University of Texas Southwestern Medical Center, Dallas, TX 75390-9119, USA.
Psychol Med. 2013 Apr;43(4):699-709. doi: 10.1017/S0033291712001675. Epub 2012 Aug 29.
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.
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.
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.
睡眠障碍是重度抑郁症 (MDD) 缓解后持续存在的残留症状，与 MDD 复发风险增加有关。本研究的目的是研究运动增强对非缓解 MDD 患者自我报告睡眠质量的影响。方法：参与者随机分为接受选择性 5-羟色胺再摄取抑制剂 (SSRI) 增强治疗，分别接受两种剂量的运动治疗：每周每公斤体重 16 千卡（KKW）或 12 周 4KKW。抑郁症状采用临床医生评定的抑郁症状清单（IDS-C）评估。IDS-C 上的四个与睡眠相关的项目（入睡困难、午夜后失眠、早醒和嗜睡）用于评估自我报告的睡眠质量。
总失眠症显著下降（p<0.0001），入睡困难、午夜后和早醒失眠症也显著下降（p<0.002）。嗜睡症无显著变化（p=0.38）。总失眠症、午夜后失眠症和早醒失眠症的变化与抑郁症状的变化无关。较高的基线嗜睡症预示着运动治疗后抑郁严重程度的更大下降（p=0.0057）。未观察到任何基线睡眠对抑郁严重程度变化的显著调节作用。在总失眠症或任何单个睡眠项目上，运动治疗组之间没有显著差异。
运动增强可改善非缓解 MDD 患者的自我报告睡眠质量。鉴于失眠症作为 MDD 治疗后的残留症状的普遍性以及与 MDD 复发相关的风险，运动增强可能在 MDD 的治疗中具有重要作用。
