Exercise key to good sleep

"Exercise is great for sleep. For the millions of people who want better sleep, exercise may help," says David Cloud, CEO of the National Sleep Foundation (NSF).

Exercisers say they sleep better

Self-described exercisers report better sleep than self-described non-exercisers even though they say they sleep the same amount each night (6 hours and 51 minutes, average on weeknights). Vigorous, moderate and light*exercisers are significantly more likely to say "I had a good night's sleep" every night or almost every night on work nights than non-exercisers (67%-56% vs. 39%). Also, more than three-fourths of exercisers (76%-83%) say their sleep quality was very good or fairly good in the past two weeks, compared to slightly more than one-half of non-exercisers (56%).

"If you are inactive, adding a 10 minute walk every day could improve your likelihood of a good night's sleep," says Max Hirshkowitz, PhD, poll task force chair. "Making this small change and gradually working your way up to more intense activities like running or swimming could help you sleep better."

"Our poll data certainly find strong relationships between good sleep and exercise," adds Hirshkowitz. "While cause and effect can be tricky, I don't think having good sleep necessarily compels us to exercise. I think it is much more likely that exercising improves sleep. And good sleep is fundamental for good health, productivity, and happiness."

Vigorous exercisers report the best sleep

Vigorous exercisers are almost twice as likely as non-exercisers to report "I had a good night's sleep" every night or almost every night during the week. They also are the least likely to report sleep problems. More than two-thirds of vigorous exercisers say they rarely or never (in the past 2 weeks) had symptoms commonly associated with insomnia, including waking up too early and not being able to get back to sleep (72%) and difficulty falling asleep (69%). In contrast, one-half (50%) of non-exercisers say they woke up during the night and nearly one-fourth (24%) had difficulty falling asleep every night or almost every night.

"Poor sleep might lead to negative health partly because it makes people less inclined to exercise," says Shawn Youngstedt, PhD, poll task force member. "More than one half (57%) of the total sample reported that their activity level will be less than usual after a night of poor sleep. Not exercising and not sleeping becomes a vicious cycle."

Non-exercisers are the sleepiest and have the highest risk for sleep apnea

Non-exercisers tend toward being more excessively sleepy than exercisers. Nearly one-fourth of non-exercisers (24%) qualify as "sleepy" using a standard excessive sleepiness clinical screening measure. This sleepiness level occurs about twice as often than for exercisers (12-15%). Also, about six in ten of non-exercisers (61%) say they rarely or never have a good night's sleep on work nights.

Sleepiness clearly interferes with many non-exercisers' safety and quality of life. One in seven non-exercisers (14%) report having trouble staying awake while driving, eating or engaging in social activity at least once a week in the past two weeks, almost three times the rate of those who exercise (4-6%).

"Sometimes we might feel tired, and that's normal," says Matthew Buman, PhD, poll task force member, "but if excessive sleepiness is your normal state, it warrants a conversation with your doctor. It could be a red flag that something is wrong with your health."

Indeed, non-exercisers have more symptoms of sleep apnea. Sleep apnea is a serious medical condition in which a person stops breathing during sleep. Its symptoms often include tiredness, snoring, and high blood pressure. It also increases the risk for heart disease and stroke. More than four in ten non-exercisers (44%) exhibit a moderate risk of sleep apnea, compared to between one in four and one in five of light exercisers (26%), moderate exercisers (22%) and vigorous exercisers (19%).

"The poll data suggest that the risk of sleep apnea in exercisers is half that of non-exercisers," says Christopher Kline, PhD, poll task force member. "People with sleep apnea are often overweight. Exercise can be part of the treatment."

Less time sitting is associated with better sleep and health

Separate from exercise, spending less time sitting may improve sleep quality and health. Those who sit for less than eight hours per day sitting are significantly more likely to say they have "very good" sleep quality than those who sit for eight hours or more (22%-25% compared to 12%-15%). Furthermore, significantly more of those who spend less than 10 hours per day sitting mention excellent health, compared to those who spend 10 hours or more sitting (25-30% compared to 16%).

"This poll is the first to show that simply spending too much time sitting might negatively affect our sleep quality," says Prof. Marco Tulio de Mello, poll task force member. "In addition to exercise, standing at your desk, getting up for short breaks, and moving around as much as possible are important healthy behaviors to include in our lives."

Exercise at any time of day appears to be good for sleep

Those who report exercising close to bedtime and earlier in the day do not demonstrate a difference in self-reported sleep quality. In fact, for most people exercise at any time seems to be better for sleep than no exercise at all.

This finding contradicts long-standing "sleep hygiene" tips that advise everyone not to exercise close to bedtime. The National Sleep Foundation has amended its sleep recommendations for "normal" sleepers to encourage exercise without any caveat to time of day as long as it's not at the expense of sleep. (However, people with chronic insomnia should continue to restrict late evening and night exercise, if this is part of their treatment regimen.)

"Exercise is beneficial to sleep. It's time to revise global recommendations for improving sleep and put exercise -- any time -- at the top of our list for healthy sleep habits," says Dr. Barbara Phillips, poll task force member.

Healthy Sleep Advice

To improve your sleep, try the following sleep tips:

• Exercise regularly. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
• Create an environment that is conducive to sleep that is quiet, dark and cool with a comfortable mattress and pillows.
• Practice a relaxing bedtime ritual, like a warm bath or listening to calming music.
• Go to sleep and wake at the same time every day, and avoid spending more time in bed than needed.
• Use bright light to help manage your "body clock." Avoid bright light in the evening and expose yourself to sunlight in the morning.
• Use your bedroom only for sleep to strengthen the association between your bed and sleep. It may help to remove work materials, computers and televisions from your bedroom.
• Save your worries for the daytime. If concerns come to mind, write them in a "worry book" so you can address those issues the next day.
• If you can't sleep, go into another room and do something relaxing until you feel tired.
• If you are experiencing excessive daytime sleepiness, snoring, or "stop breathing" episodes in your sleep, contact your health care professional for a sleep apnea screening.

Poll Methodology and Definitions

The 2013 Sleep in America® annual poll was conducted for the National Sleep Foundation by WB&A Market Research, using a sample of 1,000 adults between the ages of 23 and 60. The number of completes needed for both age groups and regions was determined using the most current U.S. Census data from 2010.

The maximum sampling error of the data for the total sample is +/- 3.1 percentage points at the 95% confidence level. The sampling error will vary depending on the sample size and the percentages being examined in the sample.

* Using a self-reported measure of physical activity, for which respondents considered physical activity they did for at least 10 minutes in the past 7 days, participants were classified into four different activity levels: vigorous, moderate, light and no activity. In this self-report measure, vigorous was defined as activities which require hard physical effort such as: running, cycling, swimming or competitive sports. The next level, moderate, was defined as activities which require more effort than normal such as: yoga, tai chi and weight lifting. Light activity was defined as walking, while those who do not do any activity classified themselves into the no activity level. Segments are often referred to as vigorous exercisers, moderate exercisers, light exercisers and non-exercisers based on this measure of self-categorization.