ID: 30135899 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reid, K.J., Baron, K.G., Lu, B., Naylor, E., Wolfe, L., & Zee, P.C. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine, 11(9), 934940. PubMed ID: 20813580 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Robergs, R.A., & Landwehr, R. (2002). The surprising history of the “HRmax = 220-age” equation. Journal of Exercise Physiology Online, 5(2), 110.

    • Search Google Scholar
    • Export Citation
  • Schnelle, J.F., Cruise, P.A., Alessi, C.A., Ludlow, K., Al-Samarrai, N.R., & Ouslander, J.G. (1998). Sleep hygiene in physically dependent nursing home residents: Behavioral and environmental intervention implications. Sleep, 21(5), 515523. PubMed ID: 9703592

    • Search Google Scholar
    • Export Citation
  • Sharma, K., & Srivastava, S. (2018). The effectiveness of sleep hygiene program on sleep quality and stress level in elderly population. Journal of Mental Health and Aging, 2(1), 2932. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sivertsen, B., Omvik, S., Pallesen, S., Bjorvatn B, Havik, O.E., Kvale, G., … Nordhus, I.H. (2006). Cognitive behavioral therapy vs zopiclone for treatment of chronic primary insomnia in older adults: A randomized controlled trial. JAMA, 295(24), 28512858. PubMed ID: 16804151 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Štefan, L., Vrgoč, G., Rupčić, T., Sporiš, G., & Sekulić, D. (2018). Sleep duration and sleep quality are associated with physical activity in elderly people living in nursing homes. International Journal of Environmental Research and Public Health, 15(11), 2512. PubMed ID: 30423981 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stepanski, E.J., & Wyatt, J.K. (2003). Use of sleep hygiene in the treatment of insomnias. Sleep Medicine Reviews, 7(3), 215225. doi:

  • Suzuki, K., Miyamoto, M., & Hirata, K. (2017). Sleep disorders in the elderly: Diagnosis and management. Journal of General and Family Medicine, 18(2), 6171. PubMed ID: 29263993 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thum, J.S., Parsons, G., Whittle, T., & Astorino, T.A. (2017). High-intensity interval training elicits higher enjoyment than moderate intensity continuous exercise. PLoS One, 12(1), e0166299. PubMed ID: 28076352 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tobaldini, E., Nobili, L., Strada, S., Casali, K.R., Braghiroli, A., & Montano, N. (2013). Heart rate variability in normal and pathological sleep. Frontiers in Physiology, 4, 294. PubMed ID: 24137133 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Weston, K.S., Wisløff, U., & Coombes, J.S. (2014). High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: A systematic review and meta-analysis. British Journal of Sports Medicine, 48(16), 12271234. PubMed ID: 24144531 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Young, H.M., Goodliffe, S., Madhani, M., Phelps, K., Regen, E., Locke, A., … Conroy, S. (2019). Co-producing progression criteria for feasibility studies: A partnership between patient contributors, clinicians and researchers. International Journal of Environmental Research and Public Health, 16(19), 3756. PubMed ID: 31590424 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Youngstedt, S.D. (2005). Effects of exercise on sleep. Clinics in Sports Medicine, 24(2), 355365. PubMed ID: 15892929 doi:

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