Rope Skipping or Badminton? The Effect of Exercise on Sleep Quality and Fatigue in University Students

doi:10.21203/rs.3.rs-3444784/v1

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Rope Skipping or Badminton? The Effect of Exercise on Sleep Quality and Fatigue in University Students

https://doi.org/10.21203/rs.3.rs-3444784/v1

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Background

Fatigue and poor sleep quality are common among university students and can negatively affect their studies, college lives, and physical and mental health. Aerobic exercise has shown promise in mitigating these issues. However, exercise interventions involved in previous studies were often time-consuming. To identify a more efficient approach, we evaluated the effects of 15-day rope skipping and badminton interventions on fatigue and sleep issues. We hypothesized that both badminton and rope skipping would be effective in mitigating fatigue and sleep problems and that the effect of rope skipping would be greater than that of badminton.

Methods

Seventy-six participants’ levels of fatigue and sleep were assessed via five variables, using the Consensus Sleep Diary, the Pittsburg Sleep Quality Index, and the fatigue diary.

Results

Both exercises were effective only in improving perceived fatigue and sleep onset latency. One of the reasons for the nonsignificant results could be that some participants’ sleep was disturbed by roommates sharing the same bedroom.

Conclusions

Short-term rope skipping and badminton can effectively improve the fatigue and sleep quality of university students. In addition, we found that some participants reported being more interested in exercise after the intervention, suggesting that exercise interventions could be used to foster exercise habits.

exercise intervention

aerobic exercise

PSQI

Chinese university student

alertness

Feelings of fatigue or sleep deprivation are common in the fast-paced modern world. Fatigue is a state of prolonged exhaustion and impaired autonomic activity [10, 52] that occurs after exposure to high workplace demands, long-term stress, or sleep disorders [1, 7, 18, 40]. Among Chinese university students, this can also be attributed to academic workload and employment concerns [31]. Fatigue and sleep issues are often interrelated and are associated with impairments in physical and mental health, cognition, emotions, and well-being [7, 13, 19, 20]. Previous studies have shown that exercise interventions can be beneficial for fatigue and sleep issues[3, 8, 17]. However, the types of exercises used in these studies were often unspecified or required a significant time investment [e.g., 3, 17, 31], which might not be efficient for university schedules. Thus far, a type of exercise intervention that is more suitable for Chinese university students has not been identified.

Fatigue and sleep problems are common among Chinese university students [29, 31]. Due to heavy academic workload and concerns about high unemployment rates for recent graduates, nearly 40% of university students reported experiencing high academic fatigue, while only 34.8% of university students reported sleeping well [30, 31, 51]. Students who perceived poor sleep quality were likely to feel dissatisfied with their academic performance [13], while fatigued students often sacrifice physical health for academic success [31]. As a result of poor sleep quality and fatigue, undergraduate students may also suffer from higher levels of anxiety and depression [24, 39]. Further, the risk of common psychiatric disorders may significantly increase [24, 39].

The effect of physical exercise on fatigue and sleep disturbances has been widely studied in recent years, and the results have been mixed. While some researchers have failed to find convincing evidence of its effectiveness [12], the potential of exercise cannot be disregarded. Indirect evidence supports the value of exercise interventions substantiated for reducing the incidence of daytime sleepiness and cognitive dysfunction caused by sleep deprivation [47]. Additionally, exercise as medicine is highly effective in treating insomnia and alleviating sleep problems and stress in clinical psychiatric disorders, such as depression [6, 34, 41]. Similar evidence was also provided in other studies that engaging in aerobic exercises can lead to improved sleep quality and reduced fatigue after several weeks of consistent or intermittent exercise [3, 26, 27, 50]. Furthermore, increasing the intensity of the exercise from mild (approximately 45 ~ 50% of maximum heart rate) to moderate (approximately 65 ~ 70% of maximum heart rate) can enhance these effects [17].

In past studies of exercise interventions, researchers typically compared the effects of aerobic or anaerobic exercise with a control group [e.g., 17, 27, 31] or with participants receiving other interventions, such as meditation [3]. However, the efficiencies among different exercise interventions have never been compared. Moreover, most experimental procedures ranged from two to 12 months [50]. Given the heavy academic workload of Chinese university students, it is likely that they have limited spare time for long-term aerobic exercises. Therefore, to relieve fatigue and sleep problems in Chinese university students more efficiently, it is necessary to identify a type of aerobic exercise that is more convenient and time-saving than existing options without compromising effectiveness.

In China, rope skipping and badminton are popular among university students because they require fewer motor skills, fields, and equipment than other sports [48, 49]. Li et al. found that a short-term (six consecutive days) physical exercise at moderate intensity could reduce fatigue and improve sleep quality effectively [31]. Hence, our aim was to investigate the effects of a similarly short-term rope skipping or badminton exercise on mitigating fatigue and improving sleep quality. We hypothesized that both rope skipping and badminton exercises would improve sleep quality and fatigue among the participants. We also hypothesized that the effect of rope skipping would be greater than that of badminton because badminton requires cooperation between two players, which may demand additional mental energy.

2.1 Participants

One hundred and thirty university students were recruited for the present study. Students who met the following criteria were included: (1) had no prior exercise habits; (2) reported a Pittsburgh Sleep Quality Index (PSQI) score higher than seven, indicating poor sleep quality [33]; (3) had no diseases or hypoglycemic symptoms; (4) were not taking any medication; and (5) were not in their menstrual period if they were female.

Due to the limited number of available actigraphs, the present study was conducted in six stages. We initiated the recruitment procedure one month prior to each stage. Once at least 15 individuals met the inclusion criteria, we commenced the current stage and assigned the participants to the experiment, resulting in 15 to 18 participants for each stage and a total of 130 participants included in the study. All participants were instructed to avoid consuming alcohol, caffeinated drinks, tobacco, and any sleep aids throughout the experiment. In addition, all participants were asked to maintain their regular daily schedules and were advised to go to bed before 12 a.m.

In the first four stages, the participants were assigned to one of three groups (the badminton group, the rope skipping group, or the control group) based on their self-reported preferences, which were collected through interviews. In the last two stages, to balance the over-recruitment of the badminton group, participants were randomly assigned to either the rope skipping group or the control group, with some rearrangements made if participants refused to perform rope skipping.

After excluding invalid data, such as data from participants who were incorrectly wearing actigraphy, we analysed data from 76 participants (59 females and 17 males) aged between 18 and 28 years. Of these participants, 19 were in the control group, 19 were in the badminton group, and 38 were in the rope skipping group.

2.2 Materials

2.2.1 Sleep Measurement

Consensus Sleep Diary

The Consensus Sleep Diary was developed for the purposes of assessing sleep variables such as perceived sleep onset latency (SOL), wake after sleep onset, and sleep quality [9]. In the original article, the diary was published in three versions: the Core Consensus Sleep Diary, the Expanded Consensus Sleep Diary for Morning, and the Expanded Consensus Sleep Diary for Evening [9].

The questions included in the present study were extracted from the Core Consensus Sleep Diary, which originally consisted of nine questions (Supplementary 1). We excluded question 5 to avoid the possible excessive burden. Additionally, we combined questions 1 and 2 and rephrased them to read “What time did you turn off the light and go to bed?” and rephrased question 3 to read “How long did it take you to fall asleep after getting into bed?”. The reason for these revisions was that all participants slept in dormitories, where students typically go to bed and simultaneously go to sleep when the main lights are turned off by dormitory managers at a designated time at night.

Furthermore, we revised the response options for question 8 to a Likert scale from zero to 10, with 0 = extremely poor and 10 = extremely good. We also added a question for the serial number of the participants. We abandoned question 9 in the original core diary because the participants were informed that they could contact the experimenters at any time. Finally, we translated all the questions into Chinese. All participants were required to complete their sleep diaries every morning after waking up throughout the experiment.

Pittsburgh Sleep Quality Index (PSQI)

The Pittsburgh Sleep Quality Index (PSQI), developed by Buysse et al., is a widely used measurement for assessing sleep [5]. It comprises 19 items evaluating 7 components of sleep, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, the use of sleeping medication, and daytime dysfunction. Each component is scored on a scale of zero to three points, with a maximum global PSQI score of 21. Higher scores indicate poorer sleep quality [5]. For the current study, we used the Chinese version of the PSQI, translated by Liu et al. [33]. Cronbach’s alpha was 0.799 in the present study, indicating good reliability. All participants were instructed to complete the PSQI before and after the experiment.

Actigraphy

An actigraph is a wrist-worn device that allows continuous monitoring of the wearer’s daily activity and sleep. Actigraphy is a reliable and precise method of assessing sleep parameters such as SOL [36]. In the present study, we measured the SOL and sleep efficiency of all participants using an Actigraph WGT3x-BT device. All participants were instructed to wear the device on their nondominant hand each night before bed.

2.2.2 Fatigue Measurement

The Fatigue Diary

The questions in the fatigue diary were adapted from the Chinese version [19] of the work diary developed by Smith & Smith [46] (Supplementary 2). The fatigue diary in the present study comprises only three items to avoid possible excessive burden, each of which is rated on a Likert scale ranging from zero to 10. All participants were asked to complete a diary before and after the experiment.

2.2.3 Sports Equipment

For the badminton group, we provided six identical Decathlon Perfly badminton rackets and more than a dozen DHS 402 badminton shuttlecocks. For the rope skipping group, we provided 30 identical Decathlon skipping ropes. Due to the limited availability of equipment, participants were instructed to share the equipment and take turns using it to ensure that everyone had equal access to the equipment.

2.3 Procedure

Before conducting the experiment, the age, height, weight, date of birth, and handedness of the participants were recorded in their actigraphs to ensure precise and personalized sleep measurements. The experiment spanned a duration of one year, from December 2021 to November 2022, in six stages, with each participant undergoing the experiment for 16 days, comprising 15 days of experimentation and one day for completing post-intervention questionnaires.

On the first day of each stage, all participants completed the PSQI and the fatigue diary questions. Each participant was given an actigraph, along with instructions for its proper use. They were informed that they could contact the experimenters at any time if they had any questions or concerns. Starting from the first day of each stage, participants in the badminton group and the rope skipping group arrived at a designated site on alternate days (i.e., the 2nd, 4th, 6th, 8th, 10th, 12th, and 14th days of each stage) between 5 p.m. and 7 p.m. Following a 2–5 min warm-up exercise, they performed their assigned exercise for 30 minutes, after which they completed a short questionnaire to record their exercise type and total exercise time. Additional exercise was not allowed for either group for the duration of the experiment. Meanwhile, the control group was instructed to maintain their regular daily activities and refrain from engaging in any sports. Furthermore, all participants completed the Consensus Sleep Diary every morning after waking up. On the 16th day of each stage, all participants returned their actigraphs and completed the PSQI and fatigue diary once again. The data were then checked and imported, and the actigraphs were initialized for the next stage.

2.4 Data Analysis

The data from the Consensus Sleep Diary, PSQI, fatigue diary, and actigraphy were analysed using IBM SPSS version 23. The statistically significant alpha level was set to be less than 0.05. Repeated measures analysis of variance (ANOVA) tests were conducted for two purposes: to assess the effects of both badminton and rope skipping exercises on the participants’ sleep quality and fatigue, and to assess the differences between them.

The present study aimed to analyse SOL, sleep efficiency, PSQI scores, and fatigue. However, due to the incorrect use of the actigraphs by some participants, the objective data for the SOL of all participants had to be excluded. Therefore, SOL was assessed solely based on data obtained from the Consensus Sleep Diary. Moreover, consequently, the data for sleep efficiency, which was recorded using actigraphy, had to be excluded as well because sleep efficiency is calculated by dividing the total amount of time asleep by the total amount of time in bed. The PSQI scores were analysed in their entirety. Fatigue was evaluated based on three items from the fatigue diary: feelings of fatigue, overall feelings, and levels of alertness. Hence, the present study included the assessment of five variables, consisting of two variables relevant to sleep and three variables relevant to fatigue.

A total of 10 repeated measures ANOVA tests, consisting of two tests for each of the five variables, were conducted to examine the effects of badminton and rope skipping. In the first ANOVA test for each variable, the badminton group and the rope skipping group were combined and labelled as the “exercise groups,” which were subsequently compared to the control group. The second ANOVA test for each variable focused specifically on the difference between the badminton group and the rope skipping group.

3.1 The Consensus Sleep Diary—SOL

The data from the first and fifteenth days at all stages were excluded due to the first night effect and the last day effect. As a result, only 13 days of SOL data were used for each participant. The main effect of time on SOL was found to be significant in both test one (Table 1), F (12, 74) = 1.915, p < 0.05, η² = 0.267, and test two (Table 2), F (12, 55) = 3.670, p < 0.001, η² = 0.500. The average SOL of the exercise groups (M = 28.072, SD = 2.195) was significantly lower than that of the control group (M = 39.802, SD = 3.802), F (1, 74) = 7.140, p < 0.01, η² = 0.088. Significant interaction effects were detected only between the exercise groups and the control group, F (12, 74) = 3.481, p < 0.001, η² = 0.399 (Fig. 1, Fig. 2).

Table 1

*Repeated measures ANOVA for SOL of the exercise groups and the control group*
	MS	F	p	η²
Time	477.042	1.915	0.049*	0.267
Group	25489.495	7.140	0.009**	0.088
Group x Time	752.631	3.481	0.001***	0.399
Note: MS = mean square; p < .05, p < .01, * p < .001*.

Table 2

*Repeated measures ANOVA for SOL of the rope skipping group and the badminton group*
	MS	F	p	η²
Time	379.640	3.670	0.001***	0.500
Group	125.345	0.046	0.831	0.001
Group x Time	232.190	0.767	0.679	0.173
Note: MS = mean square; p < .05, p < .01, * p < .001*.

3.2 PSQI Scores

The pre-intervention PSQI scores of all participants were significantly higher than their post-intervention scores, F (1, 74) = 30.043, p < 0.05, η² = 0.289, F (1, 55) = 43.305, p < 0.001, η² = 0.441. Additionally, the PSQI scores of the exercise groups differed significantly from those of the control group, F (1, 74) = 7.060, p < 0.01, η² = 0.087. However, no significant interaction effects were found (Table 3, Table 4), indicating that the changes in global PSQI scores before and after the intervention did not significantly differ between groups.

Table 3

*Repeated measures ANOVA for the PSQI scores of the exercise groups and the control group*
	MS	F	p	η²
Time	163.441	30.043	0.000***	0.289
Group	43.599	7.060	0.010**	0.087
Group x Time	10.441	1.919	0.170	0.025
Note: MS = mean square; PSQI = Pittsburgh Sleep Quality Index; p < .05, p < .01, * p < .001*.

Table 4

*Repeated measures ANOVA for the PSQI scores of the rope skipping group and badminton group*
	MS	F	p	η²
Time	218.110	43.305	0.000***	0.441
Group	4.776	0.766	0.385	0.014
Group x Time	0.987	0.196	0.660	0.004
Note: MS = mean square; PSQI = Pittsburgh Sleep Quality Index; p < .05, p < .01, * p < .001*.

3.3 Fatigue

The data for fatigue were obtained from the results of the fatigue diary. After excluding invalid data, the data for only 41 participants were received, of which six were in the control group, 29 in the rope skipping group, and six in the badminton group. Results were shown in Table 5, Table 6, and Table 7. Significant interaction effects were only detected between the exercise groups and the control group for feelings of fatigue, F (1, 39) = 6.377, p < 0.05, η² = 0.141. Average feelings of fatigue of the exercise group significantly decreased after the intervention (before: M ± SD = 6.02 ± 1.81; after: M ± SD = 3.66 ± 1.68), F (1, 33) = 48.434, p < 0.001, η² = 0.588, whereas mean feelings of fatigue of the control group did not change significantly. The overall feelings and levels of alertness of the exercise groups increased significantly but no significant interaction effects were detected.

Table 5

*Repeated measures ANOVA for feelings of fatigue, overall feelings, and alertness of the exercise groups and the control group*
		MS	F	p	η2
	Time	14.402	6.377	0.016*	0.141
Feelings of Fatigue	Group	4.424	1.168	0.287	0.029
	Group x Time	14.402	6.577	0.016*	0.141
	Time	15.642	9.210	0.004**	0.191
Overall feelings	Group	2.208	0.967	0.331	0.024
	Group x Time	5.545	3.265	0.079	0.077
	Time	22.323	11.419	0.002**	0.226
Alertness	Group	0.652	0.223	0.639	0.006
	Group x Time	6.713	3.434	0.071	0.081
Note: MS = mean square; p < .05, p < .01, * p < .001.*

Table 6

*Main effects of time on feelings of fatigue, overall feelings, and alertness of the control group*
	MS	F	p	η2
Feelings of fatigue	0.000	0.000	1.000	0.000
Overall feelings	0.750	1.000	0.363	0.167
Alertness	1.333	0.671	0.484	0.103
Note: MS = mean square; p < .05, p < .01, * p < .001.*

Table 7

*Comparisons of average feelings of fatigue, overall feelings, and alertness of the exercise groups and the control group*
		M ± SD (exercise groups)	M ± SD (control group)
Feelings of fatigue	before	6.02 ± 1.81	5.50 ± 1.64
	after	3.66 ± 1.68	5.50 ± 1.76
Overall feelings	before	5.23 ± 1.66	5.50 ± 0.55
	after	7.20 ± 1.28	6.00 ± 0.89
Alertness	before	4.94 ± 1.80	5.50 ± 1.76
	after	7.23 ± 1.21	6.17 ± 1.72

The present study aimed to investigate and compare the effects of short-term exercise interventions of badminton and of rope skipping on fatigue and sleep problems among Chinese university students with poor sleep quality (PSQI score > 7) and without any exercise habits. Seventy-six participants were divided into three groups: a badminton group, a rope skipping group, and a control group. A 15-day exercise intervention was assigned to the badminton and rope skipping groups. Our first hypothesis was partially supported—both exercises were effective only in improving perceived fatigue and sleep onset latency—while the second hypothesis was rejected, as there was no significant difference between the effects of both kinds of exercise.

The effect of exercise as a treatment for insomnia is guaranteed. In the present study, as consistent with the objective EEG results reported by Kalak et al. [27], participants who performed badminton or rope skipping during the study reported spending less time falling asleep, while those in the control group did not. In addition, although we failed to identify changes in the PSQI scores, the causal relationship between reduced global PSQI scores and exercise was corroborated in multiple studies [34]. Aside from altered feelings, exercise also generates physiological changes, such as elevating body temperature, which can assist in falling asleep [4, 34].

Researchers have not reached an agreement on the effect of exercise on fatigue. In the present study, those participants in the badminton group and the rope skipping group reported feeling less fatigued after the intervention, while those who did not engage in any exercise felt as fatigued as before the experiment. Loy and colleagues [35] suggested that the effect of exercise on fatigue could be explained by sufficient energy recovery after the exercise, as energy is expended during the exercise and subsequently subjective sleep quality may improve [34]. Moreover, we discovered that participants in the exercise groups overall felt significantly better and more alert following the experiment, while such changes were not detected in the control group.

These findings were consistent with some of the previous findings [28, 43] but not the others [44, 45]. Likewise, the elevated overall feelings and levels of alertness identified in the present study could not be attributed to badminton and rope skipping. It needs to be noted that the operationalization of assessing fatigue, alertness, and mood state may be the main cause of the mixed study results. For instance, we measured them via a questionnaire that contains one question for each variable, while others measured fatigue using other questionnaires or measured alertness objectively via psychomotor vigilance testing [44]. Additionally, the intensity and the content of exercises also varied. Hence, inconsistent results should be expected when methods and materials were not standardized.

The effects of badminton and rope skipping on subjectively perceived fatigue and sleep issues did not differ significantly from each other, contrary to our hypothesis. This suggests that additional fatigue was not generated by cooperating with an opponent during badminton, as we had assumed. However, it should be noted that participants were grouped based on their inclination, which means that cooperating with an unfamiliar opponent during badminton might not be as stressful as it would be for participants in other groups. Possible differences may be identified if randomization is utilized in future studies. Therefore, while it may imply that doubles sports and even team sports are as relaxing as individual sports, further research is necessary to assess the comparability of different exercises and sports.

We extended the existing findings on short-term exercise interventions and corroborated that a 15-day intervention with exercising on alternate days can improve perceived fatigue and SOL in university students who do not include exercise in their daily routines. Compared to strictly standardized laboratory studies, our findings are more representative of real-life scenarios. We recommend that university students, or individuals who have limited spare time, perform rope skipping or badminton on alternate days for 15 days if they experience fatigue or struggle to fall asleep. Moreover, it is worth noting that some participants reported a willingness to continue exercising even after the experiment ended. This suggests that short-term exercise interventions are likely to enhance individuals’ interest in exercise. For future studies, follow-up surveys are encouraged to investigate whether participants developed regular exercise habits. Furthermore, in light of these findings, clinical practitioners can incorporate badminton and rope skipping exercises as quick-acting interventions for individuals suffering from psychiatric disorders because these short-term exercises may alleviate symptoms by mitigating sleep issues and fatigue. If exercise is included as a part of the intervention plan but clients refuse to comply, these two exercises can also serve as strategies to encourage and establish daily exercise routines. However, further evidence is required to substantiate the potential benefits of badminton and rope skipping in clinical practises.

4.1 Limitations

The present study has several limitations that should be considered when interpreting the results. As mentioned earlier, some groups, such as the badminton group and the control group during the analysis of fatigue, had small sample sizes, which could reduce the statistical power and effect size of the results and could contribute to the insignificant results of the PSQI scores, overall feelings, and levels of alertness. In addition, the attrition rates in the present study were relatively high, with half of the data for SOL and all the data for sleep efficiency being discarded. Both questionnaires and actigraphy require participants to comply with the instructions. To address this issue in future studies, researchers should consider arranging rehearsals or practice sessions before the start of the experiment.

Another limitation of this study is that we failed to exclude a potential confounder: the dormitory environment. Some participants reported concerns about this factor, which has been shown to affect sleep quality among university students [42]. In Chinese university dormitories, students usually share the same bedroom with one to five other roommates. Participants in the present study reported that maintaining ideal sleep quality was challenging when their sleep was easily disturbed by roommates, and that their sleep quality often improved when roommates were away on weekends. On one hand, the dormitory environment is likely to be a significant confounding factor that affects the results relevant to sleep; therefore, researchers should take it into consideration for future sleep studies conducted in Chinese universities. On the other hand, in future research on fatigue or sleep issues, the effects of interventions could be evaluated for university students whose sleep quality is severely disturbed by external factors.

This study investigated the effects of short-term badminton and rope skipping interventions on fatigue and sleep issues in university students without exercise habits. The results indicated that both exercises effectively improved perceived fatigue and sleep quality, with no significant differences between the two exercise types. The study also found that some participants’ interest in exercise increased after the intervention, suggesting that exercise interventions could help cultivate exercise habits. We recommend that Chinese students make the most of their odd hours of exercise, and we also recommend that people from diverse cultures who suffer from fatigue and poor sleep quality try short-term exercise to relieve fatigue and improve sleep quality.

Ethics approval and consent to participate

The present study was approved by the Shenzhen University Faculty of Psychology Research Ethics Committee. Written informed consent was obtained from each participant prior to the start of the experiment.

Consent for publication

Not applicable.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Competing interests

The authors declare that they have no competing interests.

Funding

This research received no external funding.

Authors' contributions

ZY and YZ conceived and conducted the experiment and performed data analysis; ZY and ST were responsible for the completion of the paper; JF provided the study design, supervised the experiment, and revised the final manuscript. All authors read and approved the final manuscript.

Acknowledgements

We sincerely thank Jingdian Zeng, Zheng Gong, Xinrui Lai, Yuehua Jiang, Chuangfeng Chen, and Siyao Zheng for their assistance in data collection and management. We also acknowledge Wenjing Li and Xinrui Lai for their valuable feedback provided in drafting the manuscript.

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Supplemental1.docx
Supplementary 1.docx shows the specifics of the Core Consensus Sleep Diary in more detail.
Supplemental2.docx
Supplementary 2.docx shows the specifics of the fatigue diary in more detail.

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Rope Skipping or Badminton? The Effect of Exercise on Sleep Quality and Fatigue in University Students

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Abstract

Background

Methods

Results

Conclusions

Figures

1. Introduction

2. Method

2.1 Participants

2.2 Materials

2.2.1 Sleep Measurement

2.2.2 Fatigue Measurement

2.2.3 Sports Equipment

2.3 Procedure

2.4 Data Analysis

3. Results

3.1 The Consensus Sleep Diary—SOL

3.2 PSQI Scores

3.3 Fatigue

4. Discussion

4.1 Limitations

5. Conclusion

Declarations

References

Additional Declarations

Supplementary Files

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