Article Title

Are there associations among physical activity, fatigue, sleep quality and pain in people with mental illness? A pilot study


Accessible summary

  • Many people with mental health disorders experience fatigue, pain and poor sleep. In other patient groups, physical exercise has been shown to have positive effects on these symptoms.
  • It is unknown whether day-to-day physical activity (not necessarily exercise) affects sleep quality or severity of pain or fatigue in those with mental illness.
  • This study observed physical activity, sleep quality, pain and fatigue in four people hospitalized with severe mental illness.
  • Significant associations were found between pain and fatigue severity in the morning, but not in the evening. A significant association was found between physical activity and morning and evening pain severity. No association was found between activity and fatigue.
  • This is a preliminary study that may guide future investigations of the effect of physical activity and exercise on symptoms commonly experienced in people with mental illness.


Good mental health is imperative to well-being. Symptoms of fatigue, chronic pain and poor sleep are common in people with mental illness and contribute to substantial loss of functioning. Physical exercise interventions have shown to decrease these symptoms in a range of populations; however, their possible association with physical activity related to day-to-day functioning have not been explored in people hospitalized with severe mental illness. Inpatients (n = 4) of a metropolitan mental health facility were fitted with an Actiwatch, which collected physical activity and sleep measures for an anticipated 14-day data collection period. During this time, morning and evening pain and fatigue scores were collected on an 11-point numerical rating scale. Significant associations were found between morning pain and morning fatigue scores (β = −0.44, P = 0.023), morning pain and physical activity (β = 12.34, P = 0.042), and physical activity and evening pain scores (β = 0.20, P = 0.017). Fatigue tended towards interfering more with quality of life than did pain, but this was not significant (P = 0.07). This study provided preliminary data suggesting associations between pain and fatigue, and intensity of pain and physical activity levels. This information can be used to generate hypotheses for future clinical trials.


actigraphy, fatigue, mental health, pain, physical activity, sleep

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