Poor Sleep Quality and Heightened Perceptual Responses to Exercise in Community Dwellers: Results from the CanCOLD Study

Rationale Poor sleep quality is associated with poor health outcomes, while exercise is protective of health. However, understanding of the impact of poor sleep on exercise tolerance and capacity in community-dwelling adults is limited. Objectives To explore associations between sleep quality and exercise in a community-dwelling adult population (age > 40 y). Methods We analyzed a cross-sectional sample of adults from the CanCOLD study, a prospective cohort study conducted in adults > 40y containing demographic and cardiopulmonary exercise (CPET) outcomes. We used adjusted multiple linear regression to determine associations between Pittsburgh Sleep Quality Index (PSQI) and CPET variables at peak exercise. Logistic regression determined the odds of poor sleepers (PSQI > 5) compared to good sleepers (PSQI ≤ 5) having abnormally high dyspnea (>ULN) or abnormal physiologic CPET outcomes (<LLN or > ULN). Measurements and Main Results In 1072 analyzed individuals (425 poor sleepers; age 66.4 ± 9.7 years; 40.5% female), poor sleepers were more likely to experience abnormally high levels of dyspnea at peak CPET (dyspnea > ULN for work rate odds ratio [95% CI] 1.65 [1.21-2.24], for ⩒E 1.52 [1.07-2.17]), but no differences in the odds of having abnormal key physiologic variables at peak CPET (⩒O2peak, HR, O2 pulse normal). Dyspnea adjusted for ⩒E or ⩒O2 positively correlated, and percent-predicted work rate negatively correlated, with PSQI (ie, worse sleep; both P < .05), while most physiologic variables showed no correlation. Conclusions Perceptual responses to exercise were impacted more by poor sleep quality than physiological outcomes. These data highlight the importance of adequate sleep quality to lessen the burden of uncomfortable activity-related sensations.