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Does exercise improve self-reported sleep quality in non-remitted major depressive disorder?

Published online by Cambridge University Press:  29 August 2012

C. D. Rethorst ,
P. Sunderajan ,
T. L. Greer ,
B. D. Grannemann ,
P. A. Nakonezny ,
T. J. Carmody  and
M. H. Trivedi
C. D. Rethorst*
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
P. Sunderajan
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
T. L. Greer
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
B. D. Grannemann
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
P. A. Nakonezny
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
T. J. Carmody
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
M. H. Trivedi
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
*
*Address for correspondence: C. D. Rethorst, Ph.D., University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9119, USA. (Email: [email protected])
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Abstract

Background

Sleep disturbances are persistent residual symptoms following remission of major depressive disorder (MDD) and are associated with an increased risk of MDD recurrence. The purpose of the current study was to examine the effect of exercise augmentation on self-reported sleep quality in participants with non-remitted MDD.

Method

Participants were randomized to receive selective serotonin reuptake inhibitor (SSRI) augmentation with one of two doses of exercise: 16 kilocalories per kilogram of body weight per week (KKW) or 4 KKW for 12 weeks. Depressive symptoms were assessed using the clinician-rated Inventory of Depressive Symptomatology (IDS-C). The four sleep-related items on the IDS-C (Sleep Onset Insomnia, Mid-Nocturnal Insomnia, Early Morning Insomnia, and Hypersomnia) were used to assess self-reported sleep quality.

Results

Significant decreases in total insomnia (p < 0.0001) were observed, along with decreases in sleep onset, mid-nocturnal and early-morning insomnia (p's <0.002). Hypersomnia did not change significantly (p = 0.38). Changes in total, mid-nocturnal and early-morning insomnia were independent of changes in depressive symptoms. Higher baseline hypersomnia predicted a greater decrease in depression severity following exercise treatment (p = 0.0057). No significant moderating effect of any baseline sleep on change in depression severity was observed. There were no significant differences between exercise treatment groups on total insomnia or any individual sleep item.

Conclusions

Exercise augmentation resulted in improvements in self-reported sleep quality in patients with non-remitted MDD. Given the prevalence of insomnia as a residual symptom following MDD treatment and the associated risk of MDD recurrence, exercise augmentation may have an important role in the treatment of MDD.

Keywords

Augmentationdepressionexerciseinsomniaphysical activitysleep
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 4 , April 2013 , pp. 699 - 709
Copyright
Copyright © Cambridge University Press 2012

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