Sleep disturbance and fatigue are common in people with ankylosing spondylitis . Sleep disturbance was associated with increased pain, disease activity, depression, and anxiety . Whilst there is currently no specific evidence that for people with ankylosing spondylitis that physical activity improves sleep quality/reduce disturbance in patients, there is evidence that physical activity improves sleep in patients with rheumatoid arthritis  and in the general population[4-5].
Quality of evidence
Strength of recommendation
Whilst there is no specific evidence that physical activity improves sleep in people with ankylosing spondylitis, this recommendation has been adapted from evidence from people with rheumatoid arthritis and the general population.
- Hultgren S, Broman JE, Gudbjörnsson B, Hetta J, Lindqvist U. Sleep disturbances in outpatients with ankylosing spondylitisa questionnaire study with gender implications. Scand J Rheumatol. 2000;29(6):365-369.
- Li Y, Zhang S, Zhu J, Du X, Huang F. Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study. Arthritis Res Ther. 2012;14(5):R215.
- Durcan L, Wilson F, Cunnane G. The effect of exercise on sleep and fatigue in rheumatoid arthritis: a randomized controlled study. J Rheumatol. 2014;41(10):1966-1973.
- Department of Health. Start Active, Stay Active. In: Strategy; 2011.
- Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. J Behav Med. 2015;38(3):427-449.