- Title
- The combined effects of physical activity and sleep on the health and wellbeing of middle-aged adults
- Creator
- Rayward, Anna
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2020
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Insufficient physical activity and poor sleep health are both highly prevalent and increase with age. Both are associated with an increased risk of the development of many non-communicable chronic diseases. Clusters of unhealthy behaviours may pose higher risks to health than the simple additive risks from each individual unhealthy behaviour. Although there is strong evidence that physical activity improves sleep quality, little is known about how physical activity and sleep cluster together. This is important as sleep only recently gained attention as a novel lifestyle risk from a public health perspective. There is a growing body of evidence of a bidirectional relationship between physical activity and sleep, such that higher levels of physical activity promote good sleep, and, improved sleep promotes higher physical activity levels, but the findings are inconsistent. Harnessing the synergy of better physical activity and sleep health behaviours in multiple behaviour change interventions may lead to greater improvements in each behaviour and potentially greater benefits to health. Objectives and Methods: This thesis addresses three separate but complementary aims and is presented as a series of manuscripts which address these aims. Aim 1: To identify how different patterns of physical activity, sleep quality and sleep duration cluster together and how these patterns vary by sociodemographic characteristics. Two-Step Cluster Analyses of cross-sectional data from the HABITAT Study, a longitudinal, multi-level study examining lifestyle, health and well-being in middle-aged adults in Brisbane, Australia (n =5,854) identified four clusters of physical activity, sleep quality and sleep duration: ‘Poor Sleepers’ (31.2%), ‘Moderate Sleepers’ (30.7%), ‘Mixed Sleepers/Highly Active’ (20.5%), and ‘Excellent Sleepers/Mixed Activity’ (17.6%). The ‘Poor Sleepers’ cluster had the highest proportion of participants with less-than-recommended sleep duration and poor sleep quality, had the poorest health characteristics and a high proportion of participants with low physical activity. Few sociodemographic differences were found between the clusters. Aim 2: To examine the relationship between changes in physical activity and sleep quality and duration over time. Multinomial logistic regression analyses of data from the 2011 and 2013 waves of the HABITAT Study were conducted to examine the relationships between patterns of change in physical activity, sleep quality and sleep duration over two years among 3,649 middle-aged adults. A bidirectional relationship between physical activity and sleep quality was identified however no evidence of a relationship in any direction between physical activity and sleep duration was found. Aim 3: To compare the efficacy of a combined physical activity and sleep health intervention with a sleep health only intervention and a wait-list control for improving sleep quality, mental health and health-related quality of life. The Refresh Study was a three-arm randomised controlled trial with assessments at baseline, 3 months (primary time-point) and 6 months (follow-up time-point) post-baseline. Inactive adults (n = 275) aged 40 to 65 years reporting poor sleep quality were randomised to either the Physical Activity and Sleep Health (PAS), Sleep Health-Only (SO) or Wait-list Control (CON) groups. The main intervention component included a smartphone/tablet “app” using behaviour-change strategies to improve activity and/or sleep (e.g., self-monitoring, goal-setting, feedback). Additional email/SMS support was provided for 12 weeks. Physical Activity and Sleep Health group participants received a pedometer. Primary outcome was Pittsburgh Sleep Quality Index (PSQI) total score. Secondary outcomes included several self-reported activity measures and PSQI sub-components, mental distress (Kessler 6), symptom severity of depression, anxiety and stress (DASS-21), and HRQoL (SF-12 mental and physical health components; RAND-36 energy/fatigue component). Group differences were examined stepwise, first between pooled intervention (PI) and CON groups, then PAS and SO groups. Compared with CON, PI groups significantly improved sleep quality and PSQI sub-components scores at 3 and 6 months. There were no differences in sleep quality between intervention groups. All groups substantially increased their weekly minutes of MVPA. The PAS group reported significantly less daily sitting time at 3 months and were significantly more likely to report ≥2 days/week resistance training and meeting activity guidelines at 6 months than the SO group. The PI groups had significantly better scores relative to CON for mental distress and HRQoL mental component at 3 months, HRQoL physical component at 6 months and energy/fatigue at 3 and 6 months. There were no differences between any groups at 3 or 6 months for DASS-21 scores. The SO group had significantly better HRQoL mental health scores relative to the PAS group at 6 months. Conclusion: This thesis research identified that physical activity and sleep behaviours cluster together in distinct patterns and physical activity and sleep quality share a bidirectional relationship. These findings support the value of multiple behaviour change interventions which include physical activity and sleep to leverage their bidirectional relationship and maximise the potential co-action effects of each behaviour upon the other. Future research is required using longitudinal studies to establish causality between behavioural clusters and health indicators and to examine how changes in physical activity and sleep behaviours impact health outcomes over time.
- Subject
- physical activity; sleep; adults; m-health; behaviour change; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1411368
- Identifier
- uon:36326
- Rights
- Copyright 2020 Anna Rayward
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 8 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 391 KB | Adobe Acrobat PDF | View Details Download |