Abstract：
OBJECTIVE: To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers.
METHODS: This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months.
RESULTS: The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point.
CONCLUSIONS: The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.
METHODS: This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months.
RESULTS: The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point.
CONCLUSIONS: The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.
摘要：
目的：研究体力活动（PA）干预对睡眠质量的长期影响，以及白天午睡者和非午睡者之间的影响是否不均匀。
方法：本研究是对中国一项整群随机对照试验的二次分析。八个村庄以1：1随机分为干预组或对照组。干预组接受了为期8周的PA干预，而对照组没有。这项研究的主要结果是在24个月时匹兹堡睡眠质量指数（PSQI）全球评分的变化。
结果：511名参与者的平均年龄为70.94岁（SD5.73），55.6%为女性。干预措施显示8周时PSQI整体评分有所改善（调整后的平均差-1.05；P=0.002），在24个月时效果减弱（-0.64；P=0.06）。白天午睡的PSQI全球评分有统计学上的显着改善，但对于8周时的非午睡者则没有（调整后的平均差-0.98；P=0.01vs-1.27；P=0.05），12个月（-0.86；P=0.03vs-0.84；P=0.21），和24个月（-0.80；P=0.04vs-0.14；P=0.84），尽管这些改进低于PSQI的最低可检测水平，即1分。
结论：8周PA干预可有效改善睡眠质量，而效果减弱，低于24个月后PSQI的最低可检测水平1分。PA干预对睡眠质量的影响在白天午睡者中更为明显。其他干预措施(例如，需要关注多种行为干预措施，例如PA和健康饮食），以保持PA对一般老年人群睡眠质量的有益影响。需要进一步的研究来确认午睡效果的机制并制定量身定制的干预措施。
方法：本研究是对中国一项整群随机对照试验的二次分析。八个村庄以1：1随机分为干预组或对照组。干预组接受了为期8周的PA干预，而对照组没有。这项研究的主要结果是在24个月时匹兹堡睡眠质量指数（PSQI）全球评分的变化。
结果：511名参与者的平均年龄为70.94岁（SD5.73），55.6%为女性。干预措施显示8周时PSQI整体评分有所改善（调整后的平均差-1.05；P=0.002），在24个月时效果减弱（-0.64；P=0.06）。白天午睡的PSQI全球评分有统计学上的显着改善，但对于8周时的非午睡者则没有（调整后的平均差-0.98；P=0.01vs-1.27；P=0.05），12个月（-0.86；P=0.03vs-0.84；P=0.21），和24个月（-0.80；P=0.04vs-0.14；P=0.84），尽管这些改进低于PSQI的最低可检测水平，即1分。
结论：8周PA干预可有效改善睡眠质量，而效果减弱，低于24个月后PSQI的最低可检测水平1分。PA干预对睡眠质量的影响在白天午睡者中更为明显。其他干预措施(例如，需要关注多种行为干预措施，例如PA和健康饮食），以保持PA对一般老年人群睡眠质量的有益影响。需要进一步的研究来确认午睡效果的机制并制定量身定制的干预措施。
