Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jun;35(6):947-958.
doi: 10.1002/mds.28009. Epub 2020 Feb 24.

Randomized, Controlled Trial of Exercise on Objective and Subjective Sleep in Parkinson's Disease

Amy W Amara  1   2 , Kimberly H Wood  1   2   3 , Allen Joop  1 , Raima A Memon  1   4 , Jennifer Pilkington  1 , S Craig Tuggle  2   5 , John Reams  2   5 , Matthew J Barrett  6 , David A Edwards  7 , Arthur L Weltman  7 , Christopher P Hurt  2   8 , Gary Cutter  2   9 , Marcas M Bamman  1   2   4   10
Affiliations
Randomized Controlled Trial

Randomized, Controlled Trial of Exercise on Objective and Subjective Sleep in Parkinson's Disease

Amy W Amara et al. Mov Disord. 2020 Jun.

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. © 2020 International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease; exercise; polysomnography; rehabilitation; sleep.

PubMed Disclaimer

Conflict of interest statement

Financial Disclosure/Conflicts of Interests: none

Figures

FIG. 1.
FIG. 1.
Consort Flow Diagram
FIG. 2.
FIG. 2.
Objective Sleep Outcomes in Exercise and Sleep Hygiene Participants. In order to show improvement as a positive change, outcomes for which a lower score is better (wake after sleep onset and sleep latency) were multiplied by −1 for this figure. *Significant group x time interaction (p < 0.01).
FIG. 3.
FIG. 3.
Objective sleep outcomes on PSGs recorded at baseline, in the trained state on an exercise night (AEX), and in the trained state on a nonexercised night (CEX). A: Sleep Efficiency; B: Total Sleep Time; C: Wake after Sleep Onset; D: Time spent inN3. *Significant difference from Baseline based on Tukey’s HSD multiple comparisons procedure; +Significantly different from AEX based on Tukey’s HSD multiple comparisons procedure.
See this image and copyright information in PMC

Comment in

References

    1. Barone P, Antonini A, Colosimo C, et al. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord. 2009;24(11):1641–1649. - PubMed
    1. Politis M, Wu K, Molloy S, P GB, Chaudhuri KR, Piccini P. Parkinson’s disease symptoms: the patient’s perspective. Mov Disord. 2010;25(11):1646–1651. - PubMed
    1. Lees AJ, Blackburn NA, Campbell VL. The nighttime problems of Parkinson’s disease. Clin Neuropharmacol. 1988;11(6):512–519. - PubMed
    1. Nausieda PA, Weiner WJ, Kaplan LR, Weber S, Klawans HL. Sleep disruption in the course of chronic levodopa therapy: an early feature of the levodopa psychosis. Clin Neuropharmacol. 1982;5(2):183–194. - PubMed
    1. Chahine LM, Amara AW, Videnovic A. A systematic review of the literature on disorders of sleep and wakefulness in Parkinson’s disease from 2005 to 2015. Sleep Med Rev. 2017;35:33–50. - PMC - PubMed

Publication types