An Investigation on the Effect of Exercise on Insomnia Symptoms

Haleh Dadgostar, Afsaneh Basharkhah, Mir Farhad Ghalehbandi, Fatemeh Kashaninasab


Background: Insomnia affects the daily activities of the sufferers and reduces attention and memory. Cognitive behavioral therapy is an expensive treatment and is not applicable to all patients, and long‑term treatment with sleep medication can have side effects such as drug dependency. As an alternative form of non‑pharmacological treatments, the effect of exercise therapy on improving the symptoms of insomnia is addressed in the current study. Methods: A total of 32 patients diagnosed with insomnia participated in the study, from which 16 received combined resistance‑aerobic exercise therapy. The rest of the patients comprised the control group. The intervention group went through a 12‑week intervention in the form of aerobic exercise for 3 days a week and resistance training for another 3 days a week. Patients’ sleep quality was assessed by the Pittsburgh test before and after the intervention. Results: The results showed that combined aerobic‑resistance exercise can improve sleep quality in patients with insomnia as well as increase subjective sleep quality and actual sleep duration, and decrease daytime dysfunction due to sleeping problems. Conclusions: This study shows that, along with other insomnia treatments, exercise can improve the sleep quality of patients.


Aerobic exercise; insomnia; resistance exercise; sleep; sleep quality

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Huang CY, Chang ET, Lai HL. Comparing the effects of music

and exercise with music for older adults with insomnia. Appl

Nurs Res 2016;32:104‑10.

Zheng B, Yu C, Lin L, Du H, Lv J, Guo Y, et al. Associations

of domain‐specific physical activities with insomnia symptoms

among 0.5 million Chinese adults. J Sleep Res 2017;26:330‑7.

Mourady D, Richa S, Karam R, Papazian T, Moussa FH,

El Osta N, et al. Associations between quality of life, physical

activity, worry, depression and insomnia: A cross‑sectional

designed study in healthy pregnant women. PLoS One


Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L,

Ellis JG, et al. European guideline for the diagnosis and

treatment of insomnia. J Sleep Res 2017;26:675‑700.

Karimi S, Soroush A, Towhidi F, Makhsosi BR, Karimi M,

Jamehshorani S., et al. Surveying the effects of an exercise

program on the sleep quality of elderly males. Clin Interv Aging


American College of Sports Medicine. ACSM’s Guidelines for

Exercise Testing and Prescription. 10th ed. Lippincott Williams

& Wilkins; 2018.

Röhrig B, du Prel JB, Wachtlin D, Kwiecien R, Blettner M.

Sample size calculation in clinical trials: Part 13 of a series

on evaluation of scientific publications. Dtsch Ärztebl Int


D’Aurea CV, Poyares D, Passos GS, Santana MG,

Youngstedt SD, Souza AA, et al. Effects of resistance exercise

training and stretching on chronic insomnia. Braz J Psychiatry


Buysse DJ, Reynolds CF II, Monk TH, Berman SR, Kupfer DJ.

The Pittsburgh sleep quality index: A new instrument

for psychiatric practice and research. J Psychiatr Res


Prentice WE. Rehabilitation Techniques for Sports Medicine

and Athletic Training. Medicine & In Sports & Exercise. 5th ed.,

McGraw-Hill; 2011;197-213.

Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ,

Bittner VA, et al. Exercise standards for testing and training:

A scientific statement from the American Heart Association.

Circulation 2013;128:873‑934.

Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN,

Franklin BA, et al. Physical activity and public health: Updated

recommendation for adults from the American College of Sports

Medicine and the American Heart Association. Circulation


U.S. Department of Health and Human Services. 2008 Physical

Activity Guidelines for Americans [Internet]. Washington (DC):

U.S. Department of Health and Human Services. Availablefrom:”. [Last

accessed on 2016 Mar 28].

U.S. Department of Health and Human Services. Exercise

and Physical Activity [Internet]. Bethesda (MD): National

Institute on Aging, National Institutes of Health. Available


ExerciseGuide”. [Last accessed on 2016 Mar 28].

Ferris LT, Williams JS, Shen CL, O’Keefe KA, and Hale KB.

Resistance training improves sleep quality in older adults a pilot

study. J Sports Sci Med 2005;4:354.

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


Li F, Fisher KJ, Harmer P, Irbe D, Tearse RG, Weimer C. Tai

Chi and self‐rated quality of sleep and daytime sleepiness in

older adults: A randomized controlled trial. J Am Geriatr Soc


Mercier J, Ivers H, Savard J. A non‑inferiority randomized

controlled trial comparing a home‑based aerobic exercise

program to a self‑administered cognitive‑behavioral therapy for

insomnia in cancer patients. Sleep 2018;41:zsy149.

Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW,

Otto MW. The effects of physical activity on sleep:

A meta‑analytic review. J Behav Med 2015;38:427‑49.

Williams SM, Farmer VL, Taylor BJ, Taylor RW. Do more

active children sleep more? A repeated cross‑sectional analysis

using accelerometry. PLoS One 9:e93117.

Yamanaka Y, Hashimoto S, Takasu NN, Tanahashi Y,

Nishide SY, Honma S, et al. Morning and evening physical

exercise differentially regulate the autonomic nervous system

during nocturnal sleep in humans. Am J Physiol Regul Integr

Comp Physiol 2015;309:R1112‑21.

Passos GS, Poyares D, Santana MG, D’Aurea CV, Youngstedt SD,

Tufik S. Effects of moderate aerobic exercise training on chronic

primary insomnia. Sleep Med 2011;12:1018‑27.

Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB.

Interrelationship between sleep and exercise: A systematic

review. Adv Prev Med 2017;2017. doi: 10.1155/2017/1364387.

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.

Montgomery P, Dennis JA. Physical exercise for sleep problems

in adults aged 60+. Cochrane Database Syst Rev 2002;2002. doi:


Weltman A, Wideman L, Weltman JY, Veldhuis JD.

Neuroendocrine control of GH release during acute aerobic

exercise. J Endocrinol Invest 2003;26:843‑50.

Murphy PJ, Campbell SS. Nighttime drop in body temperature:

A physiological trigger for sleep onset? Sleep 1997;20:505‑11.

Kräuchi K, Cajochen C, Werth E, Wirz‑Justice A. Warm feet

promote the rapid onset of sleep. Nature 1999;401:36‑7.

Kryger M, Roth T, Dement WC. Principles and practice of sleep

medicine. 6th ed. Philadelphia: Elsevier; 2017.

Youngstedt SD Effects of exercise on sleep. Clin Sports Med


Herring MP, O’Connor PJ, Dishman RK. The effect of exercise

training on anxiety symptoms among patients: A systematic

review. Arch Internal Med 2010;170:321‑31.

Sudo A, Arito H, Fukuda K. Effects of swimming exercise on

circadian sleep‑waking rhythms and brain serotonin metabolism

in rats. Industrial Health 1984;22:153‑61.

Petitjean F, Buda C, Janin M, Sallanon M, Jouvet M. Insomnia

caused by administration of para‑chlorophenylalanine:

Reversibility by peripheral or central injection of

‑hydroxytryptophan and serotonin. Sleep 1985;8:56‑67.