Asian-American Midlife Women's Physical Activity and Sleep Related Symptoms

Background: Physical activities have been reported to improve the sleep quality of midlife women, a group frequently experiencing sleep-related symptoms commonly associated with the transition to menopause (Mansikkamaki et al., 2012; Tworoger et al., 2003). However, these findings have been inconsistent in relation to the types and levels of physical activity. Exercise or leisure-time physical activity was negatively associated with overall sleep duration although they were not significant predictors of the overall sleep duration (Tu et al., 2012). On the contrary, exercise intervention has been reported to improve the sleep quality of midlife women (Tworoger et al., 2003). When race/ethnicity is entered into the equation on the relationship between physical activity and sleep, the dynamics become more complex (CDC, 2004). In addition, few studies have focused on Asian-American midlife women’s sleep difficulties during the menopausal transition (Ramos et al., 2011).

Purpose/Aims: The purpose of the study is to explore the relationships between Asian-American midlife women’s physical activities and their sleep-related symptoms, while considering other covariates in the study.

Methods: This is a secondary analysis of the data from a larger study that included four major racial/ethnic groups of midlife women in the United States (U.S.)(Whites, African-Americans, Asian-Americans, and Hispanics). In the original study, the data were collected nationally using an Internet survey method. Among 542 multi-ethnic midlife women, only 123 Asian-American midlife women were included in this analysis. The analysis utilized the data that were collected using the questions on socio-demographic characteristics, menopausal stages, and health conditions; the Midlife Women’s Symptoms Index; and the Kaiser Physical Activity Survey. The data were analyzed using bivariate correlation analyses, hierarchical multiple regression analyses, and multiple logistic regression analyses.

Findings: Perceived general health and active living activities were negatively associated with the total number of sleep-related symptoms (p<.05) while household/caring activities were positively associated with it (p<.05). Similarly, household/caring activities were positively associated and active living activities were negatively associated with the total severity scores of sleep-related symptoms (p<.05). Physical activities and other covariates in the study collectively accounted for 26% of the total variances in the total numbers of sleep symptoms (R²=.26, p<.01) and 27% of the total variances in the total severity scores of sleep-related symptoms (R²=.27, p<.01). Lower perceived general health, higher household/caring activities, and lower active living activities were significant factors associated with the total number of sleep-related symptoms (p<.01) and the total severity of sleep-related symptoms (p<.05).

Conclusions: Significant associations of physical activity to Asian American midlife women’s sleep-related symptoms during their menopausal transition were found in this analysis. The increase in active living activities (leisure-time physical activities) improved Asian American midlife women’s sleep-related symptoms; however, increases in household/caring activities and occupational activities were detrimental to sleep-related symptoms. These differences need to be taken into consideration in future research that aims at improving Asian-American midlife women’s sleep-related symptoms. In addition, global collaborative research is necessary to determine the differences in sub-ethnic groups among Asian-American midlife women, to provide cultural comparisons with those in their original countries, and ultimately to help develop culturally sensitive sleep-related interventions.

Keywords:  physical activity, sleep, midlife women, Asian American

References:

CDC. (2004). Physical activity among Asians and native Hawaiian or other Pacific islanders--50 States and the District of Columbia, 2001-2003. MMWR Morb Mortal Wkly Rep, 53(33), 756-760.

Mansikkamaki, K., Raitanen, J., Nygard, C. H., Heinonen, R., Mikkola, T., EijaTomas, & Luoto, R. (2012). Sleep quality and aerobic training among menopausal women--a randomized controlled trial. Maturitas, 72(4), 339-345. doi: 10.1016/j.maturitas.2012.05.003

Ramos, A. R., Wohlgemuth, W. K., Dong, C., Gardener, H., Wright, C. B., Boden-Albala, B., . . . Rundek, T. (2011). Race-ethnic differences of sleep symptoms in an elderly multi-ethnic cohort: the Northern Manhattan Study. Neuroepidemiology, 37(3-4), 210-215. doi: 10.1159/000334315

Tu, X., Cai, H., Gao, Y. T., Wu, X., Ji, B. T., Yang, G., . . . Shu, X. O. (2012). Sleep duration and its correlates in middle-aged and elderly Chinese women: the Shanghai Women's Health Study. Sleep Med, 13(9), 1138-1145. doi: 10.1016/j.sleep.2012.06.014

Tworoger, S. S., Yasui, Y., Vitiello, M. V., Schwartz, R. S., Ulrich, C. M., Aiello, E. J., . . . McTiernan, A. (2003). Effects of a yearlong moderate-intensity exercise and a stretching intervention on sleep quality in postmenopausal women. Sleep, 26(7), 830-836.