Efficacy of daytime physical activity to improve sleep quality during a week of balneotherapy treatments

Purpose Achieving high-quality sleep is increasingly challenging in modern society. Maintaining an active daily routine (daytime physical activity) has been proven to enhance sleep quality, as well as balneotherapy in unhealthy subjects. No studies have investigated the combined effects of daytime physical activity and balneotherapy on sleep quality in healthy individuals. The current study explores the potential benefits of daytime physical activity, mud application and thermal-water bathing on sleep quality. Methods 127 healthy Italian participants (34.6% male, average age 64.61 ± 0.89 years) were actigraphically monitored during a one-week stay at a spa resort while having mud application and thermal-water bathings to collect daytime physical activity and sleep parameters. For the statistical analyses, participants were divided into tertiles based on the percentage of daytime physical activity: low: ≥19,2%-<39,5%; medium: ≥39,5%-<42,4%; high: ≥42,4%-≤73%. Increment in sleep quality was calculated as delta values between the first (mean of the second, third and fourth night of the spa stay) and the second (fifth, sixth, seventh night of the spa stay) part of the week of the spa stay. Results Independent of the mud application time, participants with a high daytime physical activity collected better values in the delta sleep parameters. For the sleep efficiency, highly active participants exhibited a 1% improvement compared to their less active counterparts (1 ± 0.53% vs -0.71 ± 0.15%; not statistically significant). Similarly, participants with high daytime physical activity decreased their sleep fragmentation during the spa stay (-1.4 ± 1.03), whereas participants with low daytime physical activity increased and worsened this parameter (1.5 ± 1, not statistically significant). Conclusion Maintaining an active daily routine in combination with balneotherapy treatments could enhance objective aspects of sleep quality. Medical experts specializing in hydrology may offer tailored recommendations to help individuals undergoing sleep treatments benefit from balneotherapy sessions and incorporate active daily routines.