Leisure-time Physical Activity and Balneotherapy: A Combined Approach to Enhancing Sleep Quality

Purpose Achieving and maintaining good sleep quality is increasingly recognized as essential for overall health. In a previous publication, we reported that during a week-long spa stay with balneotherapy treatments, objective sleep quality improved in association with either higher physical activity or more prolonged thermal water immersion. In the current study, we aimed to verify whether subjective sleep quality could improve in a sample of local customers undergoing two-week balneotherapy treatments and whether such improvements were associated with leisure-time physical activity. Methods Seventy-five participants (21.3% male; 61.5 ± 10.5 years) completed the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and the Mini Sleep Questionnaire (MSQ) at the beginning and end of a two-week balneotherapy program. The treatments were prescribed by hydrologist medical doctors and conducted at Terme di Castel San Pietro (Bologna, Italy). ANCOVA analyses (covariates: age and sex) were used to evaluate differences in MSQ scores and delta values based on GSLTPAQ categorization. FORST funded the study. Results ANCOVA revealed no statistically significant differences in MSQ scores between active and inactive participants at baseline. After two-week balneotherapy treatments, active participants (60%) reported better self-perceived sleep quality (active: 6.2±1.9, inactive: 5±2.5, p=0.03), MSQ-final score (active: 31.1±10.1, inactive: 38±13.1, p=0.02), MSQ-sleep component (active: 19.4±7.5, inactive: 22.7±8.8, p=0.08), and MSQ-awake component (active: 11.6±4.2, inactive: 15.3±6.2, p=0.02). Changes in MSQ values (delta scores) suggested greater improvements among active participants, though none reached statistical significance: delta MSQ-final score: active= -1.9±0.6, inactive= 0.57±0.4, p=0.2; MSQ-sleep component: active= -0.9±0.5, inactive: -0.5±0.4, p=0.02; MSQ-awake component: active= -1.1±0.6, inactive: 0.5±0.3, p=0.1). Conclusions After two weeks of balneotherapy, subjective sleep quality showed greater improvements in participants who engaged in more leisure-time physical activity. Although the absence of a control group limits our findings, we may hypothesize that an active lifestyle, combined with a period of self-care such as balneotherapy, may contribute to improvements in self-perceived sleep quality.