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Straus LD, ten Brink M, Sikka P, Srivastava R, Gross JJ, Colvonen PJ. The role of objective sleep in implicit and explicit affect regulation: A comprehensive review. Neurobiol Stress 2024; 31:100655. [PMID: 39036771 PMCID: PMC11260030 DOI: 10.1016/j.ynstr.2024.100655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/23/2024] Open
Abstract
Impairments in sleep and affect regulation are evident across a wide range of mental disorders. Understanding the sleep factors that relate to affect regulatory difficulties will inform mechanistic understanding and aid in treatment. Despite rising interest, some research challenges in this area include integrating across different clinical and non-clinical literatures investigating the role of sleep architecture (measured with polysomnography) and experimentally manipulated sleep, as well as integrating more explicit versus implicit affect regulation processes. In this comprehensive review, we use a unifying framework to examine sleep's relationship with implicit-automatic regulation and explicit-controlled regulation, both of which are relevant to mental health (e.g., PTSD and depression). Many studies of implicit-automatic regulation (e.g., fear extinction and safety learning) demonstrate the importance of sleep, and REM sleep specifically. Studies of explicit-controlled regulation (e.g., cognitive reappraisal and expressive suppression) are less consistent in their findings, with results differing depending on the type of affect regulation and/or way that sleep was measured or manipulated. There is a clear relationship between objective sleep and affect regulation processes. However, there is a need for 1) more studies focusing on sleep and explicit-controlled affect regulation; 2) replication with the same types of regulation strategies; 3) more studies experimentally manipulating sleep to examine its impact on affect regulation and vice versa in order to infer cause and effect; and 4) more studies looking at sleep's impact on next-day affect regulation (not just overnight change in affect reactivity).
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Affiliation(s)
- Laura D. Straus
- San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Maia ten Brink
- Department of Psychology, Stanford University, Stanford, CA, USA
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Pilleriin Sikka
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychology and Speech-Language Pathology, University of Turku, Finland
- Department of Cognitive Neuroscience and Philosophy, University of Skövde, Sweden
| | | | - James J. Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Peter J. Colvonen
- San Diego VA Health Care System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
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Yin X, Jiang T, Song Z, Zhu L, Wang G, Guo J. Increased functional connectivity within the salience network in patients with insomnia. Sleep Breath 2024; 28:1261-1271. [PMID: 38329566 DOI: 10.1007/s11325-024-03002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Insomnia is a common sleep disorder with significant negative impacts on emotional states; however, the underlying mechanism of insomnia with comorbid emotional dysregulation remains largely unknown. The salience network (SN) plays an important role in both sleep and emotional regulation. The study aimed to explore the specific alterations in functional connectivity (FC) within the SN in insomnia patients. METHODS A total of 30 eligible patients with insomnia disorder (ID group) and 30 healthy controls (HC group) underwent resting-state functional magnetic resonance imaging (fMRI) scanning and psychometric assessments. Differences in FC within the SN were examined using seed-based region-to-region connectivity analysis. RESULTS Compared with healthy controls, patients with insomnia showed increased FC within the SN, mainly between the anterior cingulate cortex (ACC) and right superior frontal gyrus (SFG), the right SFG and right supramarginal gyrus (SMG), and between the right insular (INS) and left SMG (P<0.05). Additionally, significant correlations were observed between increased FC and the Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), and Hamilton Anxiety Rating Scale (HAMA) scores (P<0.05, after Bonferroni correction). CONCLUSIONS These results suggest that increased FC within the SN may be related to poor sleep quality and negative emotions, highlighting the importance of the SN in the pathophysiological mechanisms of insomnia with comorbid emotional dysregulation.
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Affiliation(s)
- Xuejiao Yin
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Tongfei Jiang
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Zhangxiao Song
- Beijing University of Chinese Medicine, Beijing, 100105, China
| | - Liying Zhu
- Beijing University of Chinese Medicine, Beijing, 100105, China
| | - Guiling Wang
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Jing Guo
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
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Qiu SY, Yin XN, Yang Y, Li T, Lu D, Li JM, Yang WK, Wen GM, Zhang JY, Zhang Y, Lei HY, Wang X, Wu JB. Relationship between bedtime, nighttime sleep duration, and anxiety symptoms in preschoolers in China. Front Psychol 2024; 15:1290310. [PMID: 38298521 PMCID: PMC10827991 DOI: 10.3389/fpsyg.2024.1290310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/08/2024] [Indexed: 02/02/2024] Open
Abstract
Background Sleep problems in preschoolers are becoming increasingly prominent, and the association between sleep status and anxiety symptoms has attracted growing attention. However, studies investigating the relationship between bedtime and nighttime sleep duration in preschoolers and their anxiety symptoms remain scant. We used the large sample data from the Longhua Cohort Study of Children in Shenzhen, China (LCCS) to analyze the association between bedtime and sleep in preschoolers and their anxiety symptoms. Methods A cross-sectional study of 69,138 preschoolers in Longhua District, Shenzhen, China was conducted in 2022. Data on sociodemographic characteristics of families, bedtime, nighttime sleep duration of preschoolers, and their anxiety symptoms (measured by the Spence Preschool Children Anxiety Scale) were collected through a structured questionnaire completed by the parents. Using binary logistic regression models, the relationship between bedtime, nighttime sleep duration, and childhood anxiety symptoms was examined. Results The bedtimes of preschoolers were concentrated between 21:01-22:00 (52.41%). Among the preschoolers, 38.70% had bedtimes later than 22:00, and 75.49% had insufficient nighttime sleep duration. The positive screening rate for anxiety symptoms among preschoolers was 3.50%. After adjusting for confounding factors using binary logistic regression models, compared with preschoolers with bedtime ≤21:00, The OR (95%CI) values of anxiety in preschoolers with bedtime ≥23:01, 22:01-23:00 and 21:01-22:00 were 2.86 (2.21-3.69), 1.51 (1.27-1.79) and 1.48 (1.26-1.76), respectively. Compared with those with sufficient nighttime sleep duration, the OR (95%CI) of children with nighttime sleep duration less than 9 h was 1.36 (1.23-1.51). Conclusion An association exists between bedtime and nighttime sleep duration in preschoolers and their anxiety symptoms. Preschoolers with 21:00 for bedtime and a nighttime sleep duration of 10 h may have lower anxiety symptoms. These findings support the importance of adequate sleep for preventing anxiety symptoms in children.
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Affiliation(s)
- Shuang-Yan Qiu
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Xiao-Na Yin
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yanni Yang
- Xinhe Experimental School, Shenzhen, China
| | - Ting Li
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Dali Lu
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Jie-Min Li
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Wei-Kang Yang
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Guo-Ming Wen
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Jing-Yu Zhang
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yan Zhang
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Hai-Yan Lei
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Xin Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jian-Bo Wu
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
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Abstract
Sleep plays a crucial role in the consolidation of memories, including those for fear acquisition and extinction training. This chapter reviews findings from studies testing this relationship in laboratory, naturalistic, and clinical settings. While evidence is mixed, several studies in humans have linked fear and extinction recall/retention to both rapid eye-movement and slow wave sleep. Sleep appears to further aid in the processing of both simulated and actual trauma and improves psychotherapeutic treatment outcomes in those with anxiety and trauma- and stressor-related disorders. This chapter concludes with a discussion of the current challenges facing sleep and emotional memory research in addition to suggestions for improving future research.
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Affiliation(s)
- Ryan Bottary
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Laura D Straus
- Department of Research, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Edward F Pace-Schott
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA.
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Yang T, Guo Z, Cao X, Zhu X, Zhou Q, Li X, Wang H, Wang X, Wu L, Wu S, Liu X. Network analysis of anxiety and depression in the functionally impaired elderly. Front Public Health 2022; 10:1067646. [PMID: 36530716 PMCID: PMC9751796 DOI: 10.3389/fpubh.2022.1067646] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Background Evidence from previous studies has confirmed that functionally impaired elderly individuals are susceptible to comorbid anxiety and depression. Network theory holds that the comorbidity emerges from interactions between anxiety and depression symptoms. This study aimed to investigate the fine-grained relationships among anxiety and depression symptoms in the functionally impaired elderly and identify central and bridge symptoms to provide potential targets for intervention of these two comorbid disorders. Methods A total of 325 functionally impaired elderly individuals from five communities in Xi'an, China, were recruited for our investigation. The GAD-7 and PHQ-9 were used to measure anxiety and depression, respectively. SPSS 22.0 software was used for descriptive statistics, and R 4.1.1 software was used for network model construction, expected influence (EI) evaluation and bridge expected influence (BEI) evaluation. Results In the network, there were 35 edges (indicating partial correlations between symptoms) across the communities of anxiety and depression, among which the strongest edge was A1 "Nervousness or anxiety"-D2 "Depressed or sad mood." A2 "Uncontrollable worry" and D2 "Depressed or sad mood" had the highest EI values in the network, while A6 "Irritable" and D7 "Concentration difficulties" had the highest BEI values of their respective community. In the flow network, the strongest direct edge of D9 "Thoughts of death" was with D6 "Feeling of worthlessness." Conclusion Complex fine-grained relationships exist between anxiety and depression in functionally impaired elderly individuals. "Uncontrollable worry," "depressed or sad mood," "irritable" and "concentration difficulties" are identified as the potential targets for intervention of anxiety and depression. Our study emphasizes the necessity of suicide prevention for functionally impaired elderly individuals, and the symptom "feeling of worthlessness" can be used as an effective target.
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Affiliation(s)
- Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiaoqin Cao
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Qin Zhou
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xinhong Li
- Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Hui Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,Shengjun Wu
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,*Correspondence: Xufeng Liu
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