Sleep and emotions: A focus on insomnia

Department of Psychiatry & Psychotherapy, University of Freiburg Medical Center, Hauptstrasse 5, 79104 Freiburg, Germany.
Sleep Medicine Reviews (Impact Factor: 8.51). 02/2010; 14(4):227-38. DOI: 10.1016/j.smrv.2009.10.007
Source: PubMed

ABSTRACT Insomnia disorder is defined as difficulties in initiating/maintaining sleep and/or non-restorative sleep accompanied by decreased daytime functioning, persisting for at least four weeks. For many patients suffering from depression and anxiety, insomnia is a pervasive problem. Many of the aetiological theories of insomnia postulate that heightened emotional reactivity contributes to the maintenance of symptoms. This review focuses on the role of emotional reactivity in insomnia, and how the relationship between insomnia and depression and anxiety may be mediated by emotional reactivity. Furthermore, studies investigating the valence of emotions in insomnia are reviewed. Overall, there is empirical evidence that dysfunctional emotional reactivity might mediate the interaction between cognitive and autonomic hyperarousal, thus contributing to the maintenance of insomnia. Moreover, dysfunctions in sleep-wake regulating neural circuitries seem to be able to reinforce emotional disturbances. It seems plausible that dysfunctional emotional reactivity modulates the relationship between insomnia and depression and anxiety. Considering the interaction between sleep and emotional valence, poor sleep quality seems to correlate with high negative and low positive emotions, both in clinical and subclinical samples. Good sleep seems to be associated with high positive emotions, but not necessarily with low negative emotions. This review underlines the need for future research on emotions in insomnia.

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Available from: Dieter Riemann, Sep 29, 2015
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    • "The latter indicates an overall overreactivity to emotional stimuli following sleep deprivation, suggesting a general modulating effect of sleep on emotions. A review of insomnia and emotions found that insomnia is associated with various mood disorders (e.g., depression and anxiety) and heightened emotional reactivity (Baglioni et al., 2010). Additionally there is compelling evidence that the hormones cortisol and epinephrine contribute to the selective processing of emotional material during sleep (Cahill and Alkire, 2003; Payne and Nadel, 2004), with levels being particularly heightened during REM. "
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    ABSTRACT: In this paper we propose an emotion assimilation function of sleep and dreaming. We offer explanations both for the mechanisms by which waking-life memories are initially selected for processing during sleep, and for the mechanisms by which those memories are subsequently transformed during sleep. We propose that emotions act as a marker for information to be selectively processed during sleep, including consolidation into long term memory structures and integration into pre-existing memory networks; that dreaming reflects these emotion assimilation processes; and that the associations between memory fragments activated during sleep give rise to measureable elements of dream metaphor and hyperassociativity. The latter are a direct reflection, and the phenomenological experience, of emotional memory assimilation processes occurring during sleep. While many theories previously have posited a role for emotion processing and/or emotional memory consolidation during sleep and dreaming, sleep theories often do not take enough account of important dream science data, yet dream research, when conducted systematically and under ideal conditions, can greatly enhance theorizing around the functions of sleep. Similarly, dream theories often fail to consider the implications of sleep-dependent memory research, which can augment our understanding of dream functioning. Here, we offer a synthesized view, taking detailed account of both sleep and dream data and theories. We draw on extensive literature from sleep and dream experiments and theories, including often-overlooked data from dream science which we believe reflects sleep phenomenology, to bring together important ideas and findings from both domains.
    Frontiers in Psychology 08/2015; 6(1132). DOI:10.3389/fpsyg.2015.01132 · 2.80 Impact Factor
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    • "Sleep is strongly associated with affective processes in multiple ways, particularly in the encoding of emotional memories and the regulation of mood (Walker & van Der Helm, 2009). The prefrontal cortex brain region has been shown to play an important mechanistic role in the regulation of affective reactivity, and has weakened control over such emotional processes in the presence of sleep loss (Baglioni et al., 2010). Attenuated prefrontal cortex response may reflect inherent individual genetic differences moderating the relationship between depressed mood and sleep quality or mechanisms by which depressed mood can lead to impaired sleep quality. "
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    ABSTRACT: The psychological mechanisms by which depressed mood can lead to impaired sleep and poorer overall health remain unclear. The goal of this study was to investigate the extent to which a tendency to ruminate accounts for the associations between depressed mood and both sleep quality and self-reported health in 165 healthy young adults. Self-reported assessments of anxiety, depressed mood, rumination, sleep quality, and general health were collected at two different time points approximately 2 months apart. Structural equation modeling revealed that rumination measured at the earlier time point mediated the relationships between depressed mood and both sleep quality and health, all measured at the later time point, in a model that was a good fit to the data overall, χ(2) (50, N = 165) = 103.08, p < 0.001; RMSEA = 0.08 (0.06-0.10), TLI = 0.91, CFI = 0.94. Results were similar whether or not anxiety was controlled. Results indicate that rumination may be a psychological mechanism by which negative mood leads to impaired sleep and poorer perceived health.
    Journal of Behavioral Medicine 09/2014; 38(2). DOI:10.1007/s10865-014-9595-0 · 3.10 Impact Factor
    • "In our study, both groups were comparable on variables known to influence emotional response, including age, sleep duration on the night preceding the study, and the number of life events experienced during the last year and their associated psychological impact (Grühn and Scheibe, 2008; Franzen et al., 2009; Baglioni et al., 2010; Tempesta et al., 2010). However and as expected, BD patients had more psychiatric comorbidities, particularly anxiety disorders (Merikangas et al., 2007; El-Mallakh and Hollifield, 2008). "
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    ABSTRACT: The euthymic phase of bipolar disorders may be associated with residual emotional and/or subsyndromal symptoms. The aim of this study was to compare subjective and physiologic emotional response to negative, neutral and positive emotion eliciting pictures between euthymic bipolar patients (n=26) and healthy controls (n=30). We evaluated emotional response using an emotional induction method with emotional pictures from the International Affective Picture System. We measured subjective emotional response with the Self-Assessment Manikin and physiological emotional response by measuring pupil size. No difference was found between euthymic bipolar patients and controls regarding subjective emotional response. However, upon viewing positive pictures, pupil dilation was significantly lower in euthymic bipolar patients compared to controls. This finding suggests that euthymic bipolar phase may be associated with reduced physiologic emotional response to positive valence, which is consistent with a more general negative emotional bias or can be understood as a residual emotional subsyndromal symptom.
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