Physical Activity in the Management of Insomnia in Adults Aged 60 Years and Older

Insomnia is highly prevalent among adults over the age of 60 and is associated with impairments in physical, cognitive, and emotional functioning, as well as an increased risk of cardiovascular and psychiatric disorders. In this population, pharmacological treatment is often limited by adverse effects and concerns regarding long-term safety, leading to growing interest in non-pharmacological interventions, particularly exercise, for the management of insomnia. The objective of this review was to examine the existing evidence on the efficacy of physical activity as an adjunct, non-pharmacological therapy for the treatment of insomnia in individuals aged 60 years and older. A literature search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies evaluating the effects of physical activity on insomnia and sleep quality in adults aged 60 years and above were considered. Subjective sleep outcomes were primarily assessed using validated instruments, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS). Evidence from randomized controlled trials, observational studies, and meta-analyses consistently demonstrates that physical activity is associated with significant improvements in scores on the Pittsburgh Sleep Quality Index and the Insomnia Severity Index among older adults. Low-intensity to moderate-intensity exercise performed several times per week over a period of weeks was sufficient to produce meaningful reductions in insomnia symptoms. Various modalities, including resistance training, aerobic exercise, combined exercise programs, walking, and mind-body practices such as tai chi, were shown to be beneficial. Notably, resistance training appeared to yield the greatest improvements in sleep quality in several studies. Overall, exercise represents a safe, accessible, and effective non-pharmacological strategy for improving sleep quality and reducing insomnia symptoms in adults aged 60 years and older. Even modest amounts of regular, low-intensity to moderate-intensity physical activity can lead to clinically significant improvements in both subjective and objective measures of sleep.