Association between objectively measured walking steps and sleep in community-dwelling older adults: A prospective cohort study

Abstract

Physical inactivity and sleep disturbances are major problems in an ageing society. There is increasing evidence that physical activity is associated with sleep quality. However, the association between daily walking steps and sleep remain unclear. This prospective study examined the relationship between objectively measured daily walking steps and sleep parameters in Japanese community-dwelling older adults. In total, 855 community-dwelling individuals aged 65 and above, with an uninterrupted follow-up from August 2015 to March 2016, were enrolled. The participants wore a wristband sensor for an average of 7.8 days every three months. Multiple linear regression analysis was performed to examine the relationship between daily walking steps and sleep parameters, including the total sleep time, sleep efficiency, time awake after sleep onset (WASO), awakening time count during the night, and naptime. The median (interquartile range, IQR) age of the participants was 73 (69-78) years, with 317 (37.1%) men and 538 (62.9%) women. The median (IQR) educational level was 12 (11-12) years, and the median (IQR) Mini-Mental State Examination score was 29 (27-30) points. The number of daily walking steps showed a positive correlation with sleep efficiency and an inverse correlation with WASO, awakening time count, and naptime, after adjusting for covariates and correcting for the false discovery rate (β = 0.098, 95% confidence interval [CI]: 0.034 to 0.162, p = 0.003; β = -0.107, 95% CI: -0.172 to - 0.043, p = 0.001; β = -0.105, 95% CI: -0.17 to -0.04, p = 0.002; and β = -0.31, 95% CI: -0.371 to -0.249, p < 0.001, respectively). Our results can help promote walking as an intervention for preventing sleep disturbances in community-dwelling older adults.