Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects

Objectives: Sleep is associated with physical activity (PA), yet the nature and directions of this association are less understood. This study aimed to disentangle the long-term temporal sequences between sleep duration/disturbance and PA in older adults, distinguishing between- and within-person effects. Design: Longitudinal panel study. Setting and Participants: We conducted a longitudinal study using 3 waves of data collected in 2008/09 (T1), 2012/13 (T2), and 2016/17(T3) from adults aged >= 50 years in the English Longitudinal Study of Ageing (N = 10,749 individuals). Measures: Sleep duration, sleep disturbance, and PA were assessed by self-reported questionnaires. We used cross-lagged panel models (CLPMs) to examine between-person effects and random intercept cross-lagged panel models (RI-CLPMs) to examine within-person effects. Results: Our analyses revealed a reciprocal relationship between abnormal sleep duration and low PA levels at between-person level (abnormal sleep duration to PA: beta(T1-T2) = -0.053, beta(T2-T3) = -0.058, all P < .001; PA to abnormal sleep duration: beta(T1-T2) = -0.040, beta(T2-T3) = -0.045, all P < .05), with abnormal sleep duration being the driving force in the dynamic association. In addition, there was a unidirectional effect of more severe sleep disturbance on lower levels of PA at both between- and within-person levels (between-person level: beta(T1-T2) = -0.032, beta(T2-T3) = -0.028, all P < .001; within-person level: beta(T1-T2 and T2-T3) = -0.031, all P = .011). Conclusions and Implications: This study adds novel insights into the temporal directionality of sleep and PA among community-dwelling older adults and highlights poor sleep as a potential risk factor for PA. Intervention strategies should aim to improve sleep to promote PA levels and successful aging. (c) 2023 AMDA - The Society for Post-Acute and Long -Term Care Medicine.