Influence of thermal SPA therapies on physical activity and sleep

Purpose: The thermal spa’s relaxing atmosphere and treatments could favour physical activity (PA) practice and sleep improvements. To date, no studies in Italy have investigated these aspects; thus, the current study aims to shed light on PA and sleep behaviour during a week of thermal spa treatments. Methods: Sixty-five participants (M = 18, 27.7%; 64.1 ± 10.9 yrs) staying at GB- Hotels (Abano Terme, Italy) filled in the Godin- Shepard Leisure-Time Physical Activity Questionnaire (GSL-TPAQ) and the Mini Sleep Questionnaire (MSQ) at the beginning and the end of a week of thermal spa stay. A higher GSL-TPAQ score indicates a greater PA practice, with the cut-off point of 24 LSI distinguishing between active and inactive subjects. Concerning the MSQ, the lower the score, the lower the sleep problems and the better the sleep quality; a final score\24 a.u. indicates good sleep quality. The questionnaires evaluate PA and sleep during the week before the compilation; thus the questionnaires assessed PA and sleep changes during the spa stay. Furthermore, participants recorded daily the PA practice and the use of thermal pools in a diary. Results: Before the thermal spa stay, 50% of the sample had been classified as active, whereas the percentage of active subjects raised to 70% at the end of the thermal stay with a significant increase in the GSL-TPAQ score (before: 25.8 ± 18.4 LSI; during: 41.6 ± 32.7 LSI; p\0.001), indicating an increase of PA during the thermal stay. Before the spa stay, participants with no sleep problems were 33%, while they were 42% at the end of the stay. The mean MSQ score significantly decreased during the spa stay (before: 30 ± 11.2 a.u.; during: 26 ± 10 a.u.; p = 0.001), indicating better sleep quality. Oneway ANOVA showed that active and sufficiently active participants slept longer and better than inactive subjects and that those with no or occasional sleep problems practised more PA than participants with moderate and severe sleep problems (even though without significance). Correlations analysis showed a significant inverse relationship between the use of thermal pools and sleep quality (r = -0.24, p = 0.05), meaning that the greater the thermal pool use, the better the sleep quality during the spa stay. Conclusions: A week of thermal spa treatments and stay seemed effective in incrementing the PA practice and sleep quality. PA practice could be favoured by the facilities (e.g., swimming pools and gyms) and better predisposition of the participants to being active during the stay (e.g. walking and biking). Sleep could improve thanks to the relaxing atmosphere, the effect of the hot water on body temperature and mud applications on cortisol’s circadian rhythm regulation.