Insomnia and emotion regulation. Recent findings and suggestions for treatment

Recent findings suggest that insomnia and emotion regulation are closely connected. Insomnia is widely associated with medical and psychiatric conditions as well as with impaired quality of life and emotional functioning. Additionally empirical evidence suggests that emotional dysregulation plays a crucial role in the onset and maintenance of psychopathological disorders. Although these seem to interact, very few studies investigated the relationship between disturbed sleep and problems in emotion regulation. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been demonstrated to be effective in comorbid insomnia. However, emotion regulation skills are not included in this intervention. After reviewing the recent findings of the literature, we aim to discuss future directions for the inclusion of emotion regulation training in the treatment of insomnia disorde

Executive functions in insomnia disorder: a systematic review and exploratory meta-analysis

Background: Executive functions (EFs) are involved in the control of basic psychological processes such as attention and memory and also contribute to emotion regulation. Research on the presence of EFs impairments in insomnia yielded inconsistent results. Therefore, we performed a systematic review of the literature on three EFs: inhibitory control, working memory, and cognitive flexibility in adults with insomnia in order to investigate the presence and magnitude of insomnia-related EFs impairments. Methods: PubMed, Scopus, Medline, and PsycINFO were searched. Risk of bias assessment of included studies was performed by two independent researchers. Findings were summarised using both a narrative approach and meta-analysis. Cohen’s d was calculated at 95% confidence interval (CI) as effect size of between groups differences. Results: Twenty-eight studies comparing adult individuals with a diagnosis of insomnia and healthy controls on neuropsychological measures of EFs were included. Narrative synthesis revealed substantial variability across study findings. Factors that were primarily hypothesised to account for this variability are: objective sleep impairments and test sensitivity. Exploratory meta-analysis showed impaired performance of small to moderate magnitude in individuals with insomnia as compared to controls in reaction times, but not accuracy rates, of inhibitory control (d = −0.32, 95% CI: −0.52 to −0.13) and cognitive flexibility tasks (d = −0.30, 95% CI: −0.59 to −0.01). Performance in working memory tasks was also significantly impacted (d = −0.19, 95% CI: −0.38 to −0.00). Effects sizes were larger when insomnia was associated with objective sleep impairments, rather than normal sleep. Conclusions: We gathered evidence supporting small to moderate deficits in EFs in individuals with insomnia. Due to the small sample size results should be considered preliminary and interpreted carefully

Depression and mania symptoms mediate the relationship between insomnia and psychotic-like experiences in the general population

Psychotic-like experiences (PLEs) are subclinical forms of psychosis commonly experienced in the general population. The nature of PLEs has yet to be clearly defined, yet mood and sleep disturbances may be two predictors. Sleep disturbance increases paranoia and hallucinations in experimental studies, and insomnia is considered a longitudinal precursor of psychosis. Mood disturbances including depression and mania, which can be induced by insomnia, can also result in psychotic symptoms. However, whether insomnia may predict PLEs via the mediation of mood disturbance has yet to be fully clarified. To advance this field, the aim of this study was to investigate the mediation role of depression and mania symptoms on the relationship between insomnia and PLEs. 1.086 community members (28.32±9.04 years, 58.1% females) cross-sectionally completed self-reported measures of insomnia severity, depression/mania symptoms, and PLEs. Bivariate correlations, hierarchical multiple regressions and mediation analyses with bootstrap approach were performed. Insomnia and mood disturbances (depression/mania) were significantly associated with PLEs (β = 0.06, p < .05; β = 0.225, p < .001, respectively). Mediation analysis revealed a significant indirect effect between insomnia and PLEs mediated by mood disturbance through bootstrap approach (β=0.13, se= 0.02, 95% CI: 0.10 - 0.17). Our results support the view of insomnia and mood disturbances as predictors of PLEs in the general population and foster the replication of these findings using longitudinal designs

The effects of one night of partial sleep deprivation on executive functions in individuals reporting chronic insomnia and good sleepers

Background and objectives The aim of the present study was to investigate the effects of a partial sleep deprivation night on executive functions in participants reporting chronic insomnia and good sleepers using a Task Switching paradigm. Methods Sixteen participants reporting symptoms of chronic insomnia and sixteen good sleepers were tested after a night of habitual sleep and after a night of partial sleep deprivation (5\u202fh of sleep allowed). The Switch Cost (SC) and the Backward Inhibition (BI) were computed as measures of switching attention and response inhibition, respectively. Results We observed a marginally significant interaction Night\u202f 7\u202fGroup on SC (F(1,29)\u202f=\u202f4.06, p\u202f=\u202f0.053, \u3b72\u202f=\u202f0.123. Fisher's least significant difference (LSD) post-hoc revealed a smaller SC after the sleep deprived night relative to the habitual night for the good sleepers (p\u202f=\u202f0.027;M\u202f=\u202f192.23\u202f\ub1\u202f201.81 vs M\u202f=\u202f98.99\u202f\ub1\u202f141.16). Differently, participants with insomnia did not show any change after the two nights. Limitations Several limitations must be acknowledged including the use of a convenient sample of university students and the use of a single task of cognitive performance. Conclusions We found that SC was smaller in the good sleepers after a night of partial sleep deprivation compared to a habitual night, indicating a better switching performance. The insomnia group showed no differences in performance after the two experimental nights. Several factors may account for these results, including increased levels of arousal and cognitive effort during task execution

BRIO: a web server for RNA sequence and structure motif scan

The interaction between RNA and RNA-binding proteins (RBPs) has a key role in the regulation of gene expression, in RNA stability, and in many other biological processes. RBPs accomplish these functions by binding target RNA molecules through specific sequence and structure motifs. The identification of these binding motifs is therefore fundamental to improve our knowledge of the cellular processes and how they are regulated. Here, we present BRIO (BEAM RNA Interaction mOtifs), a new web server designed for the identification of sequence and structure RNA-binding motifs in one or more RNA molecules of interest. BRIO enables the user to scan over 2508 sequence motifs and 2296 secondary structure motifs identified in Homo sapiens and Mus musculus, in three different types of experiments (PAR-CLIP, eCLIP, HITS). The motifs are associated with the binding of 186 RBPs and 69 protein domains. The web server is freely available at http://brio.bio.uniroma2.it

Executive functions impairments in insomnia: A systematic review and meta-analysis.

Introduction: Executive functions (EFs) are a family of top-down processes involved in the control of affect and cognition. Influential models assume the presence of three core EFs: inhibitory control, working memory and cognitive flexibility. Research on these three functions in patients with insomnia has yielded mixed results. Therefore, we performed a systematic review of the literature on the three EFs of inhibitory control, working memory and cognitive flexibility in adults with a diagnosis of insomnia in order to clarify the presence and magnitude of EFs impairments in this population. Materials and methods: PubMed, Scopus, Medline and PsycINFO were searched from inception to 2015. Inclusion criteria were: presence of a group of adult individuals with clinical insomnia, presence of a control group, presence of at least one neuropsychological test assessing inhibitory control and/or working memory and/or cognitive flexibility. Included studies underwent quality assessment. Findings were summarized using combined narrative synthesis and meta-analysis. Cohen's d were calculated at 95% confidence interval as effect sizes of between groups differences. Heterogeneity of effects distribution as well as publication bias were evaluated. Results: Twenty-four studies met the eligibility criteria and were included. Results showed impaired performance of individuals with insomnia as compared to controls on tasks of inhibitory control with an effect of small to medium magnitude (d= .31, 95% CI: .50 – .11) and homogeneous distribution (Q= 3.356, df= 8, p= 0.910; I2= 0.000). Visual examination of the funnel plot suggested reasonable symmetry indicating low chance of publication bias. We were limited in performing meta-analyses on working memory and cognitive flexibility due to the small number of studies and high variability of outcome measures. Conclusions: Using meta-analysis, we showed that individuals with insomnia perform poorer than good sleepers on tasks of inhibitory control. Due to the high variability of outcome measures and small number of studies, we were not able to statistically estimate the magnitude of impairments with respect to working memory and cognitive flexibility tasks. To overcome these limitations and advance knowledge of EFs in insomnia, future studies are warranted adopting comparable outcome measures

Inflammatory hypotheses of sleep disturbance - depression link: Update and research agenda

Studies in human and experimental animal models support a role of inflammation in the aetiology of depression, yet the precise role played by sleep disturbance (i.e., difficulties falling or maintaining sleep) is poorly understood. Consistent evidence from prospective epidemiological studies suggests sleep disturbance as a predictor of major depression episodes and depression recurrence. In parallel, up to 20% of individuals with sleep disturbance have low-grade peripheral inflammation (i.e., CRP>3 mg/l), and preliminary longitudinal evidence showed that sleep disturbance may even predict the levels of inflammation. Therefore, it is possible that sleep disturbance may increase inflammation, which in turn may contribute (i.e., mediate) to the onset - or worsening - of depression. Alternatively, sleep disturbance may serve as a vulnerability factor and increase the risk of developing depressive symptoms when facing an immune challenge. The aim of this review was to summarise the state of the science on the role of sleep disturbance in contributing to depression-related inflammation. A research agenda is also proposed to advance the study of sleep disturbance in the psychoneuroimmunology of depression

The assessment of sleep in mental disorders

One aim of clinical and health psychology is to assess the psychological and physiological correlates of mental disorders. Sleep disturbances are highly prevalent among individuals with mental disorders. The assessment of subjective and objective sleep variables is therefore utmost important in clinical settings, and the inclusion of sleep disorders measures in patients’ clinical records is encouraged. Several tools have been developed and validated in empirical research to reach this aim. This contribute will provide a description of the state-of-the-art on sleep variables measurement in individuals with clinical conditions. The gold standard tool to assess objective sleep parameters is polysomnography, that is a composite measure including electroencephalogram, electromyogram, and electrooculogram, and is able to detect different sleep stages. Actigraphy provides a valid, reliable and ecological assessment of physiologically measured sleep and wake duration. Clinical interviews and sleep diaries are recommended in clinical guidelines for the diagnostic assessment of sleep disorders. Self-reported questionnaires are frequently adopted to screen for the presence of sleep disturbances such as chronic insomnia and circadian rhythm disorders. Following the most influential behavioural and cognitive models of the pathophysiology of insomnia, we will introduce self-report measures assessing classical perpetuating factors of sleep disturbances such as dysfunctional beliefs and attitudes about sleep, sleep-related worry and rumination, pre-sleep cognitive intrusions, pre-sleep cognitive and somatic arousal, meta-cognitive beliefs about sleep, and adherence to sleep hygiene practices