scholarly journals Aerobic Exercise and Stretching as Add-On to Inpatient Treatment for Depression Have No Differential Effects on Stress-Axis Activity, Serum-BDNF, TNF-Alpha and Objective Sleep Measures

2021 ◽  
Vol 11 (4) ◽  
pp. 411
Author(s):  
Christian Imboden ◽  
Markus Gerber ◽  
Johannes Beck ◽  
Anne Eckert ◽  
Imane Lejri ◽  
...  

(1) Background: While the antidepressant effects of aerobic exercise (AE) are well documented, fewer studies have examined impact of AE as an add-on treatment. Moreover, various effects on neurobiological variables have been suggested. This study examines effects of AE on Cortisol Awakening Reaction (CAR), serum Brain Derived Neurotrophic Factor (sBDNF), Tumor Necrosis Factor alpha (TNF-alpha) and sleep. (2) Methods: Inpatients with moderate-to-severe depression (N = 43) were randomly assigned to the AE or stretching condition (active control) taking place 3x/week for 6 weeks. CAR, sBDNF and TNF-alpha were assessed at baseline, after 2 weeks and post-intervention. The 17-item Hamilton Depression Rating Scale (HDRS17), subjective sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were obtained at baseline and post-intervention. (3) Results: Stress axis activity decreased in both groups from baseline to post-intervention. sBDNF showed a significant increase over time, whereas the number of awakenings significantly decreased. No significant time by group interactions were detected for any of the study variables. Correlational analyses showed that higher improvements in maximum oxygen capacity (VO2max) from baseline to post-intervention were associated with reduced scores on the HDRS17, PSQI and REM-latency post-intervention. (4) Conclusions: While some neurobiological variables improved during inpatient treatment (CAR, sBDNF), no evidence was found for differential effects between AE and an active control condition (stretching). However, patients in which cardiorespiratory fitness increased showed higher improvements in depression severity and depression-related sleep-parameters.

2020 ◽  
Author(s):  
Kyungmi Chung ◽  
Seoyoung Kim ◽  
Eun Lee ◽  
Jin Young Park

BACKGROUND As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. OBJECTIVE The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. METHODS During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. RESULTS Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, <i>P</i>&lt;.001) and memory complaints (40/40; ρ=.46, <i>P</i>=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; <i>t</i><sub>8</sub>=3.74, <i>P</i>=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. CONCLUSIONS This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.


2019 ◽  
Vol 46 (11) ◽  
pp. 1524-1530 ◽  
Author(s):  
Kai Fu ◽  
Joanna Makovey ◽  
Ben Metcalf ◽  
Kim L. Bennell ◽  
Yuqing Zhang ◽  
...  

Objective.To evaluate the association of sleep quality, sleep duration, and fatigue with hip pain exacerbations in persons with symptomatic hip osteoarthritis (OA).Methods.Participants (n = 252) were followed for 90 days and asked to complete online questionnaires at 10-day intervals (control periods). A hip pain exacerbation (case periods) was defined as an increase of 2 points in pain intensity compared with baseline on a numeric rating scale (0–10). Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index, and fatigue was measured by Multidimensional Assessment of Fatigue in both periods. Univariable and multivariable conditional logistic regressions were used to assess the association.Results.Of the 252 participants, 130 (52%) were included in the final analysis. Univariate association analysis showed that both poor sleep quality and greater fatigue were associated with increased odds of pain exacerbations (OR 1.72, 95% CI 1.04–2.86; OR 1.92, 95% CI 1.21–3.05, respectively). Short sleep duration was not associated with pain exacerbations. Poor sleep quality and greater fatigue remained associated with pain exacerbations after adjustment for physical activity and night pain levels in multivariable analysis. There was no significant interaction between sleep quality and fatigue (p = 0.21).Conclusion.Poor sleep quality and greater fatigue were related to pain exacerbation in persons with symptomatic hip OA. Sleep disorders and fatigue should be considered when dealing with pain exacerbations.


Author(s):  
Tatiana Plekhanova ◽  
Alex V. Rowlands ◽  
Melanie Davies ◽  
Charlotte L. Edwardson ◽  
Andrew Hall ◽  
...  

This study examined the effect of exercise training on sleep duration and quality and bidirectional day-to-day relationships between physical activity (PA) and sleep. Fourteen inactive men with obesity (49.2±7.9 years, BMI 34.9±2.8 kg/m²) completed a baseline visit, eight-week aerobic exercise intervention, and one-month post-intervention follow-up. PA and sleep were assessed continuously throughout the study duration using wrist-worn accelerometry. Generalised estimating equations (GEE) were used to examine associations between PA and sleep. Sleep duration increased from 5.2h at baseline to 6.6h during the intervention period and 6.5h at one-month post-intervention follow-up (p<0.001). Bi-directional associations showed that higher overall activity volume and moderate-to-vigorous physical activity (MVPA) were associated with earlier sleep onset time (p<0.05). Later timing of sleep onset was associated with lower overall volume of activity, most active continuous 30 minutes (M30CONT), and MVPA (p<0.05). Higher overall activity volume, M30CONT, and MVPA predicted more wake after sleep onset (WASO) (p<0.001), whereas greater WASO was associated with higher overall volume of activity, M30CONT, and MVPA (p<0.001). An aerobic exercise intervention increased usual sleep duration. Day-to-day, more PA predicted earlier sleep onset, but worse sleep quality and vice versa. Novelty: • Greater levels of physical activity in the day were associated with an earlier sleep onset time that night, whereas a later timing of sleep onset was associated with lower physical activity the next day in men with obesity • Higher physical activity levels were associated with worse sleep quality, and vice versa


10.2196/17755 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e17755
Author(s):  
Kyungmi Chung ◽  
Seoyoung Kim ◽  
Eun Lee ◽  
Jin Young Park

Background As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. Objective The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. Methods During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. Results Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, P<.001) and memory complaints (40/40; ρ=.46, P=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; t8=3.74, P=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. Conclusions This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiaoling Qin ◽  
Xue Li ◽  
Gang Chen ◽  
Xu Chen ◽  
Mingyu Shi ◽  
...  

Objective. The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson’s disease (PD). Methods. One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson’s disease rating scale (UPDRS) and Hoehn–Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton’s depression scale (HAMD), and Hamilton’s anxiety scale (HAMA). Results. The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (χ2 = −2.267, P = 0.023), shorter sleep latency (χ2 = −2.262, P = 0.024), fewer sleep medications (χ2 = −4.170, P ≤ 0.001), worse daytime functioning (χ2 = −2.347, P = 0.019), and an even higher prevalence of increased nocturia (χ2 = 4.447, P = 0.035), nightmares (χ2 = 7.887, P = 0.005), and pain (χ2 = 9.604, P = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (r = 0.216, P < 0.05), H&Y stage (r = 0.223, P < 0.05), UPDRS-I (r = 0.501, P < 0.01), UPDRS-III (r = 0.425, P < 0.01), ESS (r = −0.296, P < 0.01), RBD (r = 0.227, P < 0.05), RLS (r = 0.254, P < 0.01), HAMA (r = 0.329, P < 0.01), and HAMD (r = 0.466, P < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score (P ≤ 0.001, P ≤ 0.001, P = 0.049, P ≤ 0.001, respectively). Conclusions. Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 619-619
Author(s):  
Darina Petrovsky ◽  
Miranda Varasse ◽  
Nancy Hodgson

Abstract Our objective was to examine the independent relationship between sleep characteristics and quality of life (QOL) in community-dwelling older adults with cognitive impairment. Objective sleep variables were derived from actigraphy and included total sleep time, wake after sleep onset (WASO), efficiency, and number of awakenings. Subjective sleep quality was measured using Pittsburgh Sleep Quality Index and daytime sleepiness was measured with the Epworth Sleepiness Scale. Caregiver reported QOL-AD was used for QOL. Analyses included Spearman’s correlation and multivariate linear regression. In bivariate analyses, QOL was significantly related to clinical dementia rating scale, sex, depression, daytime sleepiness, sleep quality, WASO, and number of awakenings. Controlling for depression, daytime sleepiness remained independently associated with QOL (β= -0.24; p= 0.03). In addition, number of awakenings trended towards significance (β= -0.13; p= 0.07). Results suggest daytime sleepiness and awakenings are associated with QOL in this population.


Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1855
Author(s):  
Roberta Gasparro ◽  
Elena Calabria ◽  
Noemi Coppola ◽  
Gaetano Marenzi ◽  
Gilberto Sammartino ◽  
...  

Quality of sleep (QoS) and mood may impair oral cancer survivors’ wellbeing, however few evidences are currently available. Therefore, we aimed to assess the prevalence of sleep disorders, anxiety and depression among five-year oral cancer survivors (OC survivors). 50 OC survivors were compared with 50 healthy subjects matched for age and sex. The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hamilton Rating Scales for Depression and Anxiety (HAM-D, HAM-A), the Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI) were administered. The global score of the PSQI, ESS, HAM-A, HAM-D, NRS, T-PRI, was statistically higher in the OC survivors than the controls (p-value: <0.001). QoS of OC survivors was significantly impaired, especially with regard to some PSQI sub-items as the subjective sleep quality, sleep latency and daytime dysfunction (p-value: 0.001, 0.029, 0.004). Moreover, poor QoS was negatively correlated with years of education (p-value: 0.042 *) and positively correlated with alcohol consumption (p-value: 0.049 *) and with the use of systemic medications (p-value: 0.044 *). Sleep disorders and mood disorders are common comorbidities in OC survivors; therefore, early assessment and management before, during and after treatment should be performed in order to improve the quality of life of OC survivors.


2020 ◽  
Vol 9 (1) ◽  
pp. 7-13
Author(s):  
Maryam Eshghizadeh ◽  
Mahboubeh Esmaeili ◽  
Shahnaz Ahrari

Background: Sleep disturbances are very common among elderly population and mostly remain incurable. Practical, brief, and effective interventions are needed to promote sleep quality in older adults with moderate sleep disturbances. This study aimed to investigate the effectiveness of a brief behavioral training program in ameliorating sleep quality in older adults suffering from moderate sleep disturbances. Materials and Methods: This study was conducted on 64 older adults with moderate sleep disturbances, as defined by Pittsburgh Sleep Quality Index (PSQI) score ≥5. Participants were randomly allocated to either intervention (n=32) or control (n=32) group. Older adults in the intervention group received a brief behavioral-based sleep training program which was delivered in a single in-person session followed by four telephone sessions during 4 weeks. While their peers in the control group did not receive any intervention. The main outcome of the study was scores on the PSQI which was compared at pre- and post-intervention between both groups. Data were analyzed using the SPSS software version 19.0. Results: At 4 weeks, PSQI scores decreased in older adults receiving intervention, as compared with the scores of participants to the control group (P<0.001). Subjects in the intervention group also showed significant improvements in sleep latency, subjective sleep quality, sleep duration, and sleep efficiency (P<0.05). Conclusion: Brief behavioral interventions may be promising and useful for older adult population with moderate problems, and can be considered an efficacious and non-invasive intervention approach to improve elderly’s sleep quality.


2011 ◽  
Vol 23 (4) ◽  
pp. 167-172 ◽  
Author(s):  
Sharon L. Naismith ◽  
Naomi L. Rogers ◽  
Simon J. G. Lewis ◽  
Keri Diamond ◽  
Zoë Terpening ◽  
...  

Naismith SL, Rogers NL, Lewis SJG, Diamond K, Terpening Z, Norrie L, Hickie IB. Sleep disturbance in mild cognitive impairment: differential effects of current and remitted depression.Objective:Although patients with mild cognitive impairment (MCI) commonly report sleep disturbance, the extent to which depressive symptoms contribute to this relationship is unclear. This study sought to delineate the contribution of current and remitted major depression (MD) to sleep disturbance in MCI.Methods:Seventy-seven patients meeting criteria for MCI (mean age = 66.6 ± 8.8 years) were grouped according to those withnohistory of depression (MCI,n= 33), those meeting criteria forcurrentMD [mild cognitive impairment and meeting criteria for current major depression (DEP-C),n= 14] and those withremittedMD [mild cognitive impairment and remitted major depression (DEP-R),n= 30]. Additionally, 17 healthy controls (CON) participated. Sleep was patient-rated using the Pittsburgh Sleep Quality Index and included assessment of sleep quality, duration, efficiency, disturbances, medications, sleep onset latency and daytime dysfunction. Depression severity was clinician-rated using the Hamilton Depression Rating Scale.Results:Overall sleep disturbance was significantly greater in the DEP-C and DEP-R groups in comparison to the CON and MCI groups (p< 0.001). Only 12% of CON reported sleep disturbance, compared to 30% of MCI, 63% of DEP-R and 86% of DEP-C. Sub-scale analysis showed that the sleep disturbance in depressive groups was most evident across the domains of sleep quality, sleep efficiency, sleep latency and daytime dysfunction.Conclusion:Sleep disturbance in MCI is strongly associated with a current or past diagnosis of MD. The finding that sleep complaints are still prominent in those with remitted depression, suggests that ‘trait' markers exist that may reflect underlying neurobiological changes within the sleep–wake system.


Neurology ◽  
2020 ◽  
Vol 94 (7) ◽  
pp. e705-e717
Author(s):  
Christopher D. Stephen ◽  
David Balkwill ◽  
Peter James ◽  
Elizabeth Haxton ◽  
Kenneth Sassower ◽  
...  

ObjectiveA cross-sectional study was performed to evaluate whether quantitative oculomotor measures correlate with disease severity in late-onset GM2 gangliosidosis (LOGG) and assess cognition and sleep as potential early nonmotor features.MethodsTen patients with LOGG underwent quantitative oculomotor recordings, including measurements of the angular vestibulo-ocular reflex (VOR), with results compared to age- and sex-matched controls. Disease severity was assessed by ataxia rating scales. Cognitive/neuropsychiatric features were assessed by the cerebellar cognitive affective syndrome (CCAS) scale, Cerebellar Neuropsychiatric Rating Scale, and sleep quality evaluated using subjective sleep scales.ResultsOculomotor abnormalities were found in all participants, including 3/10 with clinically normal eye movements. Abnormalities involved impaired saccadic accuracy (5/10), abnormal vertical (8/10) and horizontal (4/10) pursuit, reduced optokinetic nystagmus (OKN) responses (7/10), low VOR gain (10/10), and impaired VOR cancellation (2/10). Compared to controls, the LOGG group showed significant differences in saccade, VOR, OKN, and visually enhanced VOR gains. Severity of saccadic dysmetria, OKN, and VOR fixation-suppression impairments correlated with ataxia scales (p < 0.05). Nine out of ten patients with LOGG had evidence of the CCAS (5/10 definite, 2/10 probable, 2/10 possible). Excessive daytime sleepiness was present in 4/10 and 8/10 had poor subjective sleep quality.ConclusionsCerebellar oculomotor abnormalities were present in all patients with LOGG, including those with normal clinical oculomotor examinations. Saccade accuracy (dorsal cerebellar vermis localization), fixation suppression, and OKN gain (cerebellar flocculus/paraflocculus localization) correlated with disease severity, suggesting that quantitative oculomotor measurements could be used to track disease progression. We found evidence of the CCAS, suggesting that cerebellar dysfunction may explain the cognitive disorder in LOGG. Sleep impairments were prevalent and require further study.


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