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Insomnia and problems sleeping? Try exercise.

 

While a few nights of lost sleep may be merely a nuisance, cumulative sleep loss results in a variety of problems.

"At this point, I'm willing to try anything -- even exercise!" you exclaim. "My doctor said regular exercise might help me sleep better. My sleeping problem began about three months ago when things were crazy at work. The company went through a major reorganization, and I dealt with a lot of stress.
I started waking up in the middle of the night, unable to get back to sleep for an hour or two. It seems I have forgotten how to sleep! I wake up in the morning exhausted. Can exercise help? And if so, what kind of exercise is best?"

Sleeping problems have reached epidemic proportions in the U.S., with about one-third of the adult population reporting problems sleeping within the past year. While a few nights of lost sleep may be merely a nuisance, cumulative sleep loss results in a variety of problems, such as poor judgment, increased risk of injury and accidents, reduced productivity and depression. Canadian sleep researcher Stanley Coren argues, "Going without sleep is as much of a public and personal safety hazard as going to work drunk."2 Plenty of deep, restorative sleep is essential for good health.

Treatment step 1: Medical clearance

While stress is the leading cause of short-term insomnia, it may also be caused by a variety of illnesses, medications or by lifestyle factors such as schedule or caffeine consumption. Clients complaining of sleep problems or fatigue should consult their healthcare providers to determine the causes of their insomnia, and seek advice on the best course of treatment.

Step 2: Manage stress

If stress is determined to be the cause of insomnia, then stress management must be part of the solution. Clients often feel better once they confront the problems that trigger feelings of stress. Clients can feel more relaxed and in control by participating in stress-management workshops, individual or group counseling, or simply acknowledging the sources of stress and devising a plan of attack. Regular exercise is an essential stress-management technique that helps people feel relaxed and revived.

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 Step 3: Lifestyle modification

Clients who have ruled out underlying illness and medication side-effects often experience improvement in their sleep quality with changes in lifestyle factors. Encourage clients to take a look at caffeine consumption. Reducing or eliminating caffeine can have dramatic results. Similarly, reducing or eliminating alcohol improves sleep quality for many people. While alcohol may help people fall asleep, it usually produces a light, restless sleep, and the individual often awakens suddenly during the night, unable to sleep again.

Sleep comes more easily to people who follow a regular sleep schedule and develop a pleasant bedtime routine. Creating a dark, quiet and comfortable sleep environment helps as well, even if darkness comes from eye covers and quiet from ear plugs.

Exercise and sleep well

Many people find that regular exercise improves sleep quality.1 Compare the side-effects to those listed on the bottle of sleeping pills. For insomnia, daily (or almost daily) exercise for at least 30 minutes is recommended. Sleep may not improve for several days or even a few weeks, so be sure clients understand that results may not be immediate. Urge them to continue anyway; exercise will still do them a great deal of good.

The best type, amount and timing of exercise for a client must be determined by trial and error.3 Exercise may be prescribed based on client preference and what types of exercise they have access to. Exercise amount depends upon a client's fitness and activity levels. Clients currently in moderately good condition, who already exercise sporadically, may require greater exercise intensity and duration to improve sleep quality. Obviously, safety comes first. All clients should begin with an appropriate exercise volume and increase gradually to avoid injury.

What about timing? It was thought that exercise late in the day would make falling asleep more difficult, and for some people this is true. But studies find now that many people have no difficulty falling asleep after evening exercise.3 Clients desperate for immediate results may want to avoid evening exercise. However, late-day exercise is sometimes the only option, and should not automatically be ruled out. Over time, each client must experiment with what time of day works best, considering the multitude of constraints that shape an exercise program.

Come into the light

Inadequate exposure to bright light has been linked to insomnia and depression, and light therapy improves sleep quality and mood. Encourage clients who rarely spend time outside to add outdoor time to their day. Midday exposure is most intense, and is desirable during short winter days. Some clients can make time for midday outdoor exercise. The combination of exercise and daylight works synergistically to regulate the body's sleep/wake cycle.

Avoid overtraining

While the right amount of exercise can improve sleep quality, overdoing it and overtraining are characterized by insomnia. Some adults report trouble sleeping after even one bout of overly intense exercise. (Sleep usually returns to normal the following night.) Overtraining occurs over time, when training is increased too quickly for the body to adapt. While elite athletes are the most likely candidates for overtraining, overly exuberant recreational exercisers can get carried away with their training programs, too, especially if they are preparing for an event. For example, a marathon requires a high volume of training.

Exercise is a good habit to form

It is worth noting that people who exercise regularly sometimes experience sleeping problems -- when they are unable to exercise for several days. Sleep quality usually returns when they get back into an exercise program. While this may sound negative, the body needs daily exercise to function normally, and if activity is missing, insomnia is a direct result. Exercise helps keep people in balance, and functioning in top form.

REFERENCES

1. King, A.C., R.F. Oman, G.S. Brassington, et al. Moderate-intensity exercise and self-rated quality of sleep in older adults: A randomized controlled trial. Journal of the American Medical Association, 277 (1): 32-37, 1997.

2. Wheeler, D.L. Ending the sleep shortage. The Chronicle of Higher Education, p.A10, August 9, 1996.

3. Youngstedt, S.D. Does exercise truly enhance sleep? Physician and Sportsmedicine, 25(10): 72-82, 1997.

Barbara A. Brehm, Ed.D., is professor of exercise and sport studies at Smith College, Northampton, Mass.

 

 

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