30-Minute Afternoon Workout Tied to Better Mood in Patients With Depression

By Lisa Rapaport

August 20, 2021

(Reuters Health) - Completing 30 minutes of moderate-intensity aerobic exercise late in the day may help improve mood in patients with unipolar depression, and it won't negatively impact sleep, a small study suggests.

Researchers randomly assigned 92 people with depression undergoing treatment in a psychosomatic inpatient rehabilitation program 1:1 to do a supervised 30-minute workout on an exercise bike at 4:45 p.m. or join a control group that spent 30 minutes at that time reading a book. Participants completed a mood questionnaire before and after these 30-minute sessions; they also had sleep efficiency measured by polysomnography and reported subjective outcomes such as sleep quality, daytime sleepiness, and mood.

Sleep efficiency didn't differ between the groups, the authors report in the journal Sleep. However, aerobic exercise was strongly associated with improved mood and didn't appear to negatively impact sleep quality or daytime sleepiness.

"A single 30-minute bout of moderate-intensity aerobic exercise seems to be enough of a stimulus to improve mood immediately after the exercise session, however, it might not be enough to affect sleep a few hours later," said lead study author Gavin Brupbacher, a sports and exercise medicine researcher at the University of Basel in Switzerland.

"We were quite surprised that none of the sleep-related outcomes were affected by the intervention since some positive effects have been shown in patients with insomnia and healthy individuals," Brupbacher said by email.

In the intervention group, exercise sessions began with a 5-minute warm up, then patients worked at 80% of individual anaerobic threshold for 30 minutes.

Researchers assessed mood using the Patient Health Questionnaire-9 (PHQ-9), which includes questions about feeling down, depressed or hopeless; the Hospital and Anxiety and Depression Scale (HADS); and the Perceived Stress Scale.

In addition to sleep efficiency, the study also assessed total sleep time, sleep onset latency, wake after sleep onset, number of awakenings, percent of total sleep time in different sleep stages, REM sleep as percent of total sleep time. Researchers also looked at subjective sleep quality and daytime sleepiness.

One limitation of the study is that many patients were excluded due to use of hypnotic medications or psychiatric or somatic comorbidities, limiting the generalizability of the results, the study team notes.

Another limitation is that polysomnography isn't the optimal tool for insomnia evaluation, said Giselle Soares Passos, an associate professor at Universidade Federal de Jatai in the Brazilian state of Goais, who wasn't involved in the study.

It's also possible that the study didn't identify an improvement in sleep efficiency after a single exercise session and a single night of sleep because the duration of the intervention and follow-up were too brief, Passos said by email.

"The evaluation of a single night may not identify common insomnia complaints, which occur at least 3 nights per week for at least 3 months," Passos said.

However, many previous studies have found positive effects on depression after chronic moderate intensity aerobic exercise in patients with chronic insomnia, Passos added.

"I'm sure exercise should be included as a non-pharmacological adjuvant strategy for insomnia and depression," Passos said.

SOURCE: https://bit.ly/3kd1kyR Sleep, online July 13, 2021.

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