Exercise improves immune function, antidepressive response, and sleep quality in patients with chronic primary insomnia

Giselle Soares Passos, Dalva Poyares, Marcos Gonçalves Santana, Alexandre Abílio de Souza Teixeira, Fábio Santos Lira, Shawn D Youngstedt, Ronaldo Vagner Thomatieli dos Santos, Sergio Tufik, Marco Túlio de Mello, Giselle Soares Passos, Dalva Poyares, Marcos Gonçalves Santana, Alexandre Abílio de Souza Teixeira, Fábio Santos Lira, Shawn D Youngstedt, Ronaldo Vagner Thomatieli dos Santos, Sergio Tufik, Marco Túlio de Mello

Abstract

The aim of this study was to evaluate the effects of moderate aerobic exercise training on sleep, depression, cortisol, and markers of immune function in patients with chronic primary insomnia. Twenty-one sedentary participants (16 women aged 44.7 ± 9 years) with chronic primary insomnia completed a 4-month intervention of moderate aerobic exercise. Compared with baseline, polysomnographic data showed improvements following exercise training. Also observed were reductions in depression symptoms and plasma cortisol. Immunologic assays revealed a significant increase in plasma apolipoprotein A (140.9 ± 22 to 151.2 ± 22 mg/dL) and decreases in CD4 (915.6 ± 361 to 789.6 ± 310 mm(3)) and CD8 (532.4 ± 259 to 435.7 ± 204 mm(3)). Decreases in cortisol were significantly correlated with increases in total sleep time (r = -0.51) and REM sleep (r = -0.52). In summary, long-term moderate aerobic exercise training improved sleep, reduced depression and cortisol, and promoted significant changes in immunologic variables.

Figures

Figure 1
Figure 1
Participant flowchart.

References

    1. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews. 2002;6(2):97–111.
    1. Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? Journal of the American Medical Association. 1989;262(11):1479–1484.
    1. AASM. The International Classification of Sleep Disorders: Diagnostic and Coding Manual. 2nd edition. American Academy of Sleep Medicine; 2005.
    1. Imeri L, Opp MR. How (and why) the immune system makes us sleep. Nature Reviews Neuroscience. 2009;10(3):199–210.
    1. Motivala SJ, Sarfatti A, Olmos L, Irwin MR. Inflammatory markers and sleep disturbance in major depression. Psychosomatic Medicine. 2005;67(2):187–194.
    1. Cover H, Irwin M. Immunity and depression: insomnia, retardation, and reduction of natural killer cell activity. Journal of Behavioral Medicine. 1994;17(2):217–223.
    1. Savard J, Laroche L, Simard S, Ivers H, Morin CM. Chronic insomnia and immune functioning. Psychosomatic Medicine. 2003;65(2):211–221.
    1. Kripke DF, Klauber MR, Wingard DL, Fell RL, Assmus JD, Garfinkel L. Mortality hazard associated with prescription hypnotics. Biological Psychiatry. 1998;43(9):687–693.
    1. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004) Sleep. 2006;29(11):1398–1414.
    1. Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. Journal of the American Medical Association. 1999;281(11):991–999.
    1. Youngstedt SD. Effects of exercise on sleep. Clinics in Sports Medicine. 2005;24(2):355–365.
    1. Passos GS, Poyares D, Santana MG, Garbuio SA, Tufik S, De Mello MT. Effect of acute physical exercise on patients with chronic primary insomnia. Journal of Clinical Sleep Medicine. 2010;6(3):270–275.
    1. Guilleminault C, Clerk A, Black J, Labanowski M, Pelayo R, Claman D. Nondrug treatment trials in psychophysiologic insomnia. Archives of Internal Medicine. 1995;155(8):838–844.
    1. Passos GS, Poyares D, Santana MG, et al. Effects of moderate aerobic exercise training on chronic primary insomnia. Sleep Medicine. 2011;12(10):1018–1027.
    1. Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine. 2010;11(9):934–940.
    1. Nehlsen-Cannarella SL, Nieman DC, Balk-Lamberton AJ, et al. The effects of moderate exercise training on immune response. Medicine and Science in Sports and Exercise. 1991;23(1):64–70.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Washington, DC, USA: American Psychiatric Press; 1994.
    1. American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Westchester, NY, USA: Diagnostic Classification Steering Committee; 2005.
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry. 1961;4:561–571.
    1. Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. Journal of Applied Physiology. 1986;60(6):2020–2027.
    1. Goldberg L, Elliot DL, Kuehl KS. Assessment of exercise intensity formulas by use of ventilatory threshold. Chest. 1988;94(1):95–98.
    1. EEG arousals: scoring rules and examples: a preliminary report from the sleep disorders atlas task force of the American Sleep Disorders Association. Sleep. 1992;15(2):173–184.
    1. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22(5):667–689.
    1. Rechtschaffen A, Kales A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Washington, DC, USA: Government Printing Office; 1968.
    1. Buysse DJ, Reynolds CF, III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989;28(2):193–213.
    1. Riemann D, Kloepfer C, Berger M. Functional and structural brain alterations in insomnia: implications for pathophysiology. European Journal of Neuroscience. 2009;29(9):1754–1760.
    1. Riemann D, Spiegelhalder K, Feige B, et al. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Medicine Reviews. 2010;14(1):19–31.
    1. Fernandez-Mendoza J, Vgontzas AN, Calhoun SL. Insomnia symptoms, objective sleep duration and hypothalamic-pituitary-adrenal activity in children. European Journal of Clinical Investigation. 2014;44(5):493–500.
    1. Youngstedt SD, O'Connor PJ, Crabbe JB, Dishman RK. Acute exercise reduces caffeine-induced anxiogenesis. Medicine and Science in Sports and Exercise. 1998;30(5):740–745.
    1. Vgontzas AN, Chrousos GP. Sleep, the hypothalamic-pituitary-adrenal axis, and cytokines: multiple interactions and disturbances in sleep disorders. Endocrinology and Metabolism Clinics of North America. 2002;31(1):15–36.
    1. Burgos I, Richter L, Klein T, et al. Increased nocturnal interleukin-6 excretion in patients with primary insomnia: a pilot study. Brain, Behavior, and Immunity. 2006;20(3):246–253.
    1. Alves ES, Lira FS, Santos RVT, Tufik S, De Mello MT. Obesity, diabetes and OSAS induce of sleep disorders: exercise as therapy. Lipids in Health and Disease. 2011;10, article 148
    1. Mackinnon LT. Chronic exercise training effects on immune function. Medicine & Science in Sports & Exercise. 2000;32(7):S369–S376.
    1. Santos RVT, Tufik S, De Mello MT. Exercise, sleep and cytokines: is there a relation? Sleep Medicine Reviews. 2007;11(3):231–239.
    1. Walsh NP, Gleeson M, Shephard RJ, et al. Position statement part one: immune function and exercise. Exercise Immunology Review. 2011;17:6–63.
    1. Woods JA, Lowder TW, Keylock KT. Can exercise training improve immune function in the aged? Annals of the New York Academy of Sciences. 2002;959:117–127.
    1. Lira FS, Pimentel GD, Santos RVT, et al. Exercise training improves sleep pattern and metabolic profile in elderly people in a time-dependent manner. Lipids in Health and Disease. 2011;10, article 113
    1. Viana VAR, Esteves AM, Boscolo RA, et al. The effects of a session of resistance training on sleep patterns in the elderly. European Journal of Applied Physiology. 2012;112(7):2403–2408.
    1. Unal M, Erdem S, Deniz G. The effects of chronic aerobic and anaerobic exercises n lymphocyte subgroups. Acta Physiologica Hungarica. 2005;92(2):163–171.
    1. Shore S, Shinkai S, Rhind S, Shephard RJ. Immune responses to training: how critical is training volume. Journal of Sports Medicine and Physical Fitness. 1999;39(1):1–11.
    1. Kennedy SL, Smith TP, Fleshner M. Resting cellular and physiological effects of freewheel running. Medicine and Science in Sports and Exercise. 2005;37(1):79–83.
    1. Michishita R, Shono N, Inoue T, Tsuruta T, Node K. Effect of exercise therapy on monocyte and neutrophil counts in overweight women. The American Journal of the Medical Sciences. 2010;339(2):152–156.
    1. Walldius G, Jungner I, Holme I, Aastveit AH, Kolar W, Steiner E. High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. The Lancet. 2001;358(9298):2026–2033.
    1. Moreno PR, Sanz J, Fuster V. Promoting mechanisms of vascular health: circulating progenitor cells, angiogenesis, and reverse cholesterol transport. Journal of the American College of Cardiology. 2009;53(25):2315–2323.
    1. Brewer HB., Jr. High-density lipoproteins: a new potential therapeutic target for the prevention of cardiovascular disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24(3):387–391.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe