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INVESTIGATION OF THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND SLEEP QUALITY IN ADULTS.

Introduction

Exercise is important for the development and improvement of both physical and mental health. An effective physical activity program develops body strength, endurance, balance, physical function, mental function and quality of life (Lok, Lok 2016). Sleep, one of the basic human needs, has an important place in human life for healthy life. Insufficient sleep causes a threat to health, as well as a decrease in cognitive, psychomotor and emotional functions (Orzech, Salafsky and Hamilton, 2011). Sleep quality has recently been emphasized by researchers. Studies show thatthere are many factors that affect sleep quality. As the most important factor, physical activity is necessary for people to protect their health and maintain a high-quality life. A study found that physical activity and exercise are associated with a better sleep quality and less sleep disorder in elderly people with mild cognitive impairment (Nakakubo et al. 2017). The sleeping individual appears to be an important variable of health affecting quality of life and well-being (Kline, 2013). Regular exercise programs are recommended to improve the health status, sleep and quality of life of individuals (Chang et al., 2016)

Physical activity is associated with better sleep quality and less sleep disturbance in healthy adults (Borodulin et al., 2010). It is also stated that regular physical activity has psychological benefits as well as physical health protection and improvement. It has been reported to have positive effects on many clinical diseases such as depression, anxiety disorders, somatoform disorders, substance abuse, especially stress and anxiety symptoms, reducing negative feelings such as anger and aggression, increasing sleep quality (Artal et al. 1998). It has been stated that exercise facilitates sleeping, provides deeper sleep, and individuals feel better when they wake up in the morning (Vardar, 2005).

It is stated that exercise is positive effects on sleep when studies evaluating the relationship between physical activity and sleep. People have reported that exercise facilitates diving into sleep, provides deeper sleep, and makes them feel better when they wake up in the morning. It has been reported that especially in the morning exercise or late evening exercise, the sleep is more positively affected by the exercise (Singh et al. 1997). According to the study about the effect of exercise on sleeping, it was stated that after exercising, the exercise performed towards the waist increased the sleep duration and that exercise in the morning hours did not affect the sleep (Youngstedt, O'Connor, Dishman 1997). Sleep, one of the basic human needs, has an important place in human life for healthy life. The physical activity involved in healthy lifestyle behavior is thought to be effective on sleep quality. In this context, the aim of this study is to determine the relationship between physical activity and sleep quality in adults.

Research Questions

1. How are individual physical activity levels?

2. How are the sleep qualities of individuals?

3. Do sociodemographic characteristics affect the physical activity levels of individuals?

4. Do sociodemographic characteristics affect individuals' sleep quality?

5. Is there a relationship between physical activity levels and sleep quality?

Methods

Research is planned in a descriptive relational type. In determining the sample of the research, the universal sampling method was used. Since the prevalence is unknown, the frequency of occurrence is calculated as 50%, the sample is calculated as 155 individuals with a standard deviation of 5% and 95% confidence interval. In gathering the data; "International Physical Activity Questionnaire" and "Pittsburgh Sleep Quality Index" were used by the researchers who questioned the socio-demographic information of the individuals.

Collection of data

The data of this study were collected by face-toface interview technique from adult individuals.

Personal Information Form

In the Personal Information Form, demographic questions such as age, gender, educational status, marital status were included.

International Physical Activity Questionnaire

In this study, the short form of the International Physical Activity Questionnaire (IPAQ) was used to determine the physical activity levels of the individuals. For this survey, conducted by the International validity and reliability study of Craig et al, validity and reliability study of university students in Turkey are made by Ozturk. There are 7 questions in the questionnaire. Questions 1 and 2 are violent activities, questions 3 and 4 are moderate violent activities, questions 5 and 6 are gait, and question 7 is the time when the individual is spending time with the resident. In the evaluation of all the activities, it is taken as a criterion that each activity is done at least 10 minutes at a time. A score of "MET minutes / week" is obtained by multiplying the minutes, days and MET values (times of resting oxygen consumption). Physical activity levels were found to be physically inactive (<600 MET / week), low level of physical activity (600-3000 MET-min / week) and adequate physical activity level (> 3000 MET- min /week). In the calculation of energy consumption for physical activities, the weekly duration (minutes) of each activity and the MET energy values for the International Physical Activity Questionnaire were multiplied. Thus, for each individual, energy consumption for severe, moderate, walking, sitting, and total physical activities was obtained in the MET minutes / week unit.

Pittsburgh Sleep Quality Index (PSQI)

The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. PUKI was developed in 1989 by Buysse et al. Validity and reliability studies in Turkey Agargun et al. (1996) was made by. PUKI provides a reliable, valid and standard measurement of sleep quality. The scale consists of a total of 24 questions. The total score is between 0-21. Sleep quality is good (0-4 points) and sleep quality is poor (5-21 points). The correlation between the total scores belonging to the scale was found to be r = 0.81.

Ethical and Legal Dimension of the Study In order to be able to carry out the research, it is started after the institutional leave and approval from the individuals. The verbal permission of the individual was taken before the investigation began. The principle of "Illuminated Consent" has been fulfilled by the principle of "autonomy", which states that patients can be withdrawn without seeking them whenever they want, by explaining the purpose of the research, the duration and the procedures to be carried out during the research. Before the forms to be used in the research were given, necessary explanations were made orally and care was taken to create a silent environment with little stimulation during application.

Evaluation of Data

After the data were collected, the option that each individual indicated for each item on the scales was entered into the SPSS 21 program by the researchers and the total scores of the individuals from the scales were calculated. Pearson's correlation analysis was used to evaluate the relationship between number and percentage distributions in the evaluation of the study's demographic data, t-test with normal distribution in binary groups to evaluate the relationship between sociodemographic characteristics and communication skills and internet dependency, Oneway ANOWA in two groups and communication skills and internet addiction. The results were assessed at 95% confidence interval and p <0.05 significance level.

Results

The average age of the individuals is 32.14 [+ or -] 3.17, 56.42% is male, 42.88% is female, 35.84% is university graduate, 50.56% is single and 45.44% is married. When physical activity levels of the individuals were evaluated, it was determined that 49.28% were inactive, 25.6% inactive and 24.32% were active, and 59.52% of sleep quality was good and 39.68% of sleep quality was poor when sleep quality levels were evaluated (Table 1).

When the socio-demographic characteristics and physical activity levels of the individuals were evaluated, it was found that the male was more active than the primary school / middle school and high school graduates and the difference was statistically significant (p <0.05) (Table 2). When the sociodemographic characteristics and sleep quality levels of the individuals were evaluated, it was found that the sleep quality was better and the difference was statistically significant (p <0.05).

When the relationship between the physical activity levels of individuals and the sleep quality was evaluated, it was found that there was a moderate correlation between physical activity and sleep quality in the positive direction and the difference was statistically significant (r: 0.68, p> 0.05). It has come to the conclusion that the physical activity levels of the individuals are better quality.

Discussion

In this study, it was found that there was a moderate correlation between physical activity levels of individuals and sleep quality in the positive direction. The increased level of physical activity of the individuals has resulted in better quality sleep. In a study conducted by McClain et al. (2014) also show that age and sex dependence of associations between physical activity and sleep. They found that physical activity were significantly lower in adults reporting more frequent daytime sleepiness in younger (20-39) and older ([greater than or equal to]60) age groups, but not in middle-aged (40-59), respondents. In younger respondents, physical activity increased with sleep duration, but in middle aged and older respondents physical activity was either unrelated to sleep duration or lower in those reporting [greater than or equal to]8 h of sleep. Objectively measured sedentary time showed limited evidence of associations with sleep duration (McClain et al. 2014). Sleep characteristics were also associated with age and sex men and the older individuals were less likely to report daytime sleepiness, and middle-aged men were more likely to report short sleep duration than older women (McClain et al. 2014).

In this study It has also been found that those who are physically female, married, and primary / secondary school graduates have low levels of physical activity. However, it has turned out that the quality of sleep is poor in those who are female and those who are married. Further research is needed to understand how sex and marital status interact to influence associations between sleep duration and physical activity. Similarly, in a study conducted by Feng, Du, Ye, & He (2014) indicated that the decrease in physical activity results in a decrease in sleep quality. Contrary to this study, in a study conducted by Kakinami et al. (2017) found that the more time spent doing sedentary activities was associated with poorer sleep quality, but physical activity was not associated.

Increasing evidence suggests that physical activity and sleep duration are associated with numerous health benefits (Janssen, Leblanc 2010). Sleep, sedentary behavior, physical activity and diet all interact and influence each other to ultimately impact health. Sleep is not a waste of time and sleep hygiene is an important factor to consider in the prevention and treatment of obesity (Chaput & Dutil 2016). In a recent review, shorter sleep duration was associated with increased obesity risk in five out of five longitudinal studies that controlled for self-reported physical activity (Patel and Hu, 2008). In a study conducted by individuals with obesity problems it was found that altered sleep duration and quality in obesity and physical activity improves sleep duration, sleep quality (Mendelson et al. 2016).

Conclusion

In this study, it was found that there was a moderate correlation between physical activity and sleep quality in the positive direction and the difference was statistically significant. Further studies are needed to understand how sex and marital status interact to influence associations between sleep duration and physical activity. Increasing evidence suggests that physical activity and sleep duration are associated with numerous health benefits.

Acknowledgments

I thank all students for participating in this study. No funding was used for this study.

References

Artal, M., Sherman, C., 1998, Exercise Against Depression. The Physician and Sports Medicine, 26(10): 57-61.

Borodulin, K., Evenson, K. R., Monda, K., Wen, F., Herring, A. H., & Dole, N., 2010, Physical activity and sleep among pregnant women. Paediatric and perinatal epidemiology, 24(1), 45-52.

Chang, S. P., Shih, K.S., Chi, C. P., Chang, C. M., Hwang, K. L., & Chen, Y. H., 2016, Association between exercise participation and quality of sleep and life among university students in Taiwan. Asia Pacific Journal of Public Health, 28(4), 356-6

Chaput, J. P., & Dutil, C., 2016, Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 103.

Feng, Q., Du, Y., Ye, Y. L., & He, Q. Q., 2014, Associations of physical activity, screen time with depression, anxiety and sleep quality among Chinese college freshmen. PLoS One, 9(6), e100914.

Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010; 7: 40. pmid:20459784

Kakinami, L., O'Loughlin, E. K., Brunet, J., Dugas, E. N., Constantin, E., Sabiston, C. M., & O'Loughlin, J., 2017, Associations between physical activity and sedentary behavior with sleep quality and quantity in young adults. Sleep Health: Journal of the National Sleep Foundation, 3(1), 56-61.

Kline, C., 2013, Sleep quality. In M.D. Gellman, J.R. Turner (Eds.), Encyclopedia of Behavioral Medicine (pp. 1809-1812). New York: Springer Lok S, Lok N: Kronik Psikiyatri Hastalarina Uygulanan Fiziksel Egsersiz Programlarinin Etkinligi: Sistematik Derleme. Cur Approach Psychiatry 2016;8(4):124-128.(in Turkish)

McClain, J. J., Lewin, D. S., Laposky, A. D., Kahle, L., & Berrigan, D., 2014, Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults. Preventive medicine, 66, 68-73.

Mendelson, M., Borowik, A., Michallet, A. S., Perrin, C., Monneret, D., Faure, P., ... & Flore, P., 2016, Sleep quality, sleep duration and physical activity in obese adolescents: effects of exercise training. Pediatric obesity, 11(1), 26-32.

Nakakubo, Sho, et al. Impact of poor sleep quality and physical inactivity on cognitive function in community- dwelling older adults. Geriatr Gerontol Int, 2017;1-6 .doi: 10.1111/ggi.12973

Orzech, K. M., Salafsky, D. B., & Hamilton, L. A., 2011, The state of sleep among college students at a large public university. Journal of American College Health, 59(7), 612-19.

Patel, S.R., Hu, F.B., 2008. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring) 16, 643-653.

Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of the effect of exercise on sleep. Sleep 1997;20:95-101

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Wu, X., Tao, S., Zhang, Y., Zhang, S., & Tao, F., 2015). Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students. PloS one, 10(3), e0119607.

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METIN SAHIN (1), NESLIHAN LOK (2), ALI SARI (3), SEFA LOK (1)

(1) Selcuk University Sport Sciences Faculty, Konya, Turkey

(2) Selcuk University Health Sciences Faculty, Konya, Turkey CORRESPONDENCE AND REPRINT REQUESTS: Selcuk University Health Sciences Faculty, Konya, Turkey e-mail: neslihanlok@selcuk.edu.tr, Phone:+903322233548

(3) Selcuk University Health Sciences Institute, Konya, Turkey

(*) the abstract was published in the 18th I.S.C. "Perspectives in Physical Education and Sport" - Ovidius University of Constanta, May 17-19, 2018, Romania

Received 11 march 2018 / Accepted 6 may 2018
Table 1. Individual Physical Activity and Sleep Quality Levels

Physical Activity            n     %

Inaktive                      40    25.6
(<600 MET-min/week)
Minimal Aktive                77    49.28
(600-3000 MET- min/week)
Very aktive                   38    24.32
(>3000 MET- min/week)
Total                        155   100,0
Sleep Quality Levels
Sleep quality is good (0-4    93    59.52
score)
Sleep quality is bad (5-21    62    39.68
score)
Total                        155   100,0

Table 2. Evaluation of sociodemographic characteristics and physical
activity levels of individuals

              Inaktive     Minimal Aktive   Very aktive
Physical      (<600 MET-   (600-3000 MET-   (>3000
Activity      min/week)    min/week)        MET-min
              n (%)        n (%)            /week)

Gender
Female        22(14.19)    30(19.2)         15(9.6)       t=2.275 (**)
Male          18(11.52)    47(30.08)        23(14.72)     p=0.01 (*)
Mariatal
Status
Married       18(11.52)    46(29.44)         7(4.48)      t=2.024 (**)
Single        20(12.8)     42(26.88)        23(14.72)     p=0.01 (*)
Educational
Level
Primary/      17(10.88)    24(15.36)        11(7.04)      F=7.207 (**)
secondary                                                 p=0.02 (*)
scholl
High scholl   10(6.4)      21(13.44)        16(10.24)
University    13(8.32)     25(16.0)         18(11.52)

(*) p<0,05

Table 4. Relationship between Individual Physical Activity Levels and
Sleep Qualities (r, p)

Variable                 X [+ or -] SS         r, p degeri

Physical Activity Scale  1730.37[+ or -]24.37  0,68
                                               0,002 (*)
Sleep Qualitiy Scale        6.24[+ or -]1.43

p<0,05 (*)
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Article Details
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Title Annotation:Original article
Author:Sahin, Metin; Lok, Neslihan; Sari, Ali; Lok, Sefa
Publication:Ovidius University Annals, Series Physical Education and Sport/Science, Movement and Health
Article Type:Report
Date:Sep 15, 2018
Words:2756
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