Aerobic exercise after 2 PM did not affect sleep amongst people with depression

1. In this study, aerobic exercise performed after 2 PM did not negatively impact subsequent night’s sleep amongst participants with unipolar depression.

2. Aerobic exercise improved mood and decreased depressiveness and anger amongst participants with depression.

Evidence Rating Level: 1 (Excellent)

Due to the strong relationship between insomnia and depression, insomnia may be targeted for treatment in people with depression. Sleep hygiene guidelines recommend aerobic exercise as a meaningful strategy to counter insomnia prior to 2 PM, which may also improve mood. However, these guidelines also suggest strenuous physical activity after 2 PM may also aggravate insomnia due to endorphin release. The primary goal of this study was to assess the effect of a single session of aerobic exercise on subsequent night’s sleep amongst participants with depression.

This two-arm parallel-group, randomized control trial enrolled 92 participants aged 18-65 years diagnosed with unipolar depression from a psychosomatic in-patient rehabilitation unit in St. Gallen, Switzerland. 46 participants were randomized to an exercise group (aerobic exercise performed at 16:45), whereas 46 participants were randomized to a control group (no exercise). Participants using medications such as hypnotics and opioids, had moderate obstructive sleep apnea, or BMI >40 were excluded. Primary outcome assessed for sleep efficiency using polysomnography. Secondary outcomes assessed for subjective measures such as sleep quality and mood state using questionnaires.

Results demonstrated that exercise after 2 PM did not significantly affect sleep efficiency, daytime sleepiness, or other subjective sleep parameters. However, participants in the exercise group did report an immediate positive effect on mood state (less agitation, depressiveness, and anger, as well as  increased levels of activation, elatio, and calmness). This study was limited due to its stringent exclusion critieria (such as participant use of hypnotics) and polysomnographic montage, which restrict generalizability of results. Nonetheless, this study was significant in suggesting that physical activity after 2 PM improved mood state and did not negatively affect sleep.

Click to read the study in Sleep

Image: PD

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