Psychophysiological reactivity to sleep-related emotional stimuli in primary insomnia

ArticleinBehaviour Research and Therapy 48(6):467-75 · February 2010with50 Reads
DOI: 10.1016/j.brat.2010.01.008 · Source: PubMed
The present study examined psychophysiological reactivity to emotional stimuli related and non-related to sleep in people with primary insomnia (PPI) and in good sleepers (GS). Twenty-one PPI and 18 GS were presented with five blocks of neutral, negative, positive, sleep-related negative and sleep-related positive pictures. During the presentation of the pictures, facial electromyography (EMG) of the corrugator and the zygomatic muscles, heart rate (HR) and cardiac vagal tone (CVT) were recorded. Subjective ratings of the stimuli were also collected. We found that only PPI exhibited greater inhibition of the corrugator activity in response to sleep-related positive stimuli compared to the other blocks of stimuli. Furthermore, PPI rated the sleep-related negative stimuli as more unpleasant and arousing and showed higher CVT in response to all stimuli as compared to GS. Results were interpreted as indicating that PPI exhibit craving for sleep-related positive stimuli, and also hyper-arousability in response to sleep-related negative stimuli, as compared to GS. Our results suggest that psychological treatment of insomnia could benefit by the inclusion of strategies dealing with emotional processes linked with sleep processes.
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    • In one of the few studies measuring direct emotional responses, Baglioni et al. showed sleeppositive stimuli (e.g., pictures of sleeping people) to insomnia patients and well sleeping controls and found inhibition of corrugator muscle activity specifically in insomnia patients, interpreted as a craving response. Sleep-negatively stimuli (e.g., pictures of people lying awake in bed) were rated subjectively as more arousing than sleep-positive stimuli by insomniacs as compared with controls (Baglioni et al., 2010). Insomnia is generally found to be associated with overall more negative feelings as compared with normal sleeping controls (Scott & Judge, 2006 ), particularly increasing in the evening (Buysse et al., 2007).
    [Show abstract] [Hide abstract] ABSTRACT: Sleep disturbances are highly prevalent and greatly affect consecutive emotional reactivity, while sleep quality itself can be strongly affected by reactions to previous emotional events. In this review, we shed light on this bidirectional relation through examples of pathology: insomnia and bipolar disorder. We show that both experimental sleep deprivation and insomnia are related to increased emotional reactivity and increased amygdala activation upon emotional stimuli presentation, and that particularly Rapid Eye Movement (REM) sleep is important for emotional processing and reorganization of emotion-specific brain activity. Increased emotional reactivity affects REM sleep quality and sleep spindles, while REM sleep is particularly affected in insomnia, possibly related to condition-specific hyperarousal levels. Normal sleep onset deactivation of brain regions important for emotional processing (amygdala, anterior cingulate cortex (ACC)) is further affected in insomnia. In bipolar disorder, sleep disturbances are common in both symptomatic and nonsymptomatic phases. Both amygdala and ACC volume and function are affected in bipolar disorder, with the ACC showing phase-dependent resting state activity differences. Deficient Gamma-aminobutyric acid (GABA) GABA-ergic activity of this region might play a role in sleep disturbances and their influence on emotional reactivity, given the inhibitory role of GABA on brain activity during sleep and its deficiency in both bipolar disorder and insomnia. Promising findings of normalizing brain activity in both insomnia and bipolar disorder upon treatment may inspire a focus on treatment studies investigating the normalization of sleep, emotional reactivity, and their corresponding brain activity patterns. (PsycINFO Database Record
    Full-text · Article · Feb 2016
    • Although this needs to be tested empirically, it is possible that interventions aimed at decreasing emotion dysregulation (Barlow et al., 2011; Harvey, Sharpley, Ree, Stinson, & Clark, 2007; Ong, Shapiro, & Manber, 2008) might improve current treatments for insomnia, such as cognitive behavioural therapy (Morin, 2006). It is also possible that, as hypothesized by Baglioni, Lombardo, et al. (2010), Baglioni, Spiegelhalder, et al. (2010), elevated negative emotionality or emotion regulation difficulties might modulate the link between insomnia and psychiatric conditions, and, if so, additional interventions targeting emotional processes could enhance treatment outcomes. A number of methodological limitations should be underscored.
    [Show abstract] [Hide abstract] ABSTRACT: Objectives The purpose of this longitudinal investigation was to examine the association between emotion regulation and future insomnia (incidence and persistence). DesignA longitudinal study in the general population. MethodsA survey was sent out to 5,000 individuals in the community. To those who returned the baseline questionnaire (n=2,333), two follow-up surveys, 6 and 18months later, were sent out and then completed by 1,887 and 1,795 individuals, respectively. The survey contained information about demographic factors, insomnia symptomatology, the Difficulties in Emotion Regulation Scale, anxiety, and depression. ResultsThe findings suggested that emotion regulation at baseline was not associated with the incidence or persistence of insomnia. Overall, the effect sizes were very small to medium. When examining changes in emotion regulation over time, a different pattern emerged. Partial support was established for the notion that decreases in emotion regulation were related to incident and persistent insomnia, as a decrease in emotion regulation was associated with a higher likelihood of future insomnia. Yet, the effect sizes were very small to small. Conclusion This study does partly point towards a longitudinal association between emotion dysregulation and insomnia. This might have implications for the conceptualization and management of insomnia as well as for future research.
    Full-text · Article · Feb 2016
    • Separating these processes out appears particularly relevant for insomnia disorder, due to its links with emotion regulation [73]. With regard to insomnia, there is evidence of impaired emotional regulation [93], and increased emotional responsiveness [92], when multiple physiological measures are assessed. With socially-relevant stimuli, however, insomnia subjects make lower ratings of intensity in faces [94], with comparable results with emotional images [93].
    [Show abstract] [Hide abstract] ABSTRACT: Sleep and emotion are closely linked, however the effects of sleep on socio-emotional task performance have only recently been investigated. Sleep loss and insomnia have been found to affect emotional reactivity and social functioning, although results, taken together, are somewhat contradictory. Here we review this advancing literature, aiming to 1) systematically review the relevant literature on sleep and socio-emotional functioning, with reference to the extant literature on emotion and social interactions, 2) summarize results and outline ways in which emotion, social interactions, and sleep may interact, and 3) suggest key limitations and future directions for this field. From the reviewed literature, sleep deprivation is associated with diminished emotional expressivity and impaired emotion recognition, and this has particular relevance for social interactions. Sleep deprivation also increases emotional reactivity; results which are most apparent with neuro-imaging studies investigating amygdala activity and its prefrontal regulation. Evidence of emotional dysregulation in insomnia and poor sleep has also been reported. In general, limitations of this literature include how performance measures are linked to self-reports, and how results are linked to socio-emotional functioning. We conclude by suggesting some possible future directions for this field. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
    Full-text · Article · Dec 2014
    • The importance of 'thinking patterns', the CAM-I phrasing for cognitive arousal, is consistent with our prediction and previous research (e.g., Lichstein and Rosenthal 1980 ). The importance of emotions (both sleep-related and other emotions) underscores growing recognition of the importance of the emotional level of explanation across disorders (Kring 2009; Kring and Werner 2004 ), and in insomnia specifically (Baglioni et al. 2010; Harvey et al. 2009). We also sought to establish the relationship between the folk theories held by patients with insomnia about the causes of theirTable 4 Folk theories of the treatment for insomnia Contributing factor Qu5: How likely do you think it is that a psychological treatment targeting these factors could help alleviate your insomnia?
    [Show abstract] [Hide abstract] ABSTRACT: The present study investigates 'folk theories' about the causes of insomnia. Participants with insomnia (n = 69) completed a qualitative and quantitative assessment of their folk theories. The qualitative assessment was to speak aloud for 1 minute in response to: 'What do you think causes your insomnia?'. The quantitative assessment involved completing the 'Causal Attributions of My Insomnia Questionnaire' (CAM-I), developed for this study. The three most common folk theories for both the causes of one's own insomnia as well as insomnia in others were 'emotions', 'thinking patterns' and 'sleep-related emotions'. Interventions targeting these factors were also perceived as most likely to be viable treatments. Seventy-five percent of the folk theories of insomnia investigated with the CAM-I were rated as more likely to be alleviated by a psychological versus a biological treatment. The results are consistent with research highlighting that folk theories are generally coherent and inform a range of judgments. Future research should focus on congruence of 'folk theories' between treatment providers and patients, as well as the role of folk theories in treatment choice, engagement, compliance and outcome.
    Full-text · Article · Oct 2013
    • Nevertheless, a sad conclusion to be drawn from the above is that symptoms of insomnia may impede people from remembering the positive aspects of their lives. Although there is an intuitive relationship between emotion and sleep (Baglioni et al., 2010), most studies have used variable-oriented approaches (Bergman & Trost, 2006) when relating measures of affect to sleep measures. For example, the health-related correlates of affect have been studied using the positive and negative affect
    [Show abstract] [Hide abstract] ABSTRACT: Patterns of affect, sleep, and autobiographical memories seem related but there are no studies we know of to verify the notion. The purpose of this research is to investigate interrelationships’ between profiles of affect, sleep, and autobiographical memories. A cross-sectional design is employed. Three hundred and thirteen adult students participated. The data generated are viewed from two complementary perspectives. Our cluster analyses identified a group of individual states whose lives appear to be arousing and stressful (high positive and negative affect) yet they slept significantly better than self-destructive states (high on negative affect and low on positive affect). Our regressions imply that negative autobiographical memories are involved in a relationship with sleep independently of fairly stable patterns of affect, biological sex, and age. We finish by noting that apart from investigating these relationships longitudinally, cultural differences in patterns of affect and their health correlates should be explored.
    Full-text · Article · Jul 2013
    • positive stimuli related to sleep) in participants with primary insomnia and in good sleepers (Baglioni et al. 2010). Those with insomnia showed increased inhibition of the corrugator activity (muscle placed at the medial end of the eyebrow) when presented with sleep-related positive stimuli (i.e., displaying people sleeping in bed at nighttime ), relative to other stimuli.
    [Show abstract] [Hide abstract] ABSTRACT: The purpose of this study was to examine whether individuals with primary insomnia (PI) have an attentional bias towards insomnia-specific stimuli, relative to normal sleepers (NS). Also, the aim was to determine if the attentional bias was characterized by vigilance or disengagement. A between-groups, matched design was employed. Forty-two individuals completed the study (PI = 21; NS = 21). Participants completed a dot-probe task with stimuli comprising insomnia-specific (fatigue/malaise) and neutral pictures. It was hypothesized that individuals with PI would show greater attentional bias to insomnia-specific stimuli compared with NS. An overall bias effect was noted. This effect was however not due to vigilance; taking into account the reaction times on neutral trials, the PI group and the NS group did not display significantly different results in reaction times to insomnia-specific pictures. On the contrary, the results suggest that the overall bias effect was due to disengagement; the PI group had significantly longer reaction times than the NS group when shifting away from the insomnia-specific pictures, relative to neutral–neutral picture presentations. The findings suggest that individuals with insomnia are not more vigilant than normal sleepers to insomnia-specific stimuli, but instead have greater difficulties in shifting away from such stimuli.
    Full-text · Article · Jun 2013
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