International Journal of Behavioral Medicine

, Volume 23, Issue 4, pp 501–506 | Cite as

Effects of Aquatic Exercise on Sleep in Older Adults with Mild Sleep Impairment: a Randomized Controlled Trial

  • Li-Jung Chen
  • Kenneth R. Fox
  • Po-Wen Ku
  • Yi-Wen Chang



Exercise has been found to be associated with improved sleep quality. However, most of the evidence is based on resistance exercise, walking, or gym-based aerobic activity.


This study aimed to examine the effects of an 8-week aquatic exercise program on objectively measured sleep parameters among older adults with mild sleep impairment.


A total of 67 eligible older adults with sleep impairment were selected and randomized to exercise and control groups, and 63 participants completed the study. The program involved 2 × 60-min sessions of aquatic exercise for 8 weeks. Participants wore wrist actigraphs to assess seven parameters of sleep for 1 week before and after the intervention. Mixed-design analysis of variance (ANOVA) was used to assess the differences between groups in each of the sleep parameters.


No significant group differences on demographic variables, life satisfaction, percentage of body fat, fitness, seated blood pressure, and any parameter of sleep were found at baseline. Significant group × time interaction effects were found in sleep onset latency, F(1,58) = 6.921, p = .011, partial eta squared = .011, and in sleep efficiency, F(1, 61) = 16.909, p < 0.001, partial eta squared = .217. The exercise group reported significantly less time on sleep onset latency (mean difference = 7.9 min) and greater sleep efficiency (mean difference = 5.9 %) than the control group at posttest. There was no significant difference between groups in change of total sleep time, wake after sleep onset, activity counts, or number and length of awakenings.


An 8-week aquatic exercise has significant benefits on some sleep parameters, including less time for sleep onset latency and better sleep efficiency in older adults with mild sleep impairment.


Physical activity Water exercise Water-based exercise Insomnia Elderly 



This work was supported by the Taiwan National Science Council (No. 102-2410-H-028-004). Professor Fox’s contribution was in part supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at Oxford University Hospitals NHS Trust and University of Oxford. The authors thank two anonymous reviewers for valuable comments.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© International Society of Behavioral Medicine 2015

Authors and Affiliations

  • Li-Jung Chen
    • 1
  • Kenneth R. Fox
    • 2
  • Po-Wen Ku
    • 3
  • Yi-Wen Chang
    • 1
  1. 1.National Taiwan University of SportTaichungTaiwan
  2. 2.University of BristolBristolUK
  3. 3.National Changhua University of EducationChanghuaTaiwan

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