Implementation of a 12-week Adapted Physical Activity (APA) Program in People Suffering From Chronic Insomnia.

According to the 2019 National Sleep and Vigilance Institute survey, in France, one-third of men and women are not satisfied with their sleep, and nearly half struggle to fall asleep or return to sleep. Given the growing evidence of the harmful effects of lack of sleep, its alteration on health, these figures are alarming.

Insomnia is characterized by dissatisfaction with the quantity or quality of sleep, difficulty initiating and/or maintaining sleep, and early morning awakenings at least three times a week for a minimum period of three months.

In a Sleep Medicine Reviews report, it was shown that many patients diagnosed with insomnia had a physiological hyperarousal disorder that resulted in poor sleep, which has been found in insomniacs in numerous studies. It is observed in particular on the autonomic nervous system by a low variability of heart rate and a high level of noradrenaline reflecting a dominant sympathetic axis. An anxiogenic and depressive profile and elevated cortisol levels are also often associated with this hyperarousal encountered in insomniacs. In addition, an alteration of the circadian rhythm seems to favor insomnia. Indeed, a decrease in core temperature and cortisol levels in the evening are primary mechanisms for sleep onset. A study showed an elevated sleep latency in individuals with this delayed circadian temperature rhythm. In the same study, a high wake-up time after sleep was associated with a high core temperature. Regarding cortisol, a smaller decline in cortisol and higher cortisol levels at the end of the day are associated with shorter sleep duration, lower sleep efficiency, and poor subjective sleep quality.

Although a first treatment of insomnia would be to find a good lifestyle and optimal sleep conditions, the majority of first-line remedies in the treatment of insomnia remain pharmacological today, through the short- or medium-term prescription of hypnotics, neuroleptics, anxiolytic benzodiazepines or some antidepressants.

If the practice of regular physical activity is now well known to improve overall health, what about sleep?