Daily sleep and physical activity each have individual impacts on a variety of health outcomes and risk factors (1,2,3). There may be reciprocal relationships between sleep and physical activity, but the extent of these relationships remains unclear. Common questions include: Does sleep duration affect physical activity intensity or duration? How much sleep loss can one tolerate and not affect physical activity? What is the best time of day to exercise? Given my time constraints, should I sleep or exercise? Researchers do not yet have all the answers to these questions, but the answer to the final question may simply be “both.” 

Sleep & Health 

Adequate sleep is necessary for all major physiological systems, including immune, endocrine and metabolic function (4,5,6). Meeting sleep guidelines (7-9 hours per night for most adults [6]) is consistently associated with beneficial physical health outcomes, including but not limited to, enhanced cognition, decreased risk for cardiovascular disease and Type 2 diabetes, and prevention of some types of cancer (5). Moreover, meeting sleep guidelines is associated with decreased psychological distress, anxiety and depression, longevity, and health-related quality of life (7). Of concern, data from the 2004-2017 National Health Information Survey and 2014 United States Behavioral Risk Factor Surveillance Survey suggest 30-35% of U.S. adults obtain less than the recommended seven hours of sleep per night (8,9). Moreover, an estimated 56% of U.S. adults live with sleep disorders, which is higher than similarly developed regions of the world (10). 

The negative impacts of sleep deprivation and sleep restriction on several health outcomes have been well documented (11,12). While many of us may not experience sleep deprivation (e.g., total loss of sleep) or chronic sleep restriction (e.g., partial nighttime sleep loss over multiple weeks, months or years), acute sleep restriction is a relatively common experience. Acute sleep restriction is commonly defined in experimental studies as a reduction in total sleep time to less than six hours of sleep per night over a single night or several nights. Obtaining less than six hours of sleep on just a single night impairs following-day cognition, including negative effects on memory (13,14), inhibitory control (15), executive function (13) and reaction time (14,16,17,18). 

Sleep & Physical Activity 

Similar to the health benefits associated with meeting sleep recommendations, meeting the 2018 ACSM Physical Activity Guidelines can reduce the risk of developing at least seven of the 10 most common chronic diseases in the United States (19). However, only 51% of American adults meet aerobic physical activity guidelines (20). Given the large portion of the population that does not meet sleep or physical activity guidelines, the next logical question to ask is “What are the relationships between these physical behaviors?” 

Most of the evidence exploring the reciprocal relationship between sleep and physical activity comes from cross-sectional and laboratory-based exercise studies (e.g., effect of sleep restriction on exercise performance). The results of cross-sectional studies are largely inconclusive, which is likely due to the wide range of subjective measurements used. Conversely, laboratory-based studies have more commonly demonstrated a negative impact of sleep restriction on subsequent exercise performance (21,22). Sleep restriction appears to be most detrimental for subsequent sub-maximal aerobic performance bouts lasting more than a couple of minutes. 

More recent research has attempted to extend these previous findings by experimentally altering sleep duration to better understand how one behavior affects another (e.g., how does a night of short sleep [3 hours] affect subsequent days of physical activity?). Some studies have demonstrated no effect of sleep restriction on light, moderate or vigorous physical activity (23,24), while others reported a reduction in physical activity (25,26,27). One comprehensive study explored the effects of two different types of sleep restriction (delayed-onset sleep restriction [going to bed in the middle of the night] and early awakening sleep restriction [waking up in the middle of the night]) on accelerometer-derived physical activity compared to a normal night of sleep in healthy adult men (26). Interestingly, the results indicated a significant reduction in total physical activity only under the early awakening sleep restriction condition, which was driven by reduced vigorous-intensity physical activity. These data suggest that the timing of sleep restriction, as well as physical activity intensity, are important considerations when understanding the relationships between these physical behaviors. 

While there are clear benefits to meeting individual sleep and physical activity guidelines, several questions about the relationships between these physical behaviors remain. A better understanding of the complex relationships between sleep, physical activity and sedentary behaviors will provide clinicians and health professionals with tools to better council patients from a holistic health perspective. 

Authors: John D. Chase, M.S., and John R. Sirard, Ph.D. 

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