Maturitas 72 (2012) 339–345 Contents lists available at SciVerse ScienceDirect Maturitas j ourna l h o me page: www.elsevier.com/locate/maturitas Sleep quality and aerobic training among menopausal women—A randomized controlled trial  Kirsi Mansikkamäki a,∗ , Jani Raitanen a,b , Clas-Håkan Nygård b , Reetta Heinonen b , Tomi Mikkola c , EijaTomás d , Riitta Luoto a,e a UKK institute for Health Promotion Research, Tampere, Finland b School of Health Sciences, University of Tampere, Finland c Helsinki University Central Hospital, Helsinki, Finland d Tampere University Hospital, Tampere, Finland e National Institute for Health and Welfare, Finland a r t i c l e i n f o Article history: Received 20 February 2012 Received in revised form 11 May 2012 Accepted 13 May 2012 Keywords: Randomized trial Aerobic training Sleep quality Hot flushes Symptomatic Menopause a b s t r a c t Background: Menopause is associated with poor sleep quality and daytime sleepiness, which may lead to impaired quality of life and impaired functioning in daily activities. Objective: To study whether exercise training improves sleep quality or decreases the amount of night time hot flushes among menopausal women with vasomotor symptoms. Study design: A randomized controlled trial. Sedentary women (N = 176) aged 43–63 years with menopausal symptoms were randomized to a six-month unsupervised aerobic training intervention (50 min 4 times per week) or a control group. Both groups attended lectures on physical activity and health once a month. Main outcome measures: Sleep quality and the amount of hot flushes disturbing sleep. The women reported daily via mobile phone whether hot flushes had disturbed their sleep and how they had slept (scale 1–5). Responses received by mobile phone over the 6-month period totaled on average 125 (5.2 per week) responses per participant. Results: At baseline there was no difference between the groups in the demographic variables. Sleep quality improved significantly more in the intervention group than in the control group (OR 1.02; 95% CI = 1.0–1.05, p = 0.043). The odds for sleep improvement were 2% per week in the intervention group and a decrease of 0.5% per week in the control group. The amount of hot flushes related to sleep diminished (p = 0.004) by the end of the intervention. Conclusions: Aerobic training for 6 months may improve sleep quality and reduce hot flushes among symptomatic menopausal women. © 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Regular aerobic exercise has been shown to reduce menopausal symptoms and improve health conditions among middle-aged women [1,2]. Among menopausal women sleep disturbances are common; 16–42% of premenopausal, 39–47% of perimenopausal and 35–60% of postmenopausal women have reported sleep dis- turbances [3]. It has been shown that vasomotor hot flushes and  Trial registration: ISRCTN54690027, http://www.controlled-trials.com/. ∗ Corresponding author at: UKK Institute for Health Promotion Research, Post Box 30, 33501 Tampere, Finland. Tel.: +358 3 2829214; fax: +358 3 2829200. E-mail addresses: kirsi.mansikkamaki@uta.fi (K. Mansikkamäki), jani.raitanen@uta.fi (J. Raitanen), clas-hakan.nygard@uta.fi (C.-H. Nygård), reetta.heinonen@uta.fi (R. Heinonen), tomi.mikkola@hus.fi (T. Mikkola), eija.tomas@pshp.fi ( EijaTomás), riitta.luoto@uta.fi (R. Luoto). night sweats resulting in sleep disturbance may lead to depressive symptoms in these women [4]. Epidemiological studies indicate that exercise may be useful in improving sleep quality and in reduc- ing daytime sleepiness [5–7]. However, the findings of long-term exercise studies are inconsistent: in a 4-month moderate-intensity walking and low-intensity yoga intervention no statistically sig- nificant effects on sleep quality were detected in symptomatic middle-aged women. The results moreover showed that both groups had fewer hot flushes [8]. In Turkish intervention study, 65 menopausal women participated in an aerobic training programme for 6 months, and the intervention group reported significantly fewer hot flushes and other menopausal symptoms [9]. Studies evaluating the effects of aerobic training on menopausal symptoms and sleep quality are rare, and the results have been con- tradictory [8,10–12]. In a 24-week walking trial for symptomatic menopausal women, the intervention did not alleviate most of sub- jects’ symptoms, except sleep problems [13]. In our earlier study 0378-5122/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.maturitas.2012.05.003