Using Intensity and Strength Training to Overcome Insomnia

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About 35% of adults do not get enough sleep, which has not changed since 2013. Poor sleep raises cortisol released from the adrenal glands, increasing blood pressure. This alone can lead to cardiovascular disease, but sleep deprivation also contributes to depression and anxiety. Findings from a 2024 research article reveal why exercise might be the secret weapon that gets you to sleep.

In the U.S., cognitive behavioral therapy is typically used to treat insomnia. However, this treatment has a financial barrier. Single therapy sessions can cost upwards of $150. Good luck getting insurance to cover it. More than 9 million Americans aged >30 depend on medications like Xanax or other sleep aids to fall asleep. However, these do not always promote the REM (deep sleep) level required for adequate stress recovery during sleep. Alcohol, which some people turn to, also causes interrupted sleep. A better, low-cost, safer, readily available prescription is exercise.

Insomnia Prevalence Across the United States 

The Findings

A systematic review and meta-analysis, recently published in Sleep Medicine Reviews, analyzed 19 studies involving over 1,200 participants to assess the effects of physical exercise on insomnia symptoms. The results show exercise significantly improves both subjective and objective sleep quality. The overall intensity of exercise enhances sleep, especially in women and the elderly, but because of the multiple papers, you cannot pinpoint the exact exercise. 

Remember a Meta-Analysis, like the one done in this article, is a  summary of data from multiple papers which may not have used the same methods in each each study. Therefore we can't say for sure which exercise contributed more than another.

Getting to the Points

• Exercise interventions enhanced subjective sleep quality with a large effect size (Standard Mean Difference (SMD) = 0.90). This means you will feel more rested if you exercise. 
• Objective improvements were observed in wake-after-sleep onset (WASO) and sleep efficiency, which showed moderate effect sizes.
• Higher exercise intensity correlated with more excellent sleep benefits.
• Women and older adults were exceptionally responsive to these interventions.

Expert Spotlight

The study's lead author, Dr. Anuschka Riedel, explains, "Physical training impacts hormonal systems and the autonomic nervous system, which likely helps to alleviate hyperarousal—a key driver of insomnia." She also emphasizes that exercise can complement CBT-I or serve as a standalone treatment for those who don't respond to therapy.

Study Limitations

As discussed in this study, we cannot pinpoint a specific exercise that works better than all others. 73.7% of the studies focused on aerobic activity like cycling and jogging. In contrast, only three studies included resistance training. However, a previous meta-analysis of 212 papers done at Hiroshima University showed that resistance (strength) training significantly improved sleep compared to other interventions like sleep education, yoga, and general walking. Exercise also improves locomotor syndrome or increases unsteadiness with age and frailty. 

A Short and Simple Biochemical Explanation

ATP is the energy biomolecule of the body. Exercise breaks down ATP and releases the "A" portion called Adenosine, which binds to A1 receptors in the brain, impeding excitatory neurotransmitter release and promoting sleepiness. Exercise enhances tryptophan uptake into the brain, increasing serotonin (5-HT) synthesis. Serotonin acts as a precursor to melatonin, the hormone responsible for sleep regulation, and this improves sleep onset and duration. Chronic exercise also lowers cortisol levels by releasing anandamide and 2-AG, endocannabinoid system components that promote relaxation and reduce anxiety. Endorphins and β-endorphins released post-exercise have mild sedative effects that reduce stress and enhance sleep quality.

Key Point: Resistance training and Intense exercise help with Insomnia.

Sample Program: Your Sleep-Boosting Routine

Here is a simple, approximately 30-minute, 3-day-a-week Plan.

Monday (Push Day)

General Warm-Up (5 min)
Stationary Bike Ride 200m
20 Inclined Wall or Ground Push Ups
10 Single Arm Dumbbell Presses (each side)

Strength Training (18 min)
3 sets of 5 Bench Press
3 sets of 5 Overhead Press
3 sets of 5 Tricep Extensions 

Rest 1:30 between sets

Intenisty Training (7 min)

AMRAP 7 minutes: Jogging or walking fast for 200 m, then 10 Air Squats
(AMRAP means as many rounds as possible in the given time: 8 min)

Wednesday (Pull Day)
General Warm Up (10 min)

20 Air Squats
50 Jump Rope Skips (40 High Knees)
Take a few minutes to build to a comfortable Deadlift Weight

Strength Training (18 min)
3 sets of 5 Deadlifts
3 sets of 5 Rows
3 sets of 5 Bicep Curls

Rest 1:30 between sets

Intensity Training (9 min)
EMOM 9: 10-15 Overhead Band Pulls Downs, 5 Wall Balls, 20 Jump Rope Skips. (EMOM means Each Minute on the Minute. The first Minute you do the pull-downs, the next minute wall balls, and then the next minute jump rope and repeat.)

Friday (Leg Day)
General Warm-Up (5 min)

Active Calf Stretches
3 Min on Treadmill (moderate level)
Leg Band Exercises
- Put a band around your legs above the knees. Take 10 steps forward, 10 steps back, 10 steps to the left, and 10 steps to the right, then 10 squats.

Strength Training (18 min)

3 sets of 5 Dumbbell Squats
3 sets of 5 Dumbbell Calf Raises 
3 sets of 5 Bodyweight Lunges (each leg)

Rest 1:30 between sets

Intensity Training
For Time:
3 Rounds of

• 5 Sprints (25 ft then 25 ft back)
• 20 High Knees (Total for both sides)
• 5 Squats

"For Time" means you record the time it took you to complete the intensity training, then try to beat this the next time you do the same training again.

Remember, consistency is key—stick to a schedule that works for you!

ALL OF THESE CAN BE SCALED. In other words, the difficulty can be changed to fit your level of exercise experience.

Now You have a Tool

As we've seen, exercise is more than a fitness tool—it's a powerful remedy for insomnia and poor sleep. Whether you're looking to complement existing treatments or find an alternative to medication, physical activity can help you sleep deeper, longer, and better. 

Assessment and Plan*

Assessment: 

1. Insomnia
2. Depression
3. Anxiety

Lifestyle Plan: 

Resistance Training with short high-intensity intervals of 30 minutes 3 times a week.

*You or a medical professional can use the assessment and Plan. Always check with your doctor before undertaking any new exercise protocol.

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Disclaimer: This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information in this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professionals for any such conditions.

References

1. Anuschka Riedel, Fee Benz, Peter Deibert, Friedrich Barsch, Lukas Frase, Anna F. Johann, Dieter Riemann, Bernd Feige, The effect of physical exercise interventions on insomnia: A systematic review and meta-analysis, Sleep Medicine Reviews, Volume 76, 2024, 101948, ISSN 1087-0792, https://doi.org/10.1016/j.smrv.2024.101948.
2. Data Source: CDC Behavioral Risk Factor Surveillance System (BRFSS), 2013–2022. Sleep is not assessed on the core survey in the following years: 2015, 2017, 2019, and 2021. Percentage of adults not getting enough sleep, adjusted for age.
3. Hirohama K, Imura T, Hori T, Deguchi N, Mitsutake T, Tanaka R. The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PLoS One. 2024 Jun 5;19(6):e0301616. doi: 10.1371/journal.pone.0301616. PMID: 38837997; PMCID: PMC11152306.