Exercise as an alternative treatment for chronic insomnia

Insomnia is characterized by difficulty initiating or maintaining sleep, waking-up too early and daytime function impairment. Its prevalence ranges from 10% to 40%, and various medications are used to treat insomnia. However, side effects are common. Non-pharmacological interventions with some efficacy may be useful, and include sleep hygiene advice (e.g., set a regular bedtime, limit alcohol and caffeine, and increase daylight exposure), cognitive–behavioral therapy and exercise. The British Journal of Sport Medicine recently published a systematic review aimed to determine whether aerobic- or resistance-training program improves sleep quality in middle-aged and older adults with sleep problems.

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The review confirmed that exercise improves subjective sleep quality. The magnitude of the effect compared with that of hypnotic pharmacotherapy is difficult to gauge. However, tailored exercise may be a safe and effective alternative to such medications. This is particularly important given the side-effect profiles of hypnotic and sedative medications in older adults. With documented efficacy, one should consider exercise as an alternative or adjunctive treatment for older adults with poor sleep quality.

Øivind Rognmo, researcher with CERG

The Rise in Dementia Diagnosis

A study published in the Lancet suggests that the number of people diagnosed with dementia has doubled over the 10 years (between the year 2005 and the year 2015).

University of Manchester researchers found 0.82% people diagnosed with dementia in 2015, compared with 0.42% in 2005. In addition, the proportion of those who received medications for dementia have increased from 15% to 36.3%.

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In Norway, it is estimated that about 1.5% of the entire population suffers from dementia, and almost every fifth person will develop dementia during their lifetime. As dementia is age-dependent and its prevalence rises sharply with increasing age, the current estimates show that the number of people with dementia will rise even further as a result of an ageing population.

By studying around 9 million patients, the researcher from University of Manchester found a steady increase in the dementia diagnosis regardless of age, although, the proportional increase in the rate of diagnosis was higher in older patients. The authors of the study attributed this rise in the dementia diagnosis to ageing population, increased clinical awareness, and implementation of national policies and guidelines.

Majority of the known risk factors for dementia are the same as for the heart disease. Therefore, primary prevention of heart disease would probably also protect against dementia. The most common interventions to reduce incidence of heart disease include less smoking, increased physical activity, and a healthy diet.

Javaid Nauman, Researcher at CERG

Study shows that walking for exercise improves quality of life in people with cancer

We all know someone who has been afflicted with cancer. In fact some 14 million people discover that they have cancer every year and more than half die from the disease.

Quality of life is particularly affected in people with advanced cancer, but research shows that exercise can play an important part and confer significant health benefits in people afflicted with cancer. Yet physical activity in cancer patients is very often low during and after treatment. Evidence shows that improving physical activity participation in people with cancer can positively affect quality of life. However, interventions targeting increased physical activity in this patient population often require supervision and attendance at specialist facilities.

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Walking is an inexpensive form of physical activity which has been shown to improve quality of life. It is a feasible form of physical activity which can be performed alone or in groups and requires no supervision or specialized facilities. However, the effect of walking on quality of life in people with metastatic cancer has not been explored .

Researchers from the UK investigated the effect of walking on quality of life and symptoms in patients with advanced cancer.   They recruited 42 patients with advanced cancer and split them into two groups: the standard care group and the intervention group. The intervention group received a short motivational interview, was encouraged to walk 30 minutes every other day and could participate in weekly volunteer led walks.

The intervention group participants reported improvements in quality of life and many participants reported that walking improved the attitude toward their illness and encouraged social participation. This is very good information as it shows that exercise in the form of walking can be suitable and beneficial for people living with cancer.

Nina Zisko, PhD student at CERG

Stair climb to fitness

Fitness is a reflection of our lifestyle. It is then no surprise that studies show that fitness is a strong predictor of heart disease and death.  However, we can modify our fitness and epidemiological studies show that even small increases in fitness reduce the risk of heart disease and premature death.

High intensity exercise seems to be the best way to improve fitness.  However, most people cite lack of time as a barrier to exercise.  However, studies show that you do not need a large time commitment to see fitness gains.  No equipment?  Also no problem. You can use your local stairs!pixabay_steps-1081909_1280

A recently published study tested the effect of different 10 minute training protocols (including a warm up and cool down period) involving climbing of stairs, performed 3x per week for 6 weeks, on fitness in 31 sedentary but otherwise healthy women. The study found that stair climbing using either 3×20 seconds interspersed with 2 minute recovery or 3×60 seconds interspersed with 60 seconds of recovery improved fitness after 6 weeks.

So if you are pressed for time and lack equipment, hit the local stairs.  A half an hour weekly commitment could get you fit just in time for the spring.

Nina Zisko, PhD student at CERG

 

Smoking hot exercise

fredrikSmoking is one of the leading risk factors for death in the world and the primary risk factor for developing chronic obstructive pulmonary disease (COPD).

Patients with smoking induced COPD have lower physical fitness, as well as locomotor, respiratory and cardiac muscle dysfunction. However, whether this is due to the COPD lung dysfunction and the inactivity that often follows, or a direct consequence of the cigarette smoke itself, is not known. In a recent study, we attempted to answer this question. We exposed mice to cigarette smoke and compared muscle function as well as cardiorespiratory fitness (VO2max) with a non-smoke exposed control group before they developed COPD. In addition we had a smoke exposed group that exercised after the smoke exposure. We found impairments in both the heart and the diaphragm in smoke exposed mice, without any evidence of COPD having developed, as well as a reduced VO2max, indicating that these changes negatively affected performance at the whole body level. Luckily, interval training prevented much of the cigarette smoke associated decline in muscle function, and VO2max was normalized.

The message of the paper is that exercise restores the decreased physical fitness caused by smoke exposure. So if you have just abandoned your smoking habit, perhaps taking up physical activity is a good idea.

Fredrik Hjulstad Bækkerud, PhD Candidate at CERG

No pain no gain?

Inger-Lise AamotAs we grow older, the risk of different diseases increases. For instance, as we reach middle age, most of us have some degree of atherosclerosis (plaques build up in the arteries). As the plaque burden increases, the lumen in the arteries narrows and blood flow becomes limited to organs and muscles. This can cause serious trouble and lead to heart attack or stroke, but another not uncommon condition is intermittent claudication (IC). This is a condition where the arteries cannot deliver enough oxygenated blood to the muscles, typically in the legs, with symptoms like pain and cramping in the leg muscles during walking. This lead to a functional limitation, reducing the walking distance and quality of life. It is estimated that about 20% of the population worldwide is affected by peripheral arterial disease, and one third of these people have IC. Major risk factors for IC are smoking and physical inactivity. Therefore, to improve functional status and quality of life, people with IC are encouraged to “stop smoking and keep walking”.

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Brain activity – the missing link between stress and development of cardiovascular disease?

Linda ErnstsenOver the past 30 years, a large and varied body of research has examined the role of chronic psychosocial stress in the development of cardiovascular disease (CVD). The mechanisms behind this association are not fully understood, but several studies support the link between increased stress levels and inflammation. Further, that inflammation is directly involved in the atherosclerotic process in the arteries. Many of the brain areas involved in emotions are also involved in sensing and regulating levels of inflammation in the body. In 2014 a group of researchers at the University in Pittsburg studied 157 healthy adult volunteers who were asked to regulate their emotional reactions to unpleasant pictures while their brain activity was measured with functional imaging. They found that individuals who showed greater brain activation when regulating their negative emotions also exhibited elevated blood levels of interleukin-6, one of the body’s pro-inflammatory cytokines that regulates the immune system and plays a role in cognitive function. Further they observed an increased thickness of the carotid artery wall, a marker of atherosclerosis. The results were independent of age, sex, race, smoking status, and other known CVD risk factors.

Last week Lancet published results from an American study of 293 mentally healthy participants without cardiovascular disease who underwent clinical measurements and scan of the brain. The participants where then followed for four years. The researchers from Harvard Medical School wanted to assess if activity in amygdala, a part of the brain that is involved in emotional processing, could predict cardiovascular events. And they did. The results showed that high activity in amygdala was independently associated with cardiovascular events, and that 39% of this association was explained by arterial inflammation. They also found that most of the association between perceived stress (measured by questionnaires) and arterial inflammation was explained by amygdala activity. Another interesting finding was that bone marrow activity explained 46% of the association between amygdala activity and arterial inflammation. Activation of the bone marrow leads to release of inflammatory cells taking part in in the atherosclerotic process.

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In turn, the results from this study reveals an important piece of the puzzle on how psychosocial stress gets under the skin. It also reminds us of the importance of coping with stress in our daily life. Some important behaviors that help our bodies to keep up this balance are regular exercise, getting enough sleep and eating healthy foods.  Practicing mindfulness, mediation and yoga have also shown to have positive effect on perceived stress levels. And last but not least, do not forget to laugh. Laughter also adds year to your lifespan.

Linda Ernstsen, Associate Professor CERG