Altered Emotion Perception in Insomnia Disorder

Abstract

For the first time we show that chronic insomnia is associated with reduced ratings of emotion intensity for face expressions displaying sadness and fear. Further work is required to elucidate possible mechanisms and pathways underlying insomnia-related emotional impairment.

Altered Perception of Facially Expressed Tiredness in Insomnia

“…Insomnia has previously been associated with reduced rating of emotion intensity for faces displaying happiness, fear and sadness (Cronlein et al, 2016;Kyle et al, 2014), and research demonstrates that experimentally induced sleep deprivation impairs recognition of several facially expressed emotions including anger, happiness and sadness (Killgore, Balkin, Yarnell, & Capaldi, 2017;Van Der Helm, Gujar, & Walker, 2010). Moreover, a recent study determined that both insomnia and sleep apnea patients show blunted intensity ratings for, and impaired ability to categorize, faces depicting happiness and sadness when compared to normal sleeping controls (Cronlein et al, 2016).…”

“…Whereas at disorder level, insomnia affects approximately 10% of the population (Morin et al, 2006). Individuals with insomnia often report problems with emotion regulation and impaired social interactions (Baglioni, Spiegelhalder, Lombardo, & Riemann, 2010;Espie et al, 2012), and recent research concurs that insomnia is associated with a blunted response to emotional facial stimuli depicting fear, sadness and happiness (Cronlein, Langguth, & Busch, 2016;Kyle, Beattie, Spiegelhalder, Rogers, & Espie, 2014). The ability to accurately gauge facial expressions is vital for social interaction and influencing social judgments (e.g.…”

“…Specifically, we compared normal sleepers and those displaying insomnia symptoms in their ratings for the expression intensity of tiredness and alertness whilst observing tired and neutral faces. Individuals with insomnia have been shown to experience a blunted response to emotional facial stimuli (Cronlein et al, 2016;Kyle et al, 2014) and interpret faces of others as appearing less tired compared to self (Akram et al, 2016b). As such, we hypothesized that individuals displaying insomnia symptoms would show lower ratings of expression intensity for tired faces relative to normal sleepers.…”

Neuroimaging Insights into Insomnia

“…At a clinical level, approximately 10 % of the population in Western industrialized countries suffers from insomnia, with an increasing prevalence with older age [3]. Chronic insomnia has a significant impact on an individual's health and wellbeing, being associated with a severely reduced quality of life [4]; cognitive and affective impairments [5,6]; physical complaints [7]; and an increased rate of home, work, and car accidents [8]. Furthermore, chronic insomnia confers a substantially increased risk for other psychiatric disorders, especially depression [9,10], as well as for cardiovascular morbidity and mortality [11•, 12], and, more generally, for ill-health [13].…”

The “Anti-Inflammatory” Properties of CBT-I

“…Additional modules focused on mood enhancement/emotion regulation and management of daytime activity levels, while sleep restriction therapy (SRT) was omitted (owing to the link between short sleep and inflammation). Some have called for greater attention to emotion regulation in insomnia etiology and management, 22,23 and indeed Dr. Sawyer recognized its importance in 1878. 1 Building on recent trends to dismantle CBT-I and assess the relative efficacy of cognitive and behavioral elements, 24,25 the field should now formally assess whether the addition of emotion regulation strategies and a focus on physical activity (perhaps, also, as a countermeasure to SRT-related sleepiness 26 ) can enhance CBT-I response.…”