Participants (≥ 60) with chronic insomnia undergo a 12-week home exercise intervention followed by a 12-week follow-up. The system integrates FitMirror AI skeletal recognition for real-time guidance and ActiGraph wearable monitoring for continuous data collection. An adaptive closed-loop mechanism tailors exercise to specific insomnia phenotypes: daytime HIIT or resistance training is prescribed to enhance sleep drive for those with sleep-onset difficulties (DFA), while nighttime yoga or Pilates targets reduced hyperarousal for those with maintenance difficulties (DMS). Effectiveness is evaluated at baseline, 12 weeks, and 24 weeks using linear mixed-effects models to track improvements in multi-dimensional sleep health and functional fitness.

The DREAMS Study evaluates an AI-driven, home-based, dual-track exercise intervention for community-dwelling older adults (≥ 60) with chronic insomnia. Integrating FitMirror skeletal recognition for real-time guidance and ActiGraph wearable monitoring for continuous data collection, the system creates a closed-loop feedback mechanism to optimize sleep health. The intervention is tailored to insomnia phenotypes: daytime HIIT or resistance training is prescribed to enhance sleep drive (targeting sleep-onset difficulties), while nighttime yoga or Pilates targets reduced hyperarousal (targeting sleep-maintenance difficulties). Using a quasi-experimental design, the study measures improvements in multi-dimensional sleep health and functional fitness at baseline, post-intervention (12 weeks), and follow-up (24 weeks).

This study evaluates sleep using Buysse's (2018) Multidimensional Sleep Health framework. To address reviewer concerns regarding distinct units, the following parameters are reported separately: 1) Sleep Efficiency (%) and Duration (min), objectively monitored by ActiGraph wGT3X-BT (7-14 days per stage). 2) Sleep Regularity (min), defined as the standard deviation of the weekly sleep midpoint. 3) Sleep Timing (clock time), representing the average weekly midpoint. 4) Subjective Quality and Daytime Alertness (1-5 scale), captured via daily diaries where lower scores indicate better health. Actigraphy data are processed at 30-second epochs using ActiLife v6.13.3. This dual-track approach monitors how daytime HIIT (building sleep drive) and nighttime relaxation (reducing hyperarousal) affect specific insomnia phenotypes, overcoming the "mismatch" between subjective and objective perception. All metrics are summarized as weekly means

The specific components of the physical assessment include the 30-second chair stand test to evaluate lower body strength by counting full stands from a seated position, and the 30-second arm curl test to measure upper body strength using 5-pound weights for women or 8-pound weights for men. Flexibility is assessed through the chair sit-and-reach test for the lower body and the back scratch test for the upper body, with distances measured in centimeters to determine the range of motion in the limbs. Agility and dynamic balance are recorded using the 8-foot up-and-go test, which times how quickly a participant can rise from a chair, walk 2.44 meters around a marker, and return to a seated position. Cardiorespiratory endurance is measured using either the 2-minute knee-up test, which counts total repetitions of lifting the knees to a specified height, or the 6-minute walk test, which measures the total distance traveled in meters and can be used to estimate maximal aerobic capacity.

Measurements are conducted in the morning, 3 hours post-meal, after emptying the bladder and avoiding vigorous exercise to prevent electrolyte and water fluctuations. Participants stand barefoot on the Tanita MC-780MA Multi-frequency Segmental Body Composition Analyzer, holding hand electrodes with arms positioned away from the torso. This assessment provides comprehensive data on basal metabolism, visceral fat index, body water, and segmental fat/muscle mass. Critically, it analyzes the Skeletal Muscle Mass Index (SMI), a key indicator for sarcopenia.