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      The effects of aerobic, resistance, and meditative movement exercise on sleep in individuals with depression: protocol for a systematic review and network meta-analysis

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          Abstract

          Background

          The main objective of this review is to assess the effects of aerobic, resistance, and meditative movement exercise on sleep quality in patients with unipolar depression. A secondary goal is to ascertain the effects on sleep duration, sleepiness, daytime functioning, use of hypnotics, and adverse events.

          Methods

          A systematic computerized search will be performed in the following online databases: PubMed, EMBASE (on Ovid), Cochrane Library, PsycINFO (on Ovid), SPORTDiscus (on EBSCOhost), CINHAL (on EBSCOhost), Clinicaltrials.gov, WHO International Clinical Trials Registry, OpenGrey, and ProQuest Dissertations and Theses. Bibliographies of all included studies as well as any other relevant reviews identified via the search will be screened. Randomized trials using aerobic, resistance, or meditative movement exercise interventions which target sleep as a primary or secondary outcome will be included. The primary outcome will be differences in sleep quality at post-intervention. Secondary outcomes will be adverse events, differences in sleep duration, daytime sleepiness and functioning, and the use of hypnotics at post-intervention. Two authors will independently screen the identified records. Disagreement will be resolved by consensus or if no consensus can be reached by adjudication of a designated third reviewer. Data extraction will be done independently by two authors using a standardized and piloted data extraction sheet. Bias in individual studies will be assessed using the revised Cochrane risk of bias tool. The certainty of evidence across all outcomes will be evaluated using the CINeMA (Confidence in Network Meta-Analysis) framework. A frequentist network meta-analysis will be conducted. The systematic review and network meta-analysis will be presented according to the PRISMA for Network Meta-Analyses (PRISMA-NMA) guideline.

          Discussion

          This systematic review and network meta-analysis will provide a synthesis of the currently available evidence concerning the effects of aerobic, resistance, and meditative movement exercises on sleep in patients with unipolar depression. Thereby, we hope to accelerate the consolidation of evidence and inform decision-makers on potential benefits and harms.

          Systematic review registration

          The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019115705).

          Electronic supplementary material

          The online version of this article (10.1186/s13643-019-1018-4) contains supplementary material, which is available to authorized users.

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          Most cited references60

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          A cognitive model of insomnia.

          Insomnia is one of the most prevalent psychological disorders, causing sufferers severe distress as well as social, interpersonal, and occupational impairment. Drawing on well-validated cognitive models of the anxiety disorders as well as on theoretical and empirical work highlighting the contribution of cognitive processes to insomnia, this paper presents a new cognitive model of the maintenance of insomnia. It is suggested that individuals who suffer from insomnia tend to be overly worried about their sleep and about the daytime consequences of not getting enough sleep. This excessive negatively toned cognitive activity triggers both autonomic arousal and emotional distress. It is proposed that this anxious state triggers selective attention towards and monitoring of internal and external sleep-related threat cues. Together, the anxious state and the attentional processes triggered by it tricks the individual into overestimating the extent of the perceived deficit in sleep and daytime performance. It is suggested that the excessive negatively toned cognitive activity will be fuelled if a sleep-related threat is detected or a deficit perceived. Counterproductive safety behaviours (including thought control, imagery control, emotional inhibition, and difficulty problem solving) and erroneous beliefs about sleep and the benefits of worry are highlighted as exacerbating factors. The unfortunate consequence of this sequence of events is that the excessive and escalating anxiety may culminate in a real deficit in sleep and daytime functioning. The literature providing preliminary support for the model is reviewed and the clinical implications and limitations discussed.
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            State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease.

            The notion that psychological states can influence physical health is hardly new, and perhaps nowhere has the mind-body connection been better studied than in cardiovascular disease (CVD). Recently, large prospective epidemiologic studies and smaller basic science studies have firmly established a connection between CVD and several psychological conditions, including depression, chronic psychological stress, posttraumatic stress disorder (PTSD), and anxiety. In addition, numerous clinical trials have been conducted to attempt to prevent or lessen the impact of these conditions on cardiovascular health. In this article, we review studies connecting depression, stress/PTSD, and anxiety to CVD, focusing on findings from the last 5 years. For each mental health condition, we first examine the epidemiologic evidence establishing a link with CVD. We then describe studies of potential underlying mechanisms and finally discuss treatment trials and directions for future research.
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              Exercise as a treatment for depression: A meta-analysis.

              This meta-analysis of randomized controlled trials (RCTs) examines the efficacy of physical exercise as treatment for unipolar depression, both as an independent intervention and as an adjunct intervention to antidepressant medication.
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                Author and article information

                Contributors
                gavin.brupbacher@unibas.ch
                Journal
                Syst Rev
                Syst Rev
                Systematic Reviews
                BioMed Central (London )
                2046-4053
                26 April 2019
                26 April 2019
                2019
                : 8
                : 105
                Affiliations
                [1 ]ISNI 0000 0004 1937 0642, GRID grid.6612.3, Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, , University of Basel, ; Birsstrasse 320 B, 4052 Basel, Switzerland
                [2 ]Oberwaid AG, Rorschacher Strasse 311, 9016 St. Gallen, Switzerland
                [3 ]ISNI 0000 0004 1937 0642, GRID grid.6612.3, Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, , University of Basel, ; Missionsstrasse 62a, 4055 Basel, Switzerland
                [4 ]University Medical Library Basel, Spiegelgasse 5, 4051 Basel, Switzerland
                [5 ]ISNI 0000 0004 1937 0642, GRID grid.6612.3, Division of Clinical Psychology and Epidemiology, Faculty of Psychology, , University of Basel, ; Missionsstrasse 62a, 4055 Basel, Switzerland
                [6 ]ISNI 0000 0004 1937 0642, GRID grid.6612.3, Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, , University of Basel, ; Birsstrasse 320 B, 4052 Basel, Switzerland
                [7 ]Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zurich, Culmannstrasse 8, 8091 Zurich, Switzerland
                Author information
                http://orcid.org/0000-0002-0140-6614
                Article
                1018
                10.1186/s13643-019-1018-4
                6486698
                31027509
                376d5d8d-eb0f-4e83-9a41-5afb8600064f
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 17 April 2018
                : 5 April 2019
                Funding
                Funded by: OBERWAID AG
                Award ID: -
                Award Recipient :
                Categories
                Protocol
                Custom metadata
                © The Author(s) 2019

                Public health
                exercise,aerobic,resistance,meditative movement,depression,sleep,randomized,trial,systematic review,network meta-analysis,protocol

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