Exercise and Insomnia

Can exercise help insomnia?

There are several available treatments for insomnia, and one that has received some interest is exercise. Some research does suggest that regular exercise can improve sleep quality in individuals who struggle with this common sleep disorder.

One recent research report analyzed the results of 22 different studies that assessed the use of exercise interventions for the treatment of insomnia. According to the result of numerous subjective assessments, exercise improved sleep quality significantly ^[1]. This means that people who participate in exercise interventions perceive their quality of sleep to be better.

In addition, the studies included in the report concluded that exercise improves sleep efficiency, meaning that people who exercise spend a greater proportion of their time in bed actually asleep ^[1].

Older research has found that exercise reduces sleep complaints and can be effective for treating chronic insomnia ^[2].

Best types of exercise for people with insomnia

There isn’t necessarily one specific type of exercise that is best for treating insomnia. Researchers have suggested that varied exercise interventions should be recommended for improving sleep quality ^[1].

Both physical exercises, such as cycling, and mind-body exercises, such as yoga, have been found to be beneficial for patients with insomnia ^[1]. Additional research has shown that a combination of aerobic exercise and resistance training, each performed three days per week, is beneficial for improving subjective sleep quality, increasing total sleep time, and reducing daytime dysfunction from lack of sleep ^[3].

While a variety of different exercise types have been found to be effective for reducing the severity of insomnia, aerobic exercise has been the most widely studied, and it has been found to be so beneficial that it is comparative in effectiveness to hypnotic medication ^[2].

Some research suggests that some forms of exercise may be better than others for improving sleep. For example, a meta-analysis of studies with middle-aged women found that moderate-intensity aerobic exercise improved sleep quality, whereas yoga, which was lower in intensity, did not ^[4].

Some studies have found lower-intensity exercises, including yoga, to be effective for treating insomnia ^[1], whereas others have not ^[4]. There is evidence to support vigorous exercise as an antidote to insomnia. One study with young adults, both men and women, found that those who exercised vigorously spent more time asleep. They also had greater amounts of REM and deep sleep, and less light sleep throughout the course of the night ^[5].

In summary, there isn’t really one exercise modality that must be used to improve sleep. There are several studies that support the use of exercise interventions to treat insomnia symptoms. What is known is that when previously-sedentary people with insomnia add exercise to their routines, they enjoy better sleep quality ^[6].

Some people may find more vigorous aerobic exercises, such as running and cycling, to be more beneficial for improving sleep quality, but what is most important is finding something that works for your individual needs.

When is the best time to exercise for a good night’s sleep?

There has been some debate regarding the proper timing of exercise for ensuring the most improvement in sleep quality. Some experts argue that nighttime exercise is too stimulating and actually interferes with sleep.

One study, published in 2014, did not find this to be true. Study results found that evening exercise, defined as physical activity performed within 4 hours of bedtime, was not associated with poor sleep. The study did find that people who exercised vigorously in the morning were more likely to report quality sleep and less likely to report waking up unrefreshed ^[7].

However, another study found that healthy young adults who exercised 1.5 hours before bedtime fell asleep more quickly and had more time spent in deep sleep when they exerted themselves more during exercise ^[8]. While this study wasn’t conducted with individuals with insomnia, the results do suggest that evening exercise can actually improve sleep quality.

The bottom line is that exercise seems to improve sleep quality, whether it’s performed in the morning or the evening. Research doesn’t show any significant reduction in sleep quality when exercise is performed close to bedtime. To reap the benefits of exercise on sleep, the best strategy is to pick a time of day that works with your individual schedule.

Can exercise cause insomnia?

As indicated above, some people have expressed concern that evening exercise may cause insomnia or worsen sleep quality, because it’s stimulating. However, the research doesn’t support this concern.

Some factors related to exercise can, on the other hand, increase the risk for insomnia. For instance, chronic pain is associated with insomnia. If exercise is intense or extreme, and leads to ongoing pain, it may interfere with sleep ^[9].

Exercise may also cause insomnia in the case of overtraining syndrome, a phenomenon seen most often in athletes, such as runners and swimmers. With overtraining syndrome, excessive exercise leads to fatigue and decreased performance, along with a range of other unpleasant symptoms. Insomnia is one of these symptoms ^[10].

Exercise generally improves sleep quality, but it may lead to insomnia in extreme cases, such as in people who have injuries or pain, or who suffer from overtraining syndrome as a result of excessive exercise.

Other ways to treat insomnia

While exercise may be beneficial for those who experience symptoms of insomnia, sometimes exercise in and of itself is not sufficient for improving sleep. In some cases, exercise may simply be an add-on to other treatments for insomnia.

Below are some additional methods of treating insomnia ^[11]:

• Sleep hygiene: Patients with insomnia may benefit from education on proper sleep hygiene. While getting enough exercise can be a component of sleep hygiene, patients should also be educated on other practices, such as limiting daytime naps, avoiding alcohol and caffeine in the evening, and keeping a consistent bedtime and wake time.
• Stimulus control therapy: This sort of therapy teaches patients to use the bed only for sleep, thereby eliminating associations between being in bed and being awake. This means cutting out activities like reading or eating in bed and stopping the use of digital devices like phones and tablets in bed.
• Cognitive Behavioral Therapy for insomnia (CBTi): CBTi is a form of cognitive behavioral therapy designed specifically for people with insomnia, and it has been found to be even more beneficial than medication. It is typically delivered over 6 to 8 weeks, with a nurse, social worker, sleep therapist, mental health therapist, or physician assistant leading the intervention. During sessions, patients are provided with sleep education and trained in relaxation techniques and stimulus control. They are also trained in sleep restriction, which reduces the number of hours in bed to increase sleep drive. Finally, they receive cognitive behavioral interventions, which help them to correct unhelpful and distorted thoughts pertaining to sleep.
• Medication: Some patients with insomnia may benefit from taking prescription medication to treat symptoms. Medications used in the treatment of insomnia include benzodiazepines, zolpidem, zaleplon, and ramelteon. Some antidepressant and antipsychotic medications may be used off-label to treat insomnia. In some cases, a doctor may recommend that a patient take melatonin over-the-counter to alleviate insomnia.