With millions of dollars being spent in the United States every year on devices and medications designed to aid sleep, it is remarkable that so many people are ignoring one of the most highly effective and inexpensive sleep aids available. It is completely portable, can be done at any time of day or night, comes in a variety of styles to fit any lifestyle or person, yet when physicians, sleep experts and friends and family members recommend it, many turn it down? What is this miracle sleep aid? It’s exercise.
When the National Sleep Foundation conducted its 2013 Sleep in America poll, they found a high correlation between exercise and better sleep. They interviewed 1,000 Americans and found that over 75% of those that exercised reported either “fairly good” or “very good” sleep quality, while only 56% of those who did not exercise reported that same level of sleep satisfaction. Conversely, 14% of those who did not exercise reported “very bad” sleep quality, while only 3% of exercisers expressed this same low level.
Max Hirshkowitz, PhD is the sleep center director of the Department of Medicine of the Houston Veterans Medical Center. He says, “There’s a very strong relationship between good sleep and exercise. People who report exercise sleep better than people who don’t exercise. Their sleep quality is better, they feel better, their general health is improved, and they have fewer bad nights of sleep.” As the task force chair for the 2013 poll, he categorized participants’ exercise into four different activity levels:
- Vigorous – Activities that need hard physical effort, such as running, cycling, swimming or competitive sports. 18% of participants represented.
- Moderate – Activities that required more effort than normal, such as yoga, Tai chi or weight lifting. 25% of participants represented.
- Light – Walking. 48% of participants represented.
- No activity – Less than ten minutes of physical activity in the previous week. 9% of participants represented.
The group was purposely representational of a cross-section of the country, coming from different geographic, economic, ethnic, educational, age and gender demographics. The results showed that though most of the group reported the same average sleep quantity of just under seven hours on weekdays and a bit over seven and a half hours on weekends, it consistently showed that those who exercised slept better and experienced fewer problems with the quality of their sleep than did those who did not exercise. Notably, between 56 and 67% of exercisers reported getting a good night’s sleep every night or almost every night, while only 39% of non-exercisers reported the same. And the survey indicated that same-day exercise improved that night’s sleep.
It comes as no surprise that the exercisers also reported better overall health than did those who did not exercise. Between 79 and 91% of exercisers indicated that they were in good or excellent health, while 42% of non-exercisers reported poor or fair overall health. Hirshkowitz says that it all goes together. “The foundation of good health involves exercise, nutrition and good sleep, and I believe there’s a synergy between them. I don’t care how good your exercise program is or how good your nutritional program is, if you don’t sleep well you’re not going to feel well.”
The study results bear this out. Those who did not exercise had the highest incidence of sleep disorder symptoms and risk for obstructive sleep apnea. Forty percent reported snoring, 72% reported tiredness, 34% had high blood pressure and 24% had BMIs greater than 35.
Of interest to the researchers involved in the survey was the fact that those who exercised most vigorously also got the best sleep and were in the best health. “The first major finding is that exercise appears to be good for sleep, the second is that vigorous exercisers do even better,” Hirshkowitz said. “You don’t have much control over how well you sleep, but you do have control over how much you exercise. My advice would be if you don’t exercise, start an exercise program. Start with walking for ten minutes per day and work your way up.”
Another important takeaway from the study is that there does not appear to be as big a drawback to exercising late as had originally been thought. Though over half of those who exercised moderately or vigorously did so at least four hours before going to bed, over 20% exercised within that four hour window, and the sleep and health benefits appeared to be the same. Barbara A. Phillips, MD, MSPH, FCCP, who is a board-certified internist, pulmonologist and sleep physician at the University of Kentucky Good Samaritan Sleep Disorders Center and one of the National Sleep Foundation’s task force members, says, “Dogma says that you shouldn’t exercise within four hours of bedtime, but in this poll we found that the people who [did] slept as well as those who exercised at any other time, and they slept better than those who didn’t exercise at all.” She says that it is time to forget the idea that exercising late is bad. “The big message to me is that it’s time to put that myth to rest. People need to exercise. It’s good for overall health; it’s good for sleep. We need to tell people to exercise whenever they can.”
Finally, the study showed that there is a significant correlation between the amount of quantity and quality of sleep that a person gets and the amount of time that they spend sitting during the day. Those who sit less than eight hours per day sleep better and are in better health than those who sit more than eight hours per day. Hirshkowitz says that based on these findings he has changed his own daily office routine and no longer sits for more than an hour at a time. He has also installed a “standing” desk at which to do his computer work.
The study showed that those who exercise regularly and vigorously were less likely to use sleep aids or need them. Seems like the answer for all of those searching for better sleep.