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University of Basel

Exercise and being in love promote a good night’s sleep

Text: Martin Hicklin

What can be done when sleep is badly disturbed, and what promotes good sleep? Research groups at the Psychiatric Clinics of the University of Basel (UPK) have been addressing such questions for some time now. Exercise is good – but so is being in love.

Doing vigorous exercise in the evening before going to bed doesn’t seem to be good advice because presumed common sense and popular opinion agree that it is bound to disturb the balance between sleep and waking; especially for young people who are still exposed to all kinds of other excitements. However, the opposite is true: Those who work out in the evening and consciously exert themselves are rewarded with better-quality sleep. This is not just reported by the roughly 20-year-old participants in a Basel study – it is also confirmed objectively by sleep electroencephalograms (sleep EEGs). This is good news for everyone who doesn’t have enough time for sport during the day and has doubts about whether training in the evening is good for them.

Waking and dreaming

The study may not be the only one that points in this direction, but it does say something about the breadth of the sleep research conducted in Basel at the Center for Affective, Stress and Sleep Disorders (ZASS). The center is located in an impressive three-storey building in the grounds of UPK Basel (Psychiatric Clinics of the University of Basel) and treats patients for burnout, depression, and similar “disorders”. For precisely this reason, the researchers there are also trying to gain a deeper understanding of how everything is linked in sleep. The center not only offers consultations for people with sleep disorders, it also has a fully equipped sleep laboratory in which all the phases of wakefulness and dreaming can be tracked in the jagged lines of sleep EEGs.

Professor Edith Holsboer-Trachsler, the center’s senior consultant, clearly enjoys talking about the realistic findings regarding sport and the ability to fall asleep, which she published together with colleagues from the Department of Sport, Exercise and Health at the University of Basel in 2014. She can demonstrate two things with this study: the broad access to sleep as a key element of human well-being, and the lack of bias with which the research questions are addressed. One can imagine a continuum ranging from healthy to sick and from young to old, where healthy young people are studied as well as adults and older clients troubled by stress, disorders and chronic illness. Today, it helps that new technical possibilities increasingly enable researchers to confirm findings objectively.

Study of teenagers sparks media interest

“In addition to our medical work, we are involved in three research groups concerned with sleep,” says Professor Holsboer. The first group, headed by the psychologist PD Dr Serge Brand, deals with the relationship between sleep, exercise and wellbeing, at the “healthy end” of the scale. They proved, for example, that sport in the morning also promotes better sleep in adolescents because it helps to reduce stress.

Dr Brand was the lead author of the remarkable study about the sleep of young people in love. It found that people who are in love suffer, albeit more or less pleasurably, from a state of “hypomania”, with a heightened level of drive as well as somewhat asocial and slightly unrealistic behavior, which is termed an “affective disorder”. It was shown that teenagers who are in love sleep an hour less in this state but that they sleep more deeply. “With such positive research questions we have no trouble finding enough participants,” says Professor Holsboer-Trachsler with a smile, “the media response reached as far as Australia.” That was not the intention, but it was not unwelcome either.

With a second group, Dr Johannes Beck, a psychiatrist, senior consultant, and attending physician at the in-patient department for depression with its sleep laboratory, investigates the relationships between stress, sleep, and “neuroplasticity”, which could be defined as the associated change in the organization and sensitivity of the brain. The main interest here is what could be interpreted as signs of a change for the better. Dr Beck’s group looks for recurring patterns in the sleep EEGs and biochemical markers of patients who suffer from insomnia. It can be seen that these likely change before external changes are observed in clinical terms. They could provide early indications as to how a therapy could be better adapted.

Stress disturbs sleep in cases of depression

“We assume that stress and sleep are closely related in cases of depression,” Professor Holsboer- Trachsler explains. “If we find a reliable indicator – and we have a few good candidates – then we can also provide more specific treatment and measure the success objectively.” It is also possible to treat such disorders by intervening directly via sleep: “The patients usually feel better if their sleep disorders can be influenced in a positive manner.”

Everything that promises a good treatment outcome deserves to be investigated. This can sometimes lead down a blind alley. Professor Holsboer- Trachsler vividly recalls previous spectacular outcomes often brought about by depriving severely depressed patients of sleep. If they were woken at 1.30 am and prevented from going back to sleep in the second half of the night, they usually promptly felt better by the break of day. “An incredible number of things happen in the brain with changes in the transmitters, the neural networks and neuroplasticity, as we now know,” the psychiatrist says, “but unfortunately the effect was gone after the next night’s sleep.” Sleep deprivation has therefore disappeared from the research arsenal for the time being. However, the firmly held conviction that the causes of depression can be tackled and treated via sleep still remains.

In order to be able to measure the impact of such procedures, perhaps long before anything changes in the external clinical picture, intensive research is being conducted at ZASS with chemical and electrophysiological biomarkers. This is the kind of topic pursued by the third research group, led by Dr Thorsten Mikoteit, a psychiatrist and head of the ZASS outpatient department. He can count on collaborations with the Max Planck Institute of Psychiatry in Munich for this.

“Deeper understanding”

One of the substances that can provide information about processes in the brain is the so-called BDN factor (brain-derived neurotrophic factor). This can deliver information about what exactly happens in the brain in the physical state known as burnout, but also in the case of sleep disorders. There is great hope that indicators of this kind can also be used for early prevention and treatment.

“Today, we have a far more multifaceted picture of what happens in the brain than we had previously, and some additional doors have also opened, providing gateways to a deeper understanding of the processes occurring in the brain,” says Professor Holsboer-Trachsler, “we have great respect for sleep.” She goes on to explain that, luckily, the research in her hospital plays a far greater role than it used to, which also pays off in the results: in more specific treatment strategies, in popular advice for everyday life – or sometimes in headlines that go round the world.

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