Physical Activity as a Tool to Improve Sleep Quality for Secure Psychiatric Inpatients: A Feasibility Study

TL;DR

A feasibility study explores whether short, frequent physical activity sessions during the day can improve sleep quality in psychiatric inpatients with severe mental illness.

Contribution

This study demonstrates the feasibility of using intermittent daytime physical activity to improve sleep patterns in psychiatric inpatients.

Findings

Participant retention was 100%, and outcome measure completion ranged from 67% to 91%.

Mid-point of sleep and wake time significantly advanced, suggesting improved sleep phase alignment.

Although insomnia severity scores did not significantly decrease, MVPA increased by 17 minutes per day.

Abstract

People with a severe mental illness (SMI) often experience insomnia and disrupted sleep–wake cycles. Daytime physical activity (PA) can retrain the sleep/wake cycle, but PA engagement is often markedly low in SMI. It is hypothesised that frequent, intermittent, short bouts of daytime PA can improve sleep outcomes in SMI. Twenty‐two inpatients from a secure psychiatric hospital (39.95 ± 16.87 years, 16 male) were recruited for a 10‐week PA intervention involving 3 × 10‐min bouts of self‐selected intensity PA/day, 5 days/week. Feasibility (primary outcome) was examined by assessing recruitment, outcome measure completion, trial adherence, and participant retention. At baseline, mid‐point, and post‐intervention, inpatients completed surveys, including the insomnia severity index (ISI) and wore the Motionwatch8 actigraph for 7 days to record sleep and PA data (including sleep efficiency (SE), total sleep time (TST), and moderate‐to‐vigorous PA (MVPA)). Outcome completion ranged from 67% to 91%. Mean trial adherence was 22% (range 2%–77%). Participant retention was 100%. Pre‐to‐post intervention, ISI scores decreased from 12.14 (SD = 4.98) to 11.38 (SD = 6.18) (t (20) = 0.65, p = 0.53). Time to bed and time of falling asleep both advanced (p > 0.05). Mid‐point of sleep (M = 38 min, SE = ≥ 15.93 min, p = 0.01) and wake time (M = 34 min, SE = 15.92 min, p = 0.02) significantly advanced. MVPA increased by 17 min/day (T = 1.17, p > 0.05). Other sleep indices (e.g., TST, SE) did not change significantly. Outcome completion and participant retention rates were high; trial adherence was low. Increasing intermittent PA can reduce psychiatric inpatients' insomnia symptoms and advance sleep phase. Sample variance and participant‐researcher rapport are discussed. Findings highlight the beneficial effect of short bouts of PA on sleep, providing scaffolding for future trials.