Brain Reactivity and Selective Attention to Sleep-Related Words in Patients With Chronic Insomnia

ABSTRACT Objective/Background: Sleep-related attentional bias has been suggested to represent an important factor for the maintenance of chronic insomnia. However, little is known about potentially underlying psychological mechanisms such as threat or craving. As these are associated with distinguishable brain activation patterns, we performed a functional neuroimaging study. Participants/Methods: Functional magnetic resonance imaging was used to investigate brain reactivity to sleep-related words in 20 patients with primary insomnia according to DSM-IV criteria and 35 good sleeper controls according to Research Diagnostic Criteria. In addition, an emotional Stroop task was performed in all participants outside the scanner to investigate sleep-related attentional bias. Results: Contrary to the hypotheses, patients with chronic insomnia did not differ from good sleeper controls in terms of threat- or craving-related brain reactivity to sleep-related words. In addition, the emotional Stroop task did not reveal any significant group difference in sleep-related attentional bias. Exploratory analyses did not show any significant correlations between brain reactivity/selective attention to sleep-related words and questionnaire scores/PSG parameters. Conclusions: The results from the present study call into question that attentional bias to sleep-related stimuli is a core feature of chronic insomnia. Future studies may use pictorial stimuli and larger sample sizes for investigating sleep-related information processing in insomnia.

[1]  Gordon Jackson-Koku,et al.  Beck Depression Inventory. , 2016, Occupational medicine.

[2]  S. Kyle,et al.  Sleep-related attentional bias in insomnia: A state-of-the-science review. , 2015, Clinical psychology review.

[3]  B. Feige,et al.  Insomnia disorder is associated with increased amygdala reactivity to insomnia-related stimuli. , 2014, Sleep.

[4]  C. Morin,et al.  Cognitive impairment in individuals with insomnia: clinical significance and correlates. , 2014, Sleep.

[5]  B. Feige,et al.  Reduced anterior internal capsule white matter integrity in primary insomnia , 2014, Human brain mapping.

[6]  Kai Spiegelhalder,et al.  Sleep changes in the disorder of insomnia: a meta-analysis of polysomnographic studies. , 2014, Sleep medicine reviews.

[7]  N. Barclay,et al.  Sleep‐related attentional bias in poor versus good sleepers is independent of affective valence , 2013, Journal of sleep research.

[8]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[9]  M. Jansson-Fröjmark,et al.  Attentional Bias in Insomnia: The Dot-Probe Task with Pictorial Stimuli Depicting Daytime Fatigue/Malaise , 2013, Cognitive Therapy and Research.

[10]  B. Feige,et al.  Insomnia does not appear to be associated with substantial structural brain changes. , 2013, Sleep.

[11]  Joseph P. Schacht,et al.  Functional neuroimaging studies of alcohol cue reactivity: a quantitative meta‐analysis and systematic review , 2013, Addiction biology.

[12]  Cathy J. Price,et al.  A review and synthesis of the first 20 years of PET and fMRI studies of heard speech, spoken language and reading , 2012, NeuroImage.

[13]  Hartwig R. Siebner,et al.  The motor system and its disorders , 2012, NeuroImage.

[14]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[15]  C. Lombardo,et al.  Psychophysiological reactivity to sleep-related emotional stimuli in primary insomnia. , 2010, Behaviour research and therapy.

[16]  K. Spiegelhalder,et al.  Is sleep-related attentional bias due to sleepiness or sleeplessness? , 2009 .

[17]  C. Espie,et al.  The clock as a focus of selective attention in those with primary insomnia: an experimental study using a modified Posner paradigm. , 2009, Behaviour research and therapy.

[18]  S. Moritz,et al.  Words may not be enough! No increased emotional Stroop effect in obsessive-compulsive disorder. , 2008, Behaviour research and therapy.

[19]  K. Spiegelhalder,et al.  Sleep‐related attentional bias in patients with primary insomnia compared with sleep experts and healthy controls , 2008, Journal of sleep research.

[20]  Hans Ivers,et al.  Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). , 2007, Sleep.

[21]  A. Etkin,et al.  Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. , 2007, The American journal of psychiatry.

[22]  C. Espie,et al.  Attention bias for sleep-related stimuli in primary insomnia and delayed sleep phase syndrome using the dot-probe task. , 2006, Sleep.

[23]  C. Espie,et al.  The attention-intention-effort pathway in the development of psychophysiologic insomnia: a theoretical review. , 2006, Sleep medicine reviews.

[24]  André Charles,et al.  Effects of sleep deprivation on Color-Word, Emotional, and Specific Stroop interference and on self-reported anxiety , 2006, Brain and Cognition.

[25]  C. Espie,et al.  Towards a valid, reliable measure of sleep effort , 2005, Journal of sleep research.

[26]  C. Espie,et al.  Sleep-related attentional bias in good, moderate, and poor (primary insomnia) sleepers. , 2005, Journal of abnormal psychology.

[27]  R. Bootzin,et al.  Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine Work Group. , 2004, Sleep.

[28]  C. Guilleminault,et al.  Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. , 2004, Sleep.

[29]  C. Espie,et al.  Attentional Bias in People With Acute Versus Persistent Insomnia Secondary to Cancer , 2003, Behavioral sleep medicine.

[30]  L. Robertson,et al.  Interpreting Stroop interference: an analysis of differences between task versions. , 2001, Neuropsychology.

[31]  C. Morin,et al.  Validation of the Insomnia Severity Index as an outcome measure for insomnia research. , 2001, Sleep medicine.

[32]  C. Feyerabend,et al.  Determinants and effects of attentional bias in smokers. , 2000, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[33]  T. Dalgleish,et al.  The emotional Stroop task and psychopathology. , 1996, Psychological bulletin.

[34]  R W Cox,et al.  AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. , 1996, Computers and biomedical research, an international journal.

[35]  A. P. Georgopoulos,et al.  Functional magnetic resonance imaging of motor cortex: hemispheric asymmetry and handedness. , 1993, Science.

[36]  M. Johns,et al.  A new method for measuring daytime sleepiness: the Epworth sleepiness scale. , 1991, Sleep.

[37]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[38]  W. Dement,et al.  Quantification of sleepiness: a new approach. , 1973, Psychophysiology.

[39]  C. Lombardo,et al.  Psychophysiological reactivity to symptom-related emotional stimuli in insomnia: A replication and extension to disordered eating , 2013 .

[40]  B. Feige,et al.  The impact of sleep-related attentional bias on polysomnographically measured sleep in primary insomnia. , 2010, Sleep.

[41]  A. Chesson,et al.  The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Techinical Specifications , 2007 .

[42]  A. Chesson,et al.  The American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications , 2007 .

[43]  J. Broman,et al.  Cognitive Bias and Memory Performance in Patients with Persistent Insomnia , 1997 .

[44]  P. Nicassio,et al.  The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale. , 1985, Behaviour research and therapy.

[45]  C. Spielberger,et al.  Manual for the State-Trait Anxiety Inventory , 1970 .

[46]  L. Creti,et al.  A COGNITIVE MODEL OF INSOMNIA , 2022 .