Impact Of Early Outpatient Cardiac Rehabilitation On Sleep Quality As Measured Via Actigraphy

Document Type

Conference Proceeding

Publication Date

8-22-2025

Publication Title

J Cardiopulm Rehabil Prev

Keywords

actigraph, actimetry, adult, algorithm, arousal, benchmarking, conference abstract, controlled study, emotional disorder, exercise, female, follow up, groups by age, heart rehabilitation, human, male, outpatient, randomized controlled trial, secondary analysis, sleep latency, sleep quality, sleep time, wake after sleep onset

Abstract

Introduction: Poor sleep is common among older adults and contributes to both physiological and psychological dysfunction. Exercise has emerged as an effective nonpharmacological intervention to improve sleep quality across age groups. Purpose: To examine the impact of early outpatient cardiac rehabilitation (CR) on actigraphy- derived sleep metrics in older adults. We hypothesized that sleep metrics would significantly improve after completing early outpatient CR. Design: Secondary analysis of a randomized controlled trial (NCT05925634) Methods: We included patients (age ≥60 yrs) who enrolled at Baystate or Henry Ford CR and completed ≥18 sessions of CR. Patients wore actigraphy devices (ActiGraph) for 7 consecutive days at three time points: Within the first two weeks of CR, during the last week of CR, and at a 6 month follow up. The Cole-Kripke algorithm was used in conjunction with sleep logs and verified by 2 blinded assessors to obtain accurate sleep periods. Key outcomes included wake after sleep onset (WASO), awakening counts, and average length of awakenings. Sleep latency and total sleep time were excluded as outcomes due to inconsistencies between the sleep log and actigraphy data. We used a repeated measures analysis with paired statistics. Results: Between August 2023 and April 2025, we evaluated 40 subjects (age = 69 ± 6 yrs, 63% men, 20% Black) with 894 nights of sleep. WASO decreased over time - from baseline, end of CR, and 6 month follow up (86 ± 60 min, 81 ± 57 min, 77 ± 56 min, p = 0.031, respectively). Total awakening counts also improved over time (20 ± 9, 19 ± 9, 18 ± 9, p = 0.016, respectively). Average length of awakenings decreased over time (4.4 ± 2, 4.3 ± 3, 4.2 ± 2 min, p = 0.036, respectively). Conclusions: Patients who attended ≥18 sessions of CR improve their sleep quality, although this was most notable at 6 months and improvements in sleep metrics were modest. In a patient population that is vulnerable to poor sleep quality, these data provide preliminary evidence to support small additional sleep benefits for those who attend CR..

Volume

45

Issue

5

First Page

E48

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