Morning Exercise for Sleep

(SiESTa 2 Trial)

Recruiting at 5 trial locations

Overseen By Research Coordinator

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Rutgers, The State University of New Jersey

Must not be taking: Sleep medications

Disqualifiers: Sleep disorders, Circadian disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

62 Participants Needed

Trial Summary

Do I need to stop taking my current medications for this trial?

If you are taking medications for sleep, you cannot participate in this trial. The protocol does not specify about other medications.

What data supports the effectiveness of the treatment Morning Exercise for improving sleep?

Research shows that exercise, including morning routines, can improve sleep quality and reduce daytime sleepiness and fatigue. A study found that both morning and evening exercise improved sleep quality and health-related quality of life in overweight and obese adults. ^{1 2 3 4 5}

Is morning exercise generally safe for humans?

Research on physical activity interventions, including morning exercise, shows that while minor injuries like muscle strains can occur, serious adverse events are rare. It's important to start slowly and gradually increase intensity to minimize risks. ^{6 7 8 9 10}

How does morning exercise as a treatment for sleep differ from other treatments?

Morning exercise is unique because it is a non-drug approach that may improve sleep by affecting body temperature, autonomic control (nervous system regulation), and metabolic functions. Unlike other treatments, it focuses on the timing of physical activity, which could influence sleep quality and daytime alertness. ^{4 11 12 13 14}

What is the purpose of this trial?

The purpose of this study is to examine the effects of a morning exercise intervention on sleep (quality and duration), mood (positive affect, anxiety, depression, anger), stress and productivity among undergraduate students (18-23 years) evening-exercisers with poor self-reported sleep quality. Aim 1. Compared to the control condition, evening-exercisers prescribed morning exercise will exhibit improved sleep quality (increased efficiency, decreased fragmentation) and increased sleep duration. Aim 2. Compared to the control condition, evening-exercisers prescribed morning exercise will exhibit improved mood (increased positive affect, decreased depression, anxiety and anger). Aim 3. Compared to the control condition, evening-exercisers prescribed morning exercise will exhibit decreased stress and increased productivity.

Research Team

Andrea Spaeth, PhD

Principal Investigator

Rutgers, The State University of New Jersey

Eligibility Criteria

This study is for undergraduate students aged 18-23 who usually exercise in the evening but are struggling with poor sleep quality. Participants should be interested in shifting their workout routine to the morning to see if it helps improve their sleep, mood, stress levels, and productivity.

Inclusion Criteria

Frequent evening exercisers (6pm-11pm, 3+ times per week)

I often have trouble sleeping well.

I am a healthy college student between 18 and 23 years old.

Exclusion Criteria

Sleep/circadian rhythm disorders

Inability to change schedule to exercise in the morning

Inability to maintain exercise frequency over the next 4 weeks

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants change their exercise times to the morning (6am-11am) or continue their normal evening exercise routine (6pm-11pm)

2 weeks

Follow-up

Participants are monitored for changes in sleep quality, mood, stress, and productivity

2 weeks

Treatment Details

Interventions

• Morning Exercise

Trial Overview The trial is testing whether switching from evening to morning exercise can lead to better sleep (both quality and length), a more positive mood (less anxiety, depression, anger), less stress, and greater productivity among college students who don't sleep well.

Participant Groups

Group I: Morning Exercise Experimental Treatment 1 Intervention

Participants will change their exercise times to the morning (6am-11am).

Group II: Normal Exercise Active Control 1 Intervention

This arm has no intervention. Participants will continue to exercise at their normal evening time (6pm-11pm).

Who Is Running the Clinical Trial?

Rutgers, The State University of New Jersey

Lead Sponsor

Trials

471

Recruited

81,700+

Findings from Research

Morning symptoms are prevalent in COPD patients, affecting 39.8% to 94.4% of individuals, and are linked to reduced physical activity levels, indicating a significant impact on daily functioning.

Treatments aligned with clinical guidelines can significantly reduce activity limitations caused by morning symptoms (p<0.0001), suggesting that addressing these symptoms should be a key focus in managing COPD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between morning symptoms and physical activity in COPD: a systematic review. van Buul, AR., Kasteleyn, MJ., Chavannes, NH., et al.[2022]

A 12-week moderate exercise training program improved physical fitness, body composition, and subjective sleep quality in overweight and obese adults, regardless of whether the exercise was done in the morning or evening.

While both morning and evening exercise led to similar overall benefits, morning workouts advanced sleep timing, while evening workouts delayed it, suggesting flexibility in scheduling exercise without compromising health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of morning versus evening exercise training on sleep, physical activity, fitness, fatigue and quality of life in overweight and obese adults. Saidi, O., Colin, E., Rance, M., et al.[2021]

In a study of 420 patients, it was found that higher levels of physical activity in the morning are significantly associated with greater increases in blood pressure and heart rate after waking, indicating that morning activity can influence cardiovascular responses.

The research suggests that when interpreting results from ambulatory blood pressure monitoring, the level of physical activity should be considered, as it can affect the magnitude of the morning surge in blood pressure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The morning surge in blood pressure and heart rate is dependent on levels of physical activity after waking. Leary, AC., Struthers, AD., Donnan, PT., et al.[2019]

Exercise therapy may improve sleep architecture in individuals without sleep disorders, potentially due to its effects on body temperature and metabolic function, although the exact mechanisms are not fully understood.

In people with obstructive sleep apnea, supervised exercise therapy can reduce daytime sleepiness, but its impact on overall sleep quality remains unclear, highlighting the need for more rigorous studies to establish effective exercise guidelines for various sleep disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sleep disorders and exercise: a mini-review. Shah, NM., Bennett, C., Hassan, H., et al.[2023]

A 12-week study involving 100 adults with overweight or obesity showed that both morning and evening exercise significantly increased daily physical activity by about 12-22 minutes compared to baseline.

Participants in both exercise groups also reported improvements in their daily routines, including more sleep (up to 36 minutes) and less time spent on sedentary activities like watching TV or playing video games.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How do previously inactive individuals restructure their time to 'fit in' morning or evening exercise: a randomized controlled trial. Brooker, PG., Gomersall, SR., King, NA., et al.[2023]

In a randomized controlled trial involving 209 elderly participants (average age 80), a home-based exercise program was found to be generally safe, with 151 adverse events reported, affecting 47% of participants.

Despite the program's safety, 14% of the adverse events were serious, highlighting that high levels of pre-existing morbidity in this population can pose challenges to maintaining consistent exercise participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events in mobility-limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices. Hinrichs, T., Bücker, B., Wilm, S., et al.[2015]

In a review of over 5,500 participants from 11 physical activity interventions, no serious study-related adverse events were reported, indicating a high level of safety in these exercise programs.

While minor musculoskeletal injuries were noted, the studies emphasized a 'start low and go slow' approach, suggesting that moderate-intensity physical activity is safe and effective for sedentary, chronically ill, or older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. Ory, M., Resnick, B., Jordan, PJ., et al.[2022]

In a 1.5-year study involving 274 male veterans with cardiovascular disease risk factors, only one serious adverse event (atrial fibrillation) occurred, indicating that a progressive walking program can be safely recommended for high-risk individuals.

While minor musculoskeletal issues were common, over half of the reported adverse events were unrelated to the exercise program, highlighting the need for strategies to help individuals with chronic illnesses safely resume physical activity after any health setbacks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events among high-risk participants in a home-based walking study: a descriptive study. Goodrich, DE., Larkin, AR., Lowery, JC., et al.[2022]

Participants with chronic health conditions expressed that adverse events (AEs) from resistance training (RT) significantly impact their willingness to engage in future exercise, highlighting the importance of understanding both the risks and benefits of RT.

The study identified that personal experiences, health conditions, and the environment in which RT occurs influence perceptions of safety and participation, suggesting that better communication about the risks of AEs is essential to encourage RT among individuals with chronic health issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring participants' perspectives on adverse events due to resistance training: a qualitative study. El-Kotob, R., Pagcanlungan, JR., Craven, BC., et al.[2023]

Researchers in resistance training studies often lack clear guidance and motivation for thorough adverse event (AE) reporting, which can lead to inconsistent practices.

There is a need for exercise-specific guidelines for AE reporting, as current standards are perceived as not applicable to exercise trials, highlighting the importance of tailored strategies to improve reporting consistency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Researchers' perspectives on adverse event reporting in resistance training trials: a qualitative study. El-Kotob, R., Pagcanlungan, JR., Craven, BC., et al.[2022]

Mild physical activity before bedtime does not change sleep patterns but increases heart rate variability during slow-wave sleep, indicating a potential impact on sleep quality.

The study found that exercising up to 1 hour before sleep leads to a higher low-frequency/high-frequency (LF/HF) ratio, suggesting reduced parasympathetic activity, which may affect overall sleep quality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Elevated variance in heart rate during slow-wave sleep after late-night physical activity. Bulckaert, A., Exadaktylos, V., Haex, B., et al.[2011]

Vigorous late-night exercise does not negatively impact overall sleep quality, as measured by polysomnography, actigraphy, and subjective assessments, in a study of 11 physically fit young adults.

While sleep quality remained stable, late-night exercise was associated with increased heart rate during the first few hours of sleep, suggesting potential effects on cardiac autonomic control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of vigorous late-night exercise on sleep quality and cardiac autonomic activity. Myllymäki, T., Kyröläinen, H., Savolainen, K., et al.[2011]

In young adults, higher daily energy expenditure is associated with better sleep efficiency, but this relationship weakens in older adults, indicating age-related changes in how physical activity affects sleep.

A 12-month exercise training program improved physical fitness in older participants but did not lead to significant changes in sleep efficiency or other sleep characteristics, suggesting that exercise may be more beneficial for those with existing sleep issues rather than for healthy older individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of physical fitness and daily energy expenditure on sleep efficiency in young and older humans. Oudegeest-Sander, MH., Eijsvogels, TH., Verheggen, RJ., et al.[2022]

A study involving five healthy university students found that late evening exercise at 50-60% VO2max for 1 hour improved subjective sleep quality the following morning.

Participants also reported decreased daytime sleepiness after engaging in late evening exercise, suggesting a potential benefit for overall alertness and well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of the timing of exercise on the night sleep. Yoshida, H., Ishikawa, T., Shiraishi, F., et al.[2013]

References

1. England pubmed.ncbi.nlm.nih.gov

Association between morning symptoms and physical activity in COPD: a systematic review. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Effect of morning versus evening exercise training on sleep, physical activity, fitness, fatigue and quality of life in overweight and obese adults. [2021]

3. Netherlands pubmed.ncbi.nlm.nih.gov

The morning surge in blood pressure and heart rate is dependent on levels of physical activity after waking. [2019]

4. China pubmed.ncbi.nlm.nih.gov

Sleep disorders and exercise: a mini-review. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

How do previously inactive individuals restructure their time to 'fit in' morning or evening exercise: a randomized controlled trial. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Adverse events in mobility-limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices. [2015]

7. England pubmed.ncbi.nlm.nih.gov

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Adverse events among high-risk participants in a home-based walking study: a descriptive study. [2022]

9. Canada pubmed.ncbi.nlm.nih.gov

Exploring participants' perspectives on adverse events due to resistance training: a qualitative study. [2023]

10. Canada pubmed.ncbi.nlm.nih.gov

Researchers' perspectives on adverse event reporting in resistance training trials: a qualitative study. [2022]

11. England pubmed.ncbi.nlm.nih.gov

Elevated variance in heart rate during slow-wave sleep after late-night physical activity. [2011]

12. England pubmed.ncbi.nlm.nih.gov

Effects of vigorous late-night exercise on sleep quality and cardiac autonomic activity. [2011]

13. Switzerland pubmed.ncbi.nlm.nih.gov

Impact of physical fitness and daily energy expenditure on sleep efficiency in young and older humans. [2022]

14. Australia pubmed.ncbi.nlm.nih.gov

Effects of the timing of exercise on the night sleep. [2013]