Insomnia Disorder and Brain’s Default-Mode Network Marques, Daniel Ruivo; Gomes, Ana Allen; Caetano, Gina ...
Current neurology and neuroscience reports,
08/2018, Letnik:
18, Številka:
8
Journal Article
Recenzirano
Purpose of Review
Insomnia disorder (ID) is a prevalent sleep disorder that significantly compromises the physical and mental health of individuals. This article reviews novel approaches in the study ...of brain networks and impaired function in ID through the application of modern neuroimaging techniques such as functional magnetic resonance imaging (fMRI).
Recent Findings
The default-mode network (DMN) is presumed to be correlated with self-referential information processing, and it appears to be altered or unbalanced in insomnia.
Summary
A growing body of evidence suggests the lack of deactivation of brain regions comprising the DMN when insomnia patients are at rest. Moreover, core areas of the DMN demonstrate greater activation in insomnia patients when compared to healthy controls in self-referential related tasks. Despite the few studies on the topic, underpinning the correlation between abnormal DMN activity and ID deserves further attention in the future. Implications for therapeutics are briefly outlined.
This paper has no abstract. First 111 words are shown Chronic insomnia disorder (CID) is a highly prevalent sleep disorder and a public health problem (Riemann et al., 2017). It is well recognized as ...a subjective disorder. Subjective because the diagnosis is fundamentally based on the self-report/complaints of the patients and in the clinical assessment of the sleep expert through a systematic clinical interview – which is the standard method (gold standard) for establishing a diagnosis of CID (Marques et al., 2018). On the contrary, the diagnosis of other sleep disorders demands the so-called objective measures such as polysomnography (PSG) (Riemann et al., 2017). We cannot forget that being CID a subjective disorder, it is important to be exhaustive in clinical assessment.
Depression, anxiety, and insomnia are all conditions that share a complex bidirectional relationship. Sleep effort is a construct with cognitive and behavioral components that perpetuates insomnia. ...Although many studies have examined the associations between these three variables, no studies have yet examined sleep effort as a mediating variable between anxiety and depression and vice versa. Online versions of the Hospital Anxiety and Depression Scale and the Glasgow Sleep Effort Scale were administered to a sample of 1927 higher education students aged 18–40 years (75.9% women and 76% from 18 to 23 years old). As part of the survey, participants also completed a sociodemographic questionnaire. Mediation analysis indicated that sleep effort mediates the relationship between depression and anxiety, when the former was the predictor and the latter was the criterion. Moreover, sleep effort also mediated the relationship between anxiety and depression when the former was the predictor and the latter was the criterion, albeit in a lesser extent. Sleep effort appears to play a bidirectional mediational role between depression and anxiety, being a potential target for intervention.
Insomnia is a widespread sleep disorder associated with physical and mental health conditions. Although the heterogeneity of insomnia presentations has been acknowledged, research investigating ...clinically meaningful insomnia subtypes is still ongoing. This study aimed at exploring insomnia subtypes according to widely-used measures of symptoms severity and sleep quality among Italian university students using a latent profile analysis. Data were collected from 490 students reporting relevant insomnia symptoms through an online cross-sectional survey comprising the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the 21-item Depression Anxiety Stress Scale, and the Short Form-12. Latent profile analysis identified five insomnia subtypes. The severe insomnia (8.8%) group showed the highest insomnia severity, with diverse complaints concerning sleep quality and daytime functioning. Moderate insomnia with sleep duration complaints (8.4%) and moderate insomnia with medication use (15.9%) subgroups were characterized by middle range insomnia severity, with problems of sleep continuity and sleep medication use, respectively. Subthreshold insomnia with sleep latency complaints (20.4%) and subthreshold insomnia (46.5%) groups showed attenuated insomnia symptoms. Higher psychological complaints and worse quality of life were associated with greater sleep complaints. Overall, these findings highlight the relevance of sleep quality domains in identifying insomnia subtypes and might help optimize insomnia treatments.
To assess the reliability and validity concerning the formal European Portuguese version of the Pittsburgh Sleep Quality Index PSQI (EP), its accuracy, and optimal cut-off point.
N
= 564 volunteers ...(18–80 years old) recruited in several settings (e.g., university campuses; work place; home; sleep consultations), agreed to complete the PSQI (EP). Subgroups completed additional measures: Insomnia Severity Index (ISI), STOP-Bang, Glasgow Sleep Effort Scale, or responded to a supplementary question about perceived sleep problems. As to internal consistency, Cronbach’s
α
= 0.75. Principal component analysis revealed a unidimensional structure. Six PSQI (EP) components and total scores were able to discriminate individuals who did versus did not describe having any sleep problem; all PSQI (EP) scores were significantly higher (denoting poorer quality) in participants suffering from a sleep disorder. Most Cohen’s
d
values showed large magnitude associations. PSQI (EP) and ISI scores were highly correlated, but no significant correlations were found considering STOP-Bang. ROC analysis confirmed an optimal cut-off point > 5 of the PSQI (EP) to detect self-reported poor/good sleepers in non-clinical settings. To discriminate non-clinical from clinical sleep patients, the optimal cutoff was > 7, and AUC = 0.94. The European Portuguese version of the PSQI performs as a reliable, valid, and accurate measure of overall sleep quality in Portuguese participants. Furthermore, results suggest that PSQI (EP) can discriminate poor sleepers in non-clinical settings, in addition to demonstrating high clinical accuracy in signaling potential sleep-disorder cases. In conclusion, the PSQI (EP) is a suitable tool to assess general sleep quality in Portuguese participants, both for clinical or non-clinical applications.
Insomnia disorder has known striking developments over the last few years. Partly due to advances in neuroimaging techniques and brain sciences, our understanding of insomnia disorder has become more ...fine-tuned. Besides, developments within psychological and psychiatric fields have contributed to improve conceptualization, assessment, and treatment of insomnia. In this paper, we present a list of promising 10 key “hot-topics” that we think in the next 10 years will continue to stimulate researchers in insomnia’s domain: increasing of systematic reviews and meta-analyses; improvement of existing self-report measures; increasing of genetic and epigenetic investigation; research on new pharmacological agents; advances in neuroimaging studies and methods; new psychological clinical approaches; effectiveness studies of e-treatments and greater dissemination of evidence-based therapies for insomnia; call for integrative models; network approach using in insomnia; and assessment of insomnia phenotypes. The breadth of all these topics demands the collaboration of researchers from different scientific fields within sleep medicine. In summarizing, in the next decade, it is predictable that insomnia’s research still benefit from different scientific disciplines.
The association between sleep quality and quality of life (QoL) in clinical samples diagnosed with sleep disorders, mental disorders, or other medical conditions has been widely investigated. ...However, few studies focused on this relationship in samples of mostly young and healthy adults. This study analyzed the associations between sleep quality and several dimensions of QoL in higher education students and examined whether or not sleep quality would significantly predict QoL after statistically controlling for psychopathological symptoms.
Observational and transversal.
Non-clinical; higher education.
A sample of 324 college students, aged 17 to 47 years (M=20.89±2.85) were enrolled.
European Portuguese versions of the Pittsburgh Sleep Quality Index (PSQI), the WHOQOL-Bref to measure QoL, and the Brief Symptom Inventory (BSI) to measure psychopathological symptoms.
All PSQI components were significantly associated with general QoL and the psychological and physical QoL domains. The subjective sleep quality and daytime dysfunction PSQI components were consistently associated with all WHOQOL-Bref domains and general QoL. Hierarchical regression analyses further showed that the PSQI components as a whole, and in particular subjective sleep quality, added significant contributions to the general QoL facet and to the psychological, physical, and environmental QoL domains, after controlling for psychopathological symptoms.
Several components of sleep quality and different facets/domains of QoL are associated in higher education students, particularly subjective sleep quality, which remains a significant predictor of most aspects of QoL, regardless of the presence of psychopathological symptoms.
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