Influencia de los niveles de sedentarismo y actividad física sobre la calidad del sueño de mujeres gestantes, perimenopáusicas y con fibromialgia

Abstract

Sleep disturbances is highly prevalent in the general population, and have a huge impact on adults’ quality of life. This disorder is predominantly characterized by dissatisfaction with sleep duration or sleep quality (SQ), difficulties initiating or maintaining sleep, and daytime dysfunction. Moreover, women are at increased risk compared to men to report sleep complaints. In this sense, sleep problems might be improve with breaking time in sedentary behaviours, increasing physical activity (PA) levels or performing physical exercise. The major aims of the present International Doctoral Thesis were: 1) to examine the association of objectively measured sedentary time (ST) and PA intensity levels with SQ during early pregnancy (Study I), and in perimenopausal women (Study II); 2) to evaluate the influence of a 4-month concurrent exercise training program (resistance and aerobic) compared to a healthy lifestyle counselling on SQ in perimenopausal women (Study III); 3) to examine the association of objectively measured ST and PA intensity levels with SQ in women with fibromyalgia (Study IV); 4) to assess whether those women who meet moderate‐to‐vigorous PA (MVPA) recommendations have better SQ than their counterparts (Study IV). To address these aims, four studies were conducted in the context of three research projects: 1) the GESTAFIT (GESTAtion and FITness) project, where 130 early pregnant women participated (Study I, cross-sectional); 2) the FLAMENCO (the Fitness League Against MENopause Cost) project randomized controlled trial (Studies II and III), that was divided in two parts: first, a study where 169 perimenopausal women participated (Study II, cross-sectional), and second, a study where a total of 150 women were divided into counselling and exercise groups (both, n=75) (Study III, experimental). The counselling consisted on four conferences about healthy lifestyle; and 3) al-Ándalus project (Study IV, cross-sectional), where 409 women with fibromyalgia were included. Sedentary time and PA intensity levels were objectively assessed with accelerometry and SQ was assessed with the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All measures were used in the three projects. Per protocol and intention-to-treat analyses were presented for the randomized controlled trial. The main findings and conclusions derived from the studies included in this thesis were: 1) there are not associations between ST and PA intensity levels with SQ in women during early pregnancy (Study I) neither in perimenopausal women (Study II); 2) Neither 4-month concurrent exercise training program (resistance and aerobic) nor a healthy lifestyle counselling have effects on SQ in perimenopausal women (Study III); 3) Lower ST and greater PA intensity levels, especially light and total PA, are associated with better SQ components in women with fibromyalgia (Study IV); 4) Women with fibromyalgia who meet physical activity recommendations (150 min/week of MVPA in bouts of ≥10 min) had better SQ than those who do not reach those recommendations (Study IV). The results of this International Doctoral Thesis enhance our understanding about how reducing ST and increasing PA levels could be a non-pharmacological treatment to improve SQ in women with fibromyalgia, and suggest that these active lifestyle interventions could not be the panacea regarding sleep in pregnant and perimenopausal women. Future studies should confirm or contrast the present findings.