Sleep and the heart: Interoceptive differences linked to poor experiential sleep quality in anxiety and depression

Ewing, Donna L.; Manassei, Miranda F.; Praag, Cassandra Gould van; Philippides, Andrew; Critchley, Hugo; Garfinkel, Sarah N.

doi:10.1016/j.biopsycho.2017.05.011

Cited by 67 publications

(67 citation statements)

References 53 publications

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“…In addition to answering questions regarding the factors underlying stability, a secondary question concerned the relationship between heartbeat counting and health/cognition during middle childhood. Contrary to predictions based on previously-reported associations in adulthood (e.g., Ewing et al, 2017;Khalsa & Lapidus, 2016;Terasawa et al, 2014), no significant relationship between heartbeat counting and anxiety, depression, sleep problems or emotion recognition was observed in this sample of children at either Time 1 or Time 2 after correction for multiple comparisons. There are several possible explanations for this lack of significant correlations.…”

Section: Tablecontrasting

confidence: 99%

“…In addition to elucidating the factors underlying the long-term stability of heartbeat counting, we capitalised on the large sample to explore associations with other traits previously shown to covary with heartbeat counting. We aimed to estimate the magnitude of shared genetic and environmental influences between heartbeat counting and other traits associated with heartbeat counting in adulthood, such as anxiety and depression (see Khalsa & Lapidus, 2016), sleep problems (e.g., reduced sleep quality and insomnia; Ewing et al, 2017;Wei et al, 2016), and aspects of higher order cognition (e.g., emotion recognition; Terasawa et al, 2014) in this sample of children. Whilst few studies have examined these relationships in childhood, those that have typically observe similar associations with anxiety (e.g., Eley et al, 2007;Eley, Stirling, Ehlers, Gregory, & Clark, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Estimating the stability of heartbeat counting in middle childhood: a twin study

Murphy¹,

Cheesman²,

Gregory³

et al. 2019

Preprint

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There is growing interest in interoception, the perception of the body’s internal state, and its relevance for health and higher-order cognition across development. To date, most evidence linking interoception to health and cognition has used the heartbeat counting task. However, the stability of the measure across time, particularly during childhood, and the etiological factors that underlie individual differences in stability remain largely unexamined. Using data from the ECHO twin sample (N=204 twin pairs), we estimated the magnitude of genetic and environmental influences on the stability of heartbeat counting across a two-year period (8-10 years), the longest time-frame examined. We found a relatively modest correlation between heartbeat counting accuracy across time (r=.35), with accuracy on the heartbeat counting task improving with age. In our longitudinal twin analysis, we found that the heritability of heartbeat counting dropped between Time 1 and Time 2 from 30% to 6%. No new genetic influences were observed at Time 2, suggesting that genetic influences across this age-range are entirely stable. In contrast, shared environmental influences increased from 6% to 22%, with most of the influence at Time 2 due to new environmental factors. Of note, nonshared environmental factors accounted for the greatest proportion of variance at both time points, 64% and 73% respectively, and were the main contributors to temporal stability in heartbeat counting accuracy. Future research should seek to identify these non-shared environmental factors and elucidate whether this relatively modest stability reflects variability of interoception across development or unreliability of the heartbeat counting task.

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Section: Tablecontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimating the stability of heartbeat counting in middle childhood: a twin study

Murphy¹,

Cheesman²,

Gregory³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…The proportion of hits and false alarms were normalised using the inverse of the standard normal cumulative distribution. As in previous studies (Ewing et al, 2017;Garfinkel et al, 2015), we quantified sensibility to a variety of internal bodily sensations with the score on the awareness subsection of the Porges Body Perception Questionnaire (BPQ) (Porges, 1993) and defined sensibility to heartbeat sensations as the median confidence rating during internal trials (Ewing et al, 2017;Forkmann et al, 2016;Garfinkel et al, 2015).…”

Section: Indicesmentioning

confidence: 99%

Skipping a beat: heartbeat-evoked potentials reflect predictions during interoceptive-exteroceptive integration

Banellis

Cruse

2020

Preprint

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Several theories propose that emotions and self-awareness arise from the integration of internal and external signals and their respective precision-weighted expectations.Supporting these mechanisms, research indicates that the brain uses temporal cues from cardiac signals to predict auditory stimuli, and that these predictions and their prediction errors can be observed in the scalp heartbeat-evoked potential (HEP). We investigated the effect of precision modulations on these cross-modal predictive mechanisms, via attention and interoceptive ability. We presented auditory sequences at short (perceived synchronous) or long (perceived asynchronous) cardio-audio delays, with half of the trials including an omission. Participants attended to the cardio-audio synchronicity of the tones (internal attention) or the auditory stimuli alone (external attention). Comparing HEPs during omissions allowed for the observation of pure predictive signals, without contaminating auditory input.We observed an early effect of cardio-audio delay, reflecting a difference in heartbeat-driven expectations. We also observed a larger positivity to omissions of sounds perceived as synchronous than to omissions of sounds perceived as asynchronous when attending internally only, consistent with the role of attentional precision for enhancing predictions.These results provide support for attentionally-modulated cross-modal predictive coding, and suggest a potential tool for investigating its role in emotion and self-awareness.

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“…The discrepancy between the immobile state of the body (internal stimulus) and the moving scenes presented (external stimulus) may be further experienced as uncomfortable due to the increased interoceptive sensitivity associated with insomnia (Ewing et al., ; Wei et al., ). Patients with insomnia have been shown to adapt insufficiently to regular internal input such as their own regular heartbeat (Wei et al., ), and the current study shows that they may also not adapt sufficiently to the discrepancy between internal and external input.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep problems have been associated with changes in interoceptive sensitivity, which is the ability to detect internal bodily sensations such as heartbeat and breathing (Yoris et al., ). Not only does poor sleep affect interoceptive accuracy (Ewing et al., ), patients with insomnia also adapt insufficiently to regular internal input such as their own regular heartbeat. This lack of adaptation has been associated with brain activity in regions implicated in the brain salience network (Wei et al., ).…”

Section: Introductionmentioning

confidence: 99%

How sleep problems contribute to simulator sickness: Preliminary results from a realistic driving scenario

Altena¹,

Daviaux²,

Sanz-Arigita

et al. 2018

Journal of Sleep Research

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Virtual reality and simulation tools enable us to assess daytime functioning in environments that simulate real life as close as possible. Simulator sickness, however, poses a problem in the application of these tools, and has been related to pre-existing health problems. How sleep problems contribute to simulator sickness has not yet been investigated. In the current study, 20 female chronic insomnia patients and 32 female age-matched controls drove in a driving simulator covering realistic city, country and highway scenes. Fifty percent of the insomnia patients as opposed to 12.5% of controls reported excessive simulator sickness leading to experiment withdrawal. In the remaining participants, patients with insomnia showed overall increased levels of oculomotor symptoms even before driving, while nausea symptoms further increased after driving. These results, as well as the realistic simulation paradigm developed, give more insight on how vestibular and oculomotor functions as well as interoceptive functions are affected in insomnia. Importantly, our results have direct implications for both the actual driving experience and the wider context of deploying simulation techniques to mimic real life functioning, in particular in those professions often exposed to sleep problems.

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Sleep and the heart: Interoceptive differences linked to poor experiential sleep quality in anxiety and depression

Cited by 67 publications

References 53 publications

Estimating the stability of heartbeat counting in middle childhood: a twin study

Estimating the stability of heartbeat counting in middle childhood: a twin study

Skipping a beat: heartbeat-evoked potentials reflect predictions during interoceptive-exteroceptive integration

How sleep problems contribute to simulator sickness: Preliminary results from a realistic driving scenario

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