期刊
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
卷 113, 期 9, 页码 2538-2543出版社
NATL ACAD SCIENCES
DOI: 10.1073/pnas.1522520113
关键词
insomnia; REM sleep; hyperarousal; self-conscious emotion; shame
资金
- ZONMW Neuropsychoanalysis Fund part of the Netherlands Organization of Scientific Research (NWO) [16.561.0001]
- VICI Grant part of the Netherlands Organization of Scientific Research (NWO) [453.07.001]
- VIDI Grant part of the Netherlands Organization of Scientific Research (NWO) [452.12.014]
- Aspasia Grant part of the Netherlands Organization of Scientific Research (NWO) [015.009.016]
- Bial Foundation [253/2012]
- European Research Council [ERC-ADG-2014-671084]
The mechanisms underlying hyperarousal, the key symptom of insomnia, have remained elusive, hampering cause-targeted treatment. Recently, restless rapid-eye-movement (REM) sleep emerged as a robust signature of sleep in insomnia. Given the role of REM sleep in emotion regulation, we hypothesized that restless REM sleep could interfere with the overnight resolution of emotional distress, thus contributing to accumulation of arousal. Participants (n = 1,199) completed questionnaires on insomnia severity, hyperarousal, self-conscious emotional distress, and thought-like nocturnal mentation that was validated to be a specific proxy for restless REM sleep (selective fragmentation: R = 0.57, P < 0.001; eye movement density: R = 0.46, P < 0.01) in 32 polysomnographically assessed participants. The experience of distress lasting overnight increased with insomnia severity (beta = 0.29, P < 10(-23)), whereas shortlasting distress did not (beta = -0.02, P = 0.41). Insomnia severity was associated with hyperarousal (beta = 0.47, P < 10(-63)) and with the thought-like nocturnal mentation that is specifically associated with restless REM sleep (beta = 0.31, P < 10(-26)). Structural equation modeling showed that 62.4% of the association between these key characteristics of insomnia was mediated specifically by reduced overnight resolution of emotional distress. The model outperformed all alternative mediation pathways. The findings suggest that restless REM sleep reflects a process that interferes with the overnight resolution of distress. Its accumulation may promote the development of chronic hyperarousal, giving clinical relevance to the role of REM sleep in emotion regulation in insomnia, depression, and posttraumatic stress disorder.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据