Sleeping worries away or worrying away sleep? Physiological evidence on sleep-emotion interactions.

Recent findings suggest that sleep might serve a role in emotional coping. However, most findings are based on subjective reports of sleep quality, while the relation with underlying sleep physiology is still largely unknown. In this study, the impact of an emotionally distressing experience on the EEG correlates of sleep was assessed. In addition, the association between sleep physiological parameters and the extent of emotional attenuation over sleep was determined. The experimental set up involved presentation of an emotionally neutral or distressing film fragment in the evening, followed by polysomnographic registration of undisturbed, whole-night sleep and assessment of emotional reactivity to film cues on the next evening. We found that emotional distress induced mild sleep deterioration, but also an increase in the proportion of slow wave sleep (SWS) and altered patterning of rapid eye movement (REM) sleep. Indeed, while REM sleep occurrence normally increases over the course of the night, emotional distress flattened this distribution and correlated with an increased number of REM periods. While sleep deterioration was negatively associated to emotional attenuation over sleep, the SWS response was positively related to such attenuation and may form part of a compensatory response to the stressor. Interestingly, trait-like SWS characteristics also correlated positively with the extent of emotion attenuation over sleep. The combined results provide strong evidence for an intimate reciprocal relation between sleep physiology and emotional processing. Moreover, individual differences in subjects' emotional and sleep responses suggest there may be a coupling of certain emotion and sleep traits into distinct emotional sleep types

Neuropsychological functioning after CPAP treatment in obstructive sleep apnea: a meta-analysis

The generally held clinical view is that treatment with continuous positive airway pressure (CPAP) improves cognition in patients with obstructive sleep apnea (OSA). However, the cognitive domains in which recovery is found differ between studies. A meta-analysis was conducted to quantify the effect of CPAP treatment in OSA on neuropsychological functioning. A literature search of studies published from January 1990 to July 2012 was performed. The inclusion criteria were: randomized controlled trial, diagnosis of OSA by poly(somno)graphy, apnea/hypopnea index, duration and compliance of CPAP treatment reported, use of one or more standardized neuropsychological tests. Mean weighted effect sizes of CPAP treatment for seven cognitive domains were calculated, including processing speed, attention, vigilance, working memory, memory, verbal fluency and visuoconstruction. Thirteen studies encompassing 554 OSA patients were included. A small, significant effect on attention was observed in favor of CPAP (d = 0.19). For the other cognitive domains the effect sizes did not reach significance. Improvement on measures of sleepiness was modest (d = 0.30-0.53) and comparable to prior research. In conclusion, this meta-analysis indicates that the effect of CPAP on cognition is small and limited to attention. Contrary to the general assumption, only slight improvement of neuropsychological functioning after CPAP treatment can be expecte

Global mood and POMS scores, pre-and post-viewing the film and stills, in the emotional and neutral conditions.

<p>Global mood and POMS scores, pre-and post-viewing the film and stills, in the emotional and neutral conditions.</p

REM sleep percentages in the first and second night half in the complete sample.

<p>The natural increase in REM sleep percentage (means and SEM) from first to second half of the night was reduced after the emotional film (black line) as compared to the neutral film (grey line).</p

Sleep architectural parameters in the emotional and neutral condition for the entire night.

<p>All: all subjects; LSQR: low sleep quality responders; HSQR: high sleep quality responders;</p><p>SWS: Slow Wave Sleep; TST: Total Sleep Time; WASO: wake after sleep onset.</p

Correlations between stressor-induced emotional responses and sleep architectural alterations in the ensuing night.

<p>All: all subjects; LSQR: low sleep quality responders; HSQR: high sleep quality responders.</p>*<p>Indicates the correlation is statistically significant after correction for multiple comparisons.</p

REM sleep percentages in first and second night half in LSQR in the two conditions.

<p>The LSQR group showed a reduced REM sleep percentage (means and SEM) in the second night half of the emotional night (black line) compared to the corresponding night half of the neutral night (grey line).</p

Correlations between depression scores and SWS% in the two night halves of the emotional night.

<p>HSQR (high sleep quality responders; upper panels) showed a very high correlation between induced depression in the emotional condition and SWS% increase in the second half of the ensuing night. In LSQR (low sleep quality responders; lower panels) no such correlation was observed.</p

Frequency distribution of sleep quality scores in the neutral (A) and emotional (B) condition.

<p>The bimodal form of the distribution in panel B suggests the existence of a group with low sleep quality and a group with high sleep quality after the emotional film.</p

Sleep architectural parameters in the emotional and neutral condition for the first and second night half.

<p>All: all subjects; LSQR: low sleep quality responders; HSQR: high sleep quality responders.</p