Skip to main content
Top
Published in: Trials 1/2018

Open Access 01-12-2018 | Study protocol

The effects of an activity-based lifestyle intervention on moderate sleep complaints among older adults: study protocol for a randomized controlled trial

Authors: Doris, S.F. Yu, Shamay S.M. Ng, Diana T.F. Lee, Kai Chow Choi, Parco M.F. Siu, Lisa P.L. Low, Jean Woo

Published in: Trials | Issue 1/2018

Login to get access

Abstract

Background

Moderate sleep complaints are major gerontological issue affecting as many as 80% of older adults. More intriguing findings have indicated that moderate sleep complaints were associated with cognitive decline, functional deterioration, clinical depression, and even morbidity and mortality among older adults. The aim of this study is to evaluate the effects of an activity-based lifestyle intervention on moderate sleep complaint among community-dwelling older adults.

Methods/Design

This sequential quantitative–qualitative mixed method study will randomly allocate 224 individuals to receive either the 16-week group-based moderate-intensity stepping exercise or 16-week health education. The exercise group receives three 60-min stepping exercises per week, whereas the education group receives weekly educative talks on health topics other than sleep. The primary outcomes are sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) and sleep pattern as measured by the actiwatch. Physical fitness and mood status are measured as mediating variables by using the Rockport walking test and Profile of Mood States. The qualitative part will invite 30 individuals from the exercise group who have different sleep-related treatment responses to participate in individual interviews to explore their overall perception of using stepping exercise as a lifestyle intervention to improve sleep. Mixed effects model with intention-to-treat analysis will be used for quantitative data. Inductive thematic analysis with a prior coding framework will be used for the qualitative data.

Discussion

By investigating the effects and the mediating mechanism of a moderate-intensity exercise program on moderate sleep complaints among older adults, this study will generate evidence of high scientific value and important public health implication. Understanding the sleep-promoting effects and acceptability of exercise informs how to apply lifestyle promotion as a public health practice to improve late-life moderate sleep complaints and forestall its progression to level of clinical severity.

Trial registration

Clinical Trial Registry Team, Center for Clinical Research and Biostatistics CUHK, CCRB00491. Registered on 1 December 2015.
Appendix
Available only for authorised users
Literature
1.
go back to reference Morphy H, Dunn KM, Lewis M, Boardman HF, Croft PR. Epidemiology of insomnia: a longitudinal study in a UK population. Sleep. 2007;30:274–80.PubMed Morphy H, Dunn KM, Lewis M, Boardman HF, Croft PR. Epidemiology of insomnia: a longitudinal study in a UK population. Sleep. 2007;30:274–80.PubMed
2.
go back to reference Miles LE. A sleep questionnaire. In: Guilleminault C, editor. Sleeping and waking disorders: indications and techniques. Menlo Park, CA: Addison-Wesley; 1982. p. 383–413. Miles LE. A sleep questionnaire. In: Guilleminault C, editor. Sleeping and waking disorders: indications and techniques. Menlo Park, CA: Addison-Wesley; 1982. p. 383–413.
4.
go back to reference Merlino G, Piani A, Gigli G, Cancelli I, Rinaldi A, Baroselli A, et al. Daytime sleepiness is associated with dementia and cognitive decline in older Italian adults: a population-based study. Sleep Med. 2010;11:372–7.CrossRefPubMed Merlino G, Piani A, Gigli G, Cancelli I, Rinaldi A, Baroselli A, et al. Daytime sleepiness is associated with dementia and cognitive decline in older Italian adults: a population-based study. Sleep Med. 2010;11:372–7.CrossRefPubMed
5.
go back to reference Jacobs JM, Cohen A, Hammerman‐Rozenberg R, Stessman J. Global sleep satisfaction of older people: the Jerusalem Cohort Study. J Am Geriatr Soc. 2006;54:325–9.CrossRefPubMed Jacobs JM, Cohen A, Hammerman‐Rozenberg R, Stessman J. Global sleep satisfaction of older people: the Jerusalem Cohort Study. J Am Geriatr Soc. 2006;54:325–9.CrossRefPubMed
6.
go back to reference Daley M, Morin C, LeBlanc M, Gregoire J, Savard J, Baillargeon L. Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Med. 2009;10:427–38.CrossRefPubMed Daley M, Morin C, LeBlanc M, Gregoire J, Savard J, Baillargeon L. Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Med. 2009;10:427–38.CrossRefPubMed
7.
go back to reference Manabe K, Matsui T, Yamaya M, Sato-Nakagawa T, Okamura N, Arai H, et al. Sleep patterns and mortality among elderly patients in a geriatric hospital. Gerontology. 2000;46:318–22.CrossRefPubMed Manabe K, Matsui T, Yamaya M, Sato-Nakagawa T, Okamura N, Arai H, et al. Sleep patterns and mortality among elderly patients in a geriatric hospital. Gerontology. 2000;46:318–22.CrossRefPubMed
10.
go back to reference Youngstedt SD, O’Connor PJ, Dishman RK. From wake to sleep. The effects of acute exercise on sleep: a quantitative synthesis. Sleep. 1997;20:203–14.CrossRefPubMed Youngstedt SD, O’Connor PJ, Dishman RK. From wake to sleep. The effects of acute exercise on sleep: a quantitative synthesis. Sleep. 1997;20:203–14.CrossRefPubMed
11.
go back to reference King AC, Oman RF, Brassington GS, Bliwise DL, Haskell WL. Moderate-intensity exercise and self-rated quality of sleep in older adults: a randomized controlled trial. J Am Med Assoc. 1997;277:32–7.CrossRef King AC, Oman RF, Brassington GS, Bliwise DL, Haskell WL. Moderate-intensity exercise and self-rated quality of sleep in older adults: a randomized controlled trial. J Am Med Assoc. 1997;277:32–7.CrossRef
12.
go back to reference Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med. 2010;11:934–40.CrossRefPubMedPubMedCentral Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med. 2010;11:934–40.CrossRefPubMedPubMedCentral
13.
go back to reference King AC, Pruitt LA, Woo S, Castro CM, Ahn DK, Vitiello MV, et al. Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J Gerontol A Biol Sci Med Sci. 2008;63:997–1004.CrossRefPubMed King AC, Pruitt LA, Woo S, Castro CM, Ahn DK, Vitiello MV, et al. Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J Gerontol A Biol Sci Med Sci. 2008;63:997–1004.CrossRefPubMed
14.
go back to reference Tworoger SS, Yasui Y, Vitiello MV, Schwartz RS, Ulrich CM, Aiello EJ, et al. Effects of a yearlong moderate-intensity exercise and a stretching intervention on sleep quality in postmenopausal women. Sleep. 2003;26:830–8.CrossRefPubMed Tworoger SS, Yasui Y, Vitiello MV, Schwartz RS, Ulrich CM, Aiello EJ, et al. Effects of a yearlong moderate-intensity exercise and a stretching intervention on sleep quality in postmenopausal women. Sleep. 2003;26:830–8.CrossRefPubMed
15.
go back to reference Hedeker D, Gibbons RD, Waternaux C. Sample size estimation for longitudinal designs with attrition: comparing time-related contrasts between two groups. J Educ Behav Stat. 1999;24:70–93.CrossRef Hedeker D, Gibbons RD, Waternaux C. Sample size estimation for longitudinal designs with attrition: comparing time-related contrasts between two groups. J Educ Behav Stat. 1999;24:70–93.CrossRef
16.
go back to reference Loehlin JC, Beaujean AA. Latent variable models: an introduction to factor, path, and structural equation analysis (5th ed.). New York NY: Routledge, 2017. Loehlin JC, Beaujean AA. Latent variable models: an introduction to factor, path, and structural equation analysis (5th ed.). New York NY: Routledge, 2017.
17.
go back to reference Charmaz K. Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage; 2006. Charmaz K. Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage; 2006.
18.
go back to reference Mason M. Sample size and saturation in PhD studies using qualitative interviews. Forum Qual Soc Res. 2010;11:Art.8. Mason M. Sample size and saturation in PhD studies using qualitative interviews. Forum Qual Soc Res. 2010;11:Art.8.
19.
go back to reference Ritchie J, Lewis J, Elam G. Designing and selecting samples. In: Ritchie J, Lewis J, editors. Qualitative research practice. A guide for social science students and researchers. Thousand Oaks, CA: Sage; 2003. p. 77–108. Ritchie J, Lewis J, Elam G. Designing and selecting samples. In: Ritchie J, Lewis J, editors. Qualitative research practice. A guide for social science students and researchers. Thousand Oaks, CA: Sage; 2003. p. 77–108.
20.
go back to reference American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, et al. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41:1510–30.CrossRef American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, et al. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41:1510–30.CrossRef
21.
go back to reference Wang MY, Flanagan S, Song J-E, Greendale GA, Salem GJ. Lower-extremity biomechanics during forward and lateral stepping activities in older adults. Clin Biomech. 2003;18:214–21.CrossRef Wang MY, Flanagan S, Song J-E, Greendale GA, Salem GJ. Lower-extremity biomechanics during forward and lateral stepping activities in older adults. Clin Biomech. 2003;18:214–21.CrossRef
22.
go back to reference Woo J, Hong A, Lau E, Lynn H. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing. 2007;36:262–8.CrossRefPubMed Woo J, Hong A, Lau E, Lynn H. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing. 2007;36:262–8.CrossRefPubMed
24.
go back to reference Lichstein KL, Stone KC, Donaldson J, Nau SD, Soeffing JP, Murray D, et al. Actigraphy validation with insomnia. Sleep. 2006;29:232–9.PubMed Lichstein KL, Stone KC, Donaldson J, Nau SD, Soeffing JP, Murray D, et al. Actigraphy validation with insomnia. Sleep. 2006;29:232–9.PubMed
25.
go back to reference Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14:1943–52.CrossRefPubMed Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14:1943–52.CrossRefPubMed
26.
go back to reference Fenstermaker KL, Plowman SA, Looney MA. Validation of the Rockport Fitness Walking Test in females 65 years and older. Res Q Exerc Sport. 1992;63:322–7.CrossRefPubMed Fenstermaker KL, Plowman SA, Looney MA. Validation of the Rockport Fitness Walking Test in females 65 years and older. Res Q Exerc Sport. 1992;63:322–7.CrossRefPubMed
27.
go back to reference Chen K-M, Snyder M, Krichbaum K. Translation and equivalence: the profile of mood states short form in English and Chinese. Int J Nurs Stud. 2002;39:619–24.CrossRefPubMed Chen K-M, Snyder M, Krichbaum K. Translation and equivalence: the profile of mood states short form in English and Chinese. Int J Nurs Stud. 2002;39:619–24.CrossRefPubMed
28.
go back to reference Borkovec TD, Nau SD. Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatry. 1972;3:257–60.CrossRef Borkovec TD, Nau SD. Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatry. 1972;3:257–60.CrossRef
Metadata
Title
The effects of an activity-based lifestyle intervention on moderate sleep complaints among older adults: study protocol for a randomized controlled trial
Authors
Doris, S.F. Yu
Shamay S.M. Ng
Diana T.F. Lee
Kai Chow Choi
Parco M.F. Siu
Lisa P.L. Low
Jean Woo
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-018-2465-2

Other articles of this Issue 1/2018

Trials 1/2018 Go to the issue