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Insomnia treatment among individuals with comorbid insomnia and obstructive sleep apnea is suboptimal. In a pilot randomized controlled trial, 19 individuals with comorbid insomnia and obstructive sleep apnea were allocated to one of two arms: EX + EX, consisting of two 8-week phases of exercise training (EX), or RE + CBTiEX, encompassing 8 weeks of relaxation training (RE) followed by 8 weeks of combined cognitive-behavioral therapy and exercise (CBTiEX). Outcomes included Insomnia Severity Index (ISI), polysomnography, and cardiorespiratory fitness measures. A mixed-model analysis of variance revealed a Group × Time interaction on peak oxygen consumption change, F(1, 14) = 10.1, p =.007, and EX increased peak oxygen consumption (p =.03, g′ = −0.41) and reduced ISI (p =.001, g′ = 0.82) compared with RE (p =.49, g = 0.16) post-8 weeks. Post-16 weeks, there was a significant Group × Time interaction (p =.014) driven by RE + CBTiEX yielding a larger improvement in ISI (p =.023, g′ = 1.48) than EX + EX (p =.88, g′ < 0.1). Objective sleep was unchanged. This study showed promising effects of regular EX alone and combined with cognitive-behavioral therapy for insomnia on ISI in comorbid insomnia and obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Summary: Sleep loss is associated with reduced health and quality of life, and increased risk of Alzheimer's disease and related dementias. Up to 66% of persons with Alzheimer's disease and related dementias experience poor sleep, which can predict or accelerate the progression of cognitive decline. Exercise is a widely accessible intervention for poor sleep that can protect against functional and cognitive decline. No previous systematic reviews have investigated the effectiveness of exercise for sleep in older adults with mild cognitive impairment or Alzheimer's disease and related dementias. We systematically reviewed controlled interventional studies of exercise targeting subjectively or objectively (polysomnography/actigraphy) assessed sleep in persons with mild cognitive impairment or Alzheimer's disease and related dementias. We conducted searches in PubMed, Embase, Scopus and Cochrane‐Library (n = 6745). Nineteen randomised and one non‐randomised controlled interventional trials were included, representing the experiences of 3278 persons with mild cognitive impairment or Alzheimer's disease and related dementias. Ten had low‐risk, nine moderate‐risk, and one high‐risk of bias. Six studies with subjective and eight with objective sleep outcomes were meta‐analysed (random‐effects model). We found moderate‐ to high‐quality evidence for the beneficial effects of exercise on self‐reported and objectively‐measured sleep outcomes in persons with mild cognitive impairment or Alzheimer's disease and related dementias. However, no studies examined key potential moderators of these effects, such as sex, napping or medication use. Our results have important implications for clinical practice. Sleep may be one of the most important modifiable risk factors for a range of health conditions, including cognitive decline and the progression of Alzheimer's disease and related dementias. Given our findings, clinicians may consider adding exercise as an effective intervention or adjuvant strategy for improving sleep in older persons with mild cognitive impairment or Alzheimer's disease and related dementias. [ABSTRACT FROM AUTHOR]

Objective: To identify facilitators and barriers to older adults' participation in telehealth interventions for primary prevention and health promotion. Methods: Relevant articles were searched using keywords in Embase and MEDLINE. Study characteristics, type of telehealth interventions and technology involved, as well as facilitators and barriers to their use, were extracted from selected articles. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model was used to organise data. Results: A total of 24 articles (pertaining to 20 studies) were included. Nine facilitators and 11 barriers influencing the participation in telehealth interventions for primary prevention and health promotion among older adults were identified. The most recurrent facilitators were related to the individual's performance expectancy and effort expectancy, as well as the presence of a social dimension associated with the intervention (i.e. having a good relationship with the other participants in the program). The two most prevalent barriers were also related to effort expectancy and performance expectancy, followed by barriers related to the inherent characteristics of the technology and older adults' health condition. Experience, age and gender were also found to moderate technology use and acceptance. Conclusions: This rapid review highlights the importance of adopting a holistic perspective when designing telehealth interventions aimed at preventive and health promotion purposes among older adults. [ABSTRACT FROM AUTHOR]

Cross‐frequency coupling (CFC) between brain oscillations during non‐rapid‐eye‐movement (NREM) sleep (e.g. slow oscillations [SO] and spindles) may be a neural mechanism of overnight memory consolidation. Declines in CFC across the lifespan might accompany coinciding memory problems with ageing. However, there are few reports of CFC changes during sleep after learning in older adults, controlling for baseline effects. Our objective was to examine NREM CFC in healthy older adults, with an emphasis on spindle activity and SOs from frontal electroencephalogram (EEG), during a learning night after a declarative learning task, as compared to a baseline night without learning. Twenty‐five older adults (M [SD] age = 69.12 [5.53] years; 64% female) completed a two‐night study, with a pre‐ and post‐sleep word‐pair associates task completed on the second night. SO‐spindle coupling strength and a measure of coupling phase distance from the SO up‐state were both examined for between‐night differences and associations with memory consolidation. Coupling strength and phase distance from the up‐state peak were both stable between nights. Change in coupling strength between nights was not associated with memory consolidation, but a shift in coupling phase towards (vs. away from) the up‐state peak after learning predicted better memory consolidation. Also, an exploratory interaction model suggested that associations between coupling phase closer to the up‐state peak and memory consolidation may be moderated by higher (vs. lower) coupling strength. This study supports a role for NREM CFC in sleep‐related memory consolidation in older adults. [ABSTRACT FROM AUTHOR]

Recent evidence suggests that the autonomic nervous system can contribute to memory consolidation during sleep. Whether fluctuations in cardiac autonomic activity during sleep following physical exercise contribute to the process of memory consolidation has not been studied. We assessed the effects of a non‐rapid eye movement (NREM) nap following acute exercise on cardiac autonomic regulation assessed with heart rate variability (HRV) to examine if HRV influences memory processes. Fifty‐six (59% female) healthy young adults (23.14 ± 3.74 years) were randomly allocated to either the exercise plus nap (ExNap, n = 27) or nap alone (NoExNap, n = 29) groups. The ExNap group performed a 40‐minute moderate‐intensity cycling, while the NoExNap group was sedentary prior to learning 45 neutral pictures for a later test. Subsequently, participants underwent a 60‐minute NREM nap while measuring EKG, followed by a visual recognition test. Our results indicated that heart rate did not significantly differ between the groups (p =.243), whereas vagally mediated HRV indices were lower in the ExNap group compared to the NoExNap group (p <.05). There were no significant differences in sleep variables between the groups (p >.05). Recognition accuracy was significantly higher in the ExNap group than in the NoExNap group (p =.027). In addition, the recognition accuracy of the ExNap group was negatively associated with vagally mediated HRV (p <.05). Pre‐nap acute exercise appears to attenuate parasympathetic activity and to alter the relationship between memory and cardiac autonomic activity. Our findings reinforce those of previous studies and together show the contribution of parasympathetic tone to memory consolidation during sleep. The negative relationship between recognition memory performance and parasympathetic activity indicates that the alteration of parasympathetic tone following acute exercise may be unfavorable to memory consolidation. [ABSTRACT FROM AUTHOR]