Self-Reported Sleep Quality Modulates Amygdala Resting-State Functional Connectivity in Anxiety and Depression

Abstract

Sufficient sleep plays an important role in neurocognitive function, yet, problematic sleep is ubiquitous in the general population. It is also frequently predictive of, and concurrent with, internalizing psychopathologies (IPs) such as anxiety and depression suggesting sleep quality is dimensional and transdiagnostic. Along with problematic sleep, IPs are characterized by negative affectivity, therefore, prominent neurobiological models of internalizing conditions involve the amygdala, a region central to emotion. In resting-state studies (independent of sleep considerations), abnormalities in amygdala-frontal functional connectivity are commonly observed suggesting emotion dysregulation may contribute to clinically-relevant phenotypes. In a separate line of research, studies of sleep deprivation, and insomnia disorder suggest sleep loss may alter amygdala-frontal connectivity. Taken together, findings point to shared neurobiology between sleep and emotion systems, however, the impact of sleep quality on the amygdala circuit in anxiety or depression is unclear. Therefore, we evaluated variance in naturalistic sleep quality on amygdala-based circuity in individuals with and without psychiatric illness. Resting-state fMRI data was collected in 87 un-medicated, treatment-seeking adults diagnosed with a primary anxiety disorder (n = 68) or primary depressive disorder (n = 19) in addition to healthy individuals (n = 40). Regression analysis was conducted with bilateral anatomical amygdala as seed regions and self-reported sleep quality was indexed with a validated self-report measure, the Pittsburgh Sleep Quality Index (PSQI). Post-hoc analysis was performed to evaluate whether diagnostic status (primary anxiety, primary depression, healthy) significantly explained functional connectivity results. Whole-brain regression analysis, controlling for anxiety and depression symptoms, revealed worse sleep quality (i.e., higher PSQI total scores) predicted increased left amygdala-subgenual anterior cingulate functional connectivity and reduced connectivity with posterior cerebellar lobe and superior temporal gyrus. For right amygdala, increased coupling with postcentral gyrus corresponded with worse sleep. Post-hoc analysis did not detect a significant relationship between diagnostic status and whole-brain findings. Results expand on previous studies and indicate variance in sleep quality tracks brain pathways involved in cognitive-emotion functions implicated in the neurobiology of IPs that may extend to individuals at risk for clinical anxiety or depression. Altogether, the clinical relevance of identifying phenotypes to improve our understanding of psychopathology may be improved by incorporating sleep quality.

Sleep and Childhood Mental Health: Role of Physical Activity and Cardiorespiratory Fitness

“…19 This is owing to the fact that depressed or anxious individuals have excessive amygdala reactivity, and sleep problems have been shown to stimulate this area of the brain to a large extent. 20 Sleep quality was also associated with conduct problems in boys and girls. Such evidence was also found in a study carried out with adolescents, indicating that those who had sleep problems were more likely to develop conduct problems both immediately and one year later.…”

Reduced resting‐state functional connectivity and sleep impairment in abstinent male alcohol‐dependent patients

“…First, we only employed subjective measures of sleep in this study. Previous experiments associating PSQI with resting‐state experiments also failed to measure objective measures of sleep (Klumpp et al, ; Klumpp, Hosseini, & Phan, ). Objective measures, such as polysomnography should be used to further investigate the association of alcohol dependence and sleep in future study.…”

Transdiagnostic neural correlates of volitional emotion regulation in anxiety and depression

“…Specifically, owing to high concordance between HAM-A and HAM-D scores (r = 0.82, P < 0.001), the summation of HAM-A and HAM-D total scores was the covariate of interest (Klumpp, Hosseini, & Phan, 2018;Klumpp, Kinney, et al, 2018),…”

“…, owing to high concordance between HAM-A and HAM-D scores (r = 0.82, P < 0.001), the summation of HAM-A and HAM-D total scores was the covariate of interest(Klumpp, Hosseini, & Phan, 2018;Klumpp, Kinney, et al, 2018), whereas age, education, gender, and diagnostic status (dummy coded) were added as covariates of no-interest. To test whether anxiety (HAM-A) and/or depression (HAM-D) were more significant in driving neural activity, post hoc analyses were performed.…”