Physical Exercise, CBT Alleviate Sleep Impairment in Patients With Panic Disorder

By Thomas S. May

FLORENCE, Italy -- April 3, 2017 -- Both cognitive behaviour therapy (CBT) and regular physical exercise have positive effects on symptoms of sleep impairment in patients with panic disorder, according to a study presented here at the 25th European Congress of Psychiatry (EPA).

Insomnia and sleep impairment are highly prevalent in many psychiatric disorders, including panic disorder, and approximately 70% of patients with panic disorder have symptoms indicative of insomnia. Sleep impairment such as insomnia is a risk factor for the development of anxiety and for other disorders, including depression.

Anders Hovland, PhD, University of Bergen, Bergen, Norway, and colleagues conducted a study in which 36 patients with panic disorder were randomised to receive CBT or physical exercise.

Physical exercise consisted of 3 supervised 60-minute sessions per week and included both aerobic and resistance training. CBT was administered for 2 hours per week by experienced clinical psychologists. Both treatments lasted for 12 weeks, and attendance rates were above 85% for both.

The effects of these interventions on sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). PSQI was measured both before and after the interventions, and the researchers used repeated measures ANOVA and t-tests to evaluate the results.

The researchers found that both interventions had positive effects on sleep quality and the effect of time was significant (P = .003). Symptoms were significantly reduced from pre- to post-treatment (physical exercise, P = .008; CBT, P = .044).

There were significant changes in sleep quality and sleep disturbance (P< .05) among patients in the CBT group. Patients in the exercise group had positive changes in sleep duration and sleep disturbance.

According to Dr. Hovland, the effects of psychotherapy for anxiety do not appear to be sufficient to provide remission or adequate improvement for sleep problems, which suggests that sleep impairment should be addressed specifically in the treatment of anxiety.

“Furthermore, if physical exercise affects sleep through different mechanisms than psychotherapy, the impact of combining these treatments should be investigated further,” said Dr. Hovland.

[Presentation title: Comparing the Effects of Cognitive Behaviour Therapy or Regular Physical Exercise on Sleep in the Treatment of Patients With Panic Disorder. Abstract ED006]
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