0469 Changes in Physical Function and Sleep Quality According to Compliance With a Home-Based Resistance Exercise Program in Patients With Chronic Insomnia

Abstract Introduction To evaluate the efficacy of a 3-month home-based resistance exercise program on sleep quality and physical function in patients with chronic insomnia, and to examine whether exercise adherence moderates the relationship between physical improvements and sleep outcomes. Methods Between April 2024–November 2025, 137 participants (mean age 59.5 ± 10.6 years; 77.4% female) at Samsung Medical Center were recruited for a non-face-to-face RE program. The RE program spanned 9 months and included outpatient evaluations, remote guidance, and video-based progressive resistance training with stretching. Assessments were conducted at baseline (Time 1) and 3-month follow-up (Time 2). Exercise adherence was assessed and categorized as high (n=51, 49.5%), moderate (n=28, 27.2%), or low (n=24, 23.3%) based on completion rates and exercise during 3moths. Primary outcomes were Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included ISI component scores, skeletal muscle index (SMI), grip strength, chair stand test, and psychological measures. Paired t-tests were used to evaluate pre-post changes, and correlation analyses stratified by adherence level examined the relationship between chang of physical function and sleep score improvements. Results ISI and PSQI improved significantly by 20% and 11%, respectively. Sleep latency decreased by 41.4%, and sleep duration increased from 5.70 to 6.13 hours. SMI increased significantly by 0.06 kg/m2. Exercise adherence moderated key outcomes, with the high-adherence subgroup demonstrating a strong negative correlation between SMI and ISI changes (r = –0.506, p = 0.005). Participants with high adherence and SMI improvement showed the greatest reduction in ISI (–5.92 points, 42%) and significantly greater reductions in body fat percentage compared with the low-adherence group. Conclusion Home-based resistance exercise produced significant improvements in sleep quality and muscle mass in patients with chronic insomnia. The link between muscle gains and sleep improvement appeared only among highly adherent participants. High adherence is therefore essential for maximizing the clinical benefits of exercise-based insomnia interventions. Support (if any)