Casual walking and nighttime sleep quality among older adults: evidence from Kaneohe, Hawai‛i utilizing the Pittsburgh Sleep Quality Index

Abstract

The studies included in this dissertation examine the relationship between casual walking and nighttime sleep quality among older adults. Previous research shows that sleep would be influenced from walking briskly or for long periods of time. This research tested whether casual walking a few days per week improved sleep. Sleep quality was assessed prior to and following one month of walking with the Pittsburgh Sleep Quality Index (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989), an instrument proven to be valid and reliable with numerous different populations. In a preliminary study, a volunteer convenience sample of 30 older adults was recruited in 2002 from an Assisted Living Facility (ALF) in Tallahassee, Florida. After hearing a presentation about the benefits of walking on sleep, residents were invited to participate in the study. Everyone attending two presentations agreed to walk and walks took place either in the morning or afternoon in the halls of the ALF, in two groups of 15. Half (50%) of the residents that participated for one month experienced an improvement in the quality of their sleep, 30% experienced no change, and 19% experienced a decrease in the quality of their sleep. The improvement, however, was not statistically significant. Subsequently, while a research student in the Graduate School of Medicine, Department of Social Gerontology at Tokyo University, a Nepalese colleague offered to conduct comparative research with older adults in Kathmandu. In 2009, 43 older Nepalese adults were recruited in a volunteer convenience sample at Pashupati Briddaashram, a social welfare facility in Kathmandu, to walk there with Hom Nath Chalise, Ph.D., one of the directors of Geriatric Center Nepal, and several volunteers. Every attempt was made to recreate the research conducted in Tallahassee; however, walks took place early in the morning and occurred outside. Since the studies in Kathmandu and Tallahassee are not comparable, the Nepalese research became a second preliminary study. To increase the ability to make generalizations from this research, arrangements were made to conduct another study with older adults on Oahu walking outside utilizing a control group. The results of the study on Oahu, as well as the two preliminary studies are contained in this dissertation. The evidence presented shows that, while walking is a beneficial activity and has numerous other benefits for an older adult, casually walking is not sufficient to significantly improve older adults' nighttime sleep quality.