Chronic insomnia, REM sleep instability and emotional dysregulation: A pathway to anxiety and depression?
Dieter Riemann, Raphael J Dressle, Fee Benz, Kai Spiegelhalder, Anna F Johann, Christoph Nissen, Elisabeth Hertenstein, Chiara Baglioni, Laura Palagini, Lukas Krone, Michael L Perlis, Katharina Domschke, Mathias Berger, Bernd Feige
Journal of Sleep Research May 29, 2024 DOI: 10.1111/jsr.14252 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Anxiety Depression Dreaming |
| Keywords | Humans Polysomnography Sleep, rem Anxiety disorders Female Insomnia Consciousness Micro‐arousals |
| Key points | Proposes that instability of rapid eye movement sleep may account for the mismatch between minor objective polysomnographic changes and substantial subjective sleep impairment in insomnia disorder, and may play a central role in the association between insomnia and depressive and anxiety disorders. |
Abstract
The world-wide prevalence of insomnia disorder reaches up to 10% of the adult population. Women are more often afflicted than men, and insomnia disorder is a risk factor for somatic and mental illness, especially depression and anxiety disorders. Persistent hyperarousals at the cognitive, emotional, cortical and/or physiological levels are central to most theories regarding the pathophysiology of insomnia. Of the defining features of insomnia disorder, the discrepancy between minor objective polysomnographic alterations of sleep continuity and substantive subjective impairment in insomnia disorder remains enigmatic. Microstructural alterations, especially in rapid eye movement sleep ("rapid eye movement sleep instability"), might explain this mismatch between subjective and objective findings. As rapid eye movement sleep represents the most highly aroused brain state during sleep, it might be particularly prone to fragmentation in individuals with persistent hyperarousal. In consequence, mentation during rapid eye movement sleep may be toned more as conscious-like wake experience, reflecting pre-sleep concerns. It is suggested that this instability of rapid eye movement sleep is involved in the mismatch between subjective and objective measures of sleep in insomnia disorder. Furthermore, as rapid eye movement sleep has been linked in previous works to emotional processing, rapid eye movement sleep instability could play a central role in the close association between insomnia and depressive and anxiety disorders.
Comparable studies
Other theoretical and historical papers on anxiety, most cited first.
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|---|---|---|---|
| Psychedelics as Medicines: An Emerging New Paradigm General population | 2016 | Theoretical or philosophical paper | |
| Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance | 2020 | Theoretical or philosophical paper | |
| Taking Psychedelics Seriously | 2018 | Theoretical or philosophical paper | |
| How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale | 2009 | Theoretical or philosophical paper | |
| Embedding existential psychology within psychedelic science: reduced death anxiety as a mediator of the therapeutic effects of psychedelics | 2019 | Theoretical or philosophical paper |
Citations in the library
Cited by 3
- Unveiling the subconscious: How sexual dreams reflect and intensify mental problems Sleep Research December 17, 2024
- Dispositional Mindfulness and Its Impact on the Relationship Between Anxiety, Quality of Life, and Insomnia in Older Adults Research Square September 10, 2026
- Systematic review: REM sleep, dysphoric dreams and nightmares as transdiagnostic features of psychiatric disorders with emotion dysregulation - Clinical implications. Sleep Medicine December 1, 2024
Cites 8
- Assessing sleep consciousness within subjects using a serial awakening paradigm Frontiers in Psychology 2013
- Insomnia—perchance a dream? Results from a NREM/REM sleep awakening study in good sleepers and patients with insomnia Sleep February 8, 2018
- Conscious experiences and high-density EEG patterns predicting subjective sleep depth. Current Biology December 20, 2021
- The effects of suppressing intrusive thoughts on dream content, dream distress and psychological parameters Journal of Sleep Research May 16, 2013
- High thought suppressors dream more of their negative waking-life experiences than low thought suppressors. Dreaming November 9, 2017
and 3 more in the library