The majority of patients with depression have problems with sleep, usually insomnia. But about 10 to 12 percent have the opposite problem.
In this edition of Vital Signs, Dr. Madhukar Trivedi, Director of UT Southwestern’s Center for Depression Research and Clinical Care, and chief of the Mood Disorders Division of Psychiatry at UT Southwestern, talks about hypersomnia and how aerobic exercise may alleviate the problem.
Highlights from Dr. Trivedi’s interview:
What is hypersomnia: “Hypersomnia is when people sleep too much. When they wake up, even though they’ve slept ten, 12 hours, they don’t feel rested. During the daytime, they also get sleepy or have small naps, and therefore hypersomnia lasts all 24 hours. It does seem it’s disrupting the circadian rhythm all of us have. Secondly, that may be associated with different kinds of hormones and proteins in the brain that may be responsible for this.”
Hypersomnia’s link to major depressive disorder: “That’s the primary symptom. People who have hypersomnia also eat a lot, or at least snack a lot, much more weight gain as opposed to people with insomnia, and more fatigue and a different subtype of depression.”
Why aerobic exercise may alleviate hypersomnia: “There’s very good pre-clinical, or animal, data showing that if exercise leads to neurogenesis – that is, brain cells actually regenerate – and there are also reductions in stress hormone and inflammation, in a related publication from this very study we find that those patients who have more inflammation do better with exercise. And if you compare that with other studies, SSRI’s like Prozac, etc, they actually do less for people who have inflammation. So it’s almost like exercise is an anti-inflammatory treatment.
“So what we found is that people who have this higher inflammation, they are really not responding to regular antidepressants. When you give them exercise as a treatment, either on a treadmill or on a bike with moderate intensity, this inflammation goes down and that is how their sleep improves.
“Before they were put into the study, they had tried an SSRI. The SSRI had not worked, and they still had significant depressive symptoms. When we put them through the exercise regimen for 12 weeks with this intensity of exercise, the effect of exercise of their depression is very similar to the effect you see with an SSRI.”
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