A systematic review of sleep disturbance in anxiety and related disorders

Cox, Rebecca C.; Olatunji, Bunmi O.

doi:10.1016/j.janxdis.2015.12.001

Cited by 302 publications

(187 citation statements)

References 182 publications

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“…Furthermore, findings support the notion that sleep dysfunction is transdiagnostic and etiologically linked to various forms of psychopathology due in part to shared neurobiology between sleep systems and emotion regulation (Cox & Olatunji, ; Harvey, Murray, Chandler, & Soehner, ). That said, there was no comparative healthy control group or cohort comprising participants with sleep dysfunction but not psychopathology.…”

Section: Discussionsupporting

confidence: 69%

“…Findings are in line with reports that poor sleep is a risk factor in the development and maintenance of mood disorders (Ford & Kamerow, ; Gillin, ; Gregory et al., ). Problematic sleep has also been shown to exacerbate symptom severity (Cox & Olatunji, ) and may reflect the general influence sleep has on the capacity to regulate emotions (Gruber & Cassoff, ). In further support of close ties between mood and sleep, 40–50% of individuals who suffer from sleep difficulties have a concurrent psychiatric disorder (Ford & Kamerow, ; Gillin, ; Gregory et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Subjective and objective sleep quality modulate emotion regulatory brain function in anxiety and depression

et al. 2017

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Background Disturbances in emotion regulation and sleep are shared across anxiety and mood disorders. Poor sleep has been shown to impair cognitive processes which may undermine cognitive regulatory function. However, it remains unknown if sleep quality impacts regulatory mechanisms in clinical anxiety and depression. Methods During fMRI, 78 patients with social anxiety disorder, generalized anxiety disorder, and/or major depressive disorder completed a validated emotion regulation task, which involved reappraisal (i.e., decrease negative affect) as compared to viewing aversive images. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and actigraphy, representing subjective and objective measures of sleep, respectively. Regression analysis was conducted with the PSQI and actigraphy sleep efficiency, duration, and wake-after sleep onset variables. Results PSQI and actigraphy measures indicated that the majority of patients experienced problematic sleep, however, subjective and objective sleep measures were uncorrelated. Whole-brain voxel-wise regression analysis, controlling for diagnosis, revealed worse self-reported sleep corresponded with less reappraise-related activation in the dorsal anterior cingulate cortex (DACC). The same analysis performed with actigraphy data showed less sleep efficiency positively corresponded with DACC activation. Post-hoc stepwise regression analysis showed these sleep measures predicted DACC activity whereas anxiety and depression symptoms did not. Conclusions Individual differences in self-perceived and objective sleep quality differentially modulated the DACC, which is implicated in cognitive reappraisal. Findings suggest neural correlates of emotion regulation tracks different aspects of the sleep experience. Results also indicate sleep disturbance may play a role in the emotion dysregulation observed in anxiety and depressive disorders.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Subjective and objective sleep quality modulate emotion regulatory brain function in anxiety and depression

et al. 2017

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“…Youth in the poor sleep group were more likely to have MDD than those in the other groups, and by middle adolescence (ages 14-16) those in the poor group were also more likely to have an anxiety disorder and DBD. Because sleep disturbances are diagnostic criteria for MDD (American Psychiatric Association, 2013), and frequently occur in anxiety disorders and DBD (Cox & Olatunji, 2016; Aronen, Lampenius, Fontell, & Simola, 2014), it may be that those youth were identified as poor sleepers as a consequence of this psychopathology, just as much as poor sleep may have contributed to the likelihood of having these disorders. While we are unable to determine the direction of effect in these analyses because assessments at each age are cross-sectional, future longitudinal work should aim to do so.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal sleep phenotypes among offspring of bipolar parents and community controls

Levenson

Soehner

Rooks

et al. 2017

Journal of Affective Disorders

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Background Sleep disturbances are a prominent feature of bipolar disorder (BP). However, it remains unclear how sleep phenotypes may evolve among at-risk youth, and their relevance to BP onset. Methods Pittsburgh Bipolar Offspring Study (BIOS) offspring (ages 10-18) and their parents completed assessments approximately every two years pertaining to current psychopathology and offspring sleep habits. A latent transition analysis (LTA) identified latent sleep groups within offspring based on their ratings of six sleep domains using the School Sleep Habits Survey. Demographic and clinical characteristics were compared between sleep groups. Logistic regression tested links between sleep group and BP onset at the subsequent assessment. Results The LTA model identified latent groups of good, poor, and variable sleepers. We observed an overall trend of good sleep becoming variable, and then poor, as youth age. Offspring in the poor sleep group were more likely to have psychopathology. Adjusting for age and depression, poor sleepers had nearly twice the odds of developing BP relative to good (OR=1.99, CI=0.45-8.91) or variable (OR=2.03, CI=0.72-5.72) sleepers. Limitations include the use of proximal sleep phenotypes to predict BP onset, and a self-report measure of sleep. Conclusions We found three non-overlapping sleep phenotype groups in a large sample of offspring of bipolar probands and offspring of demographically-matched community control parents. Clinicians should consider that youth will likely experience variable and/or poor sleep as they age, and that at-risk youth with poor sleep may be at increased risk of developing MDD and BP at their next assessment.

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“…The first analyses used least squares regressions to examine the direct effects on psychopathology risk of: (1) SleepDur (i.e., the linear term of sleep duration, centered); (2) the squared (i.e., quadratic term) value of SleepDur (SleepDurSq) because both short (Cox & Olatunji, ; Zhai et al., ) and long sleep (Patel et al., ; van Mill et al., ; Zhai et al., ) are related to psychopathology risk, and (3) indicator variables for morning‐type and evening‐type preferences (intermediate type = reference group). We then performed separate mediation analysis on PHQ‐2 and GAD‐7 scores, using only those sleep variables with significant direct effects from the first analysis.…”

Section: Methodsmentioning

confidence: 99%

Personal sleep debt and daytime sleepiness mediate the relationship between sleep and mental health outcomes in young adults

et al. 2018

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This study reports potential mediating mechanisms related to the increased mental health risk conferred by short sleep and evening chronotype. These results have implications for how primary care physicians assess psychopathology risk, arguing for a focus on the assessment of daytime sleepiness and sleep debt in university populations, while for young adults in the general population, these factors may be less important.

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A systematic review of sleep disturbance in anxiety and related disorders

Cited by 302 publications

References 182 publications

Subjective and objective sleep quality modulate emotion regulatory brain function in anxiety and depression

Subjective and objective sleep quality modulate emotion regulatory brain function in anxiety and depression

Longitudinal sleep phenotypes among offspring of bipolar parents and community controls

Personal sleep debt and daytime sleepiness mediate the relationship between sleep and mental health outcomes in young adults

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