Amy W Amara1,2, Kimberly H Wood1,2,3, Allen Joop1, Raima A Memon1,4, Jennifer Pilkington1, S Craig Tuggle2,5, John Reams2,5, Matthew J Barrett6, David A Edwards7, Arthur L Weltman7, Christopher P Hurt2,8, Gary Cutter2,9, Marcas M Bamman1,2,4,10. 1. Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA. 2. UAB Center for Exercise Medicine. Birmingham, Alabama, USA. 3. Department of Psychology, Samford University, Birmingham, Alabama, USA. 4. Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA. 5. Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA. 6. Department of Neurology, University of Virginia, Charlottesville, Virginia, USA. 7. Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA. 8. Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA. 9. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA. 10. Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama, USA.
Abstract
BACKGROUND: Sleep dysfunction is common and disabling in persons with Parkinson's Disease (PD). Exercise improves motor symptoms and subjective sleep quality in PD, but there are no published studies evaluating the impact of exercise on objective sleep outcomes. The goal of this study was to to determine if high-intensity exercise rehabilitation combining resistance training and body-weight interval training, compared with a sleep hygiene control improved objective sleep outcomes in PD. METHODS: Persons with PD (Hoehn & Yahr stages 2-3; aged ≥45 years, not in a regular exercise program) were randomized to exercise (supervised 3 times a week for 16 weeks; n = 27) or a sleep hygiene, no-exercise control (in-person discussion and monthly phone calls; n = 28). Participants underwent polysomnography at baseline and post-intervention. Change in sleep efficiency was the primary outcome, measured from baseline to post-intervention. Intervention effects were evaluated with general linear models with measurement of group × time interaction. As secondary outcomes, we evaluated changes in other aspects of sleep architecture and compared the effects of acute and chronic training on objective sleep outcomes. RESULTS: The exercise group showed significant improvement in sleep efficiency compared with the sleep hygiene group (group × time interaction: F = 16.0, P < 0.001, d = 1.08). Other parameters of sleep architecture also improved in exercise compared with sleep hygiene, including total sleep time, wake after sleep onset, and slow-wave sleep. Chronic but not acute exercise improved sleep efficiency compared with baseline. CONCLUSIONS: High-intensity exercise rehabilitation improves objective sleep outcomes in PD. Exercise is an effective nonpharmacological intervention to improve this disabling nonmotor symptom in PD.
BACKGROUND: Sleep dysfunction is common and disabling in persons with Parkinson's Disease (PD). Exercise improves motor symptoms and subjective sleep quality in PD, but there are no published studies evaluating the impact of exercise on objective sleep outcomes. The goal of this study was to to determine if high-intensity exercise rehabilitation combining resistance training and body-weight interval training, compared with a sleep hygiene control improved objective sleep outcomes in PD. METHODS: Persons with PD (Hoehn & Yahr stages 2-3; aged ≥45 years, not in a regular exercise program) were randomized to exercise (supervised 3 times a week for 16 weeks; n = 27) or a sleep hygiene, no-exercise control (in-person discussion and monthly phone calls; n = 28). Participants underwent polysomnography at baseline and post-intervention. Change in sleep efficiency was the primary outcome, measured from baseline to post-intervention. Intervention effects were evaluated with general linear models with measurement of group × time interaction. As secondary outcomes, we evaluated changes in other aspects of sleep architecture and compared the effects of acute and chronic training on objective sleep outcomes. RESULTS: The exercise group showed significant improvement in sleep efficiency compared with the sleep hygiene group (group × time interaction: F = 16.0, P < 0.001, d = 1.08). Other parameters of sleep architecture also improved in exercise compared with sleep hygiene, including total sleep time, wake after sleep onset, and slow-wave sleep. Chronic but not acute exercise improved sleep efficiency compared with baseline. CONCLUSIONS: High-intensity exercise rehabilitation improves objective sleep outcomes in PD. Exercise is an effective nonpharmacological intervention to improve this disabling nonmotor symptom in PD.
Authors: Michael Deuschle; Michael Schredl; Christian Wisch; Claudia Schilling; Maria Gilles; Olga Geisel; Rainer Hellweg Journal: J Sleep Res Date: 2017-06-28 Impact factor: 3.981
Authors: Michael J Stec; Anna Thalacker-Mercer; David L Mayhew; Neil A Kelly; S Craig Tuggle; Edward K Merritt; Cynthia J Brown; Samuel T Windham; Louis J Dell'Italia; C Scott Bickel; Brandon M Roberts; Kristina M Vaughn; Irina Isakova-Donahue; Gina M Many; Marcas M Bamman Journal: Exp Gerontol Date: 2017-09-28 Impact factor: 4.032
Authors: Christopher G Goetz; Barbara C Tilley; Stephanie R Shaftman; Glenn T Stebbins; Stanley Fahn; Pablo Martinez-Martin; Werner Poewe; Cristina Sampaio; Matthew B Stern; Richard Dodel; Bruno Dubois; Robert Holloway; Joseph Jankovic; Jaime Kulisevsky; Anthony E Lang; Andrew Lees; Sue Leurgans; Peter A LeWitt; David Nyenhuis; C Warren Olanow; Olivier Rascol; Anette Schrag; Jeanne A Teresi; Jacobus J van Hilten; Nancy LaPelle Journal: Mov Disord Date: 2008-11-15 Impact factor: 10.338
Authors: Neil A Kelly; Kimberly H Wood; Jane B Allendorfer; Matthew P Ford; C Scott Bickel; Jon Marstrander; Amy W Amara; Thomas Anthony; Marcas M Bamman; Frank M Skidmore Journal: Med Sci Monit Date: 2017-12-23
Authors: Jacqueline A Osborne; Rachel Botkin; Cristina Colon-Semenza; Tamara R DeAngelis; Oscar G Gallardo; Heidi Kosakowski; Justin Martello; Sujata Pradhan; Miriam Rafferty; Janet L Readinger; Abigail L Whitt; Terry D Ellis Journal: Phys Ther Date: 2022-04-01
Authors: Ikjae Lee; Mohamed Kazamel; Tarrant McPherson; Jeremy McAdam; Marcas Bamman; Amy Amara; Daniel L Smith; Peter H King Journal: PLoS One Date: 2021-05-06 Impact factor: 3.240
Authors: Adeel Ali Memon; Corina Catiul; Zachary Irwin; Jennifer Pilkington; Raima A Memon; Allen Joop; Kimberly H Wood; Gary Cutter; Marcas Bamman; Svjetlana Miocinovic; Amy W Amara Journal: Front Rehabil Sci Date: 2022-08-11
Authors: Kimberly H Wood; Adeel A Memon; Raima A Memon; Allen Joop; Jennifer Pilkington; Corina Catiul; Adam Gerstenecker; Kristen Triebel; Gary Cutter; Marcas M Bamman; Svjetlana Miocinovic; Amy W Amara Journal: J Parkinsons Dis Date: 2021 Impact factor: 5.568