The Impact of Insufficient Sleep and Insomnia Disorder on Behavioral and Neural Markers of Emotion Regulation

Beth Israel Deaconess Medical Center, Boston MA

Investigators

Linked publications & trials

Abstract

PROJECT SUMMARY Healthy functioning necessitates an ability to manage our emotions. A growing body of evidence suggests that sleep plays a crucial role in this adaptive process by maintaining the neural circuitry required to optimize emotion regulation. Further, chronically disrupted sleep is a common feature and potentially an underlying cause of a number of psychiatric disorders marked by impaired mood and emotion regulation, such as depression. The consequences of this relationship become even more dire with the recognition that chronic sleep disruption more than doubles the risk of suicide. The objective of the proposed study is to determine the overlapping and differential impact of clinical insomnia in patients and multiple nights of insufficient sleep in healthy controls on behavioral and neural responses during an emotion regulation task. My central hypothesis is that clinical sleep disturbance and multiple nights of truncated sleep both disrupt the circuitry needed for successful emotion regulation, and therefore are critical drivers in the dysregulation of emotional functioning. The primary rationale is that a vast majority of our understanding of the relationship between disrupted sleep and emotion function has relied either on single-night, acute sleep deprivation or assessment of trends in large samples, leaving a major gap in understanding the mechanistic impact of longer, more chronic sleep loss on emotion regulation. This information is essential to understand the degree to which different forms of disrupted sleep account for mood and emotion dysregulation in a host of psychiatric conditions. In the proposed study, I will recruit patients with Insomnia Disorder (ID; n=25) and healthy individuals that undergo a normal sleep (n=25) or sleep restriction (n=25) protocol. All participants will complete an emotion regulation paradigm on two occasions, once as a baseline, and a second time during functional magnetic resonance imaging (fMRI). I predict that when employing emotion regulation strategies to aversive stimuli, sleep restricted participants and ID patients will have largely overlapping behavioral and neural network outcomes, including impaired ability to volitionally reduce negative behavioral responses, amygdala hyperactivity, and weaker negative connectivity between the amygdala and prefrontal cortex. The study is a necessary next step in determining the behavioral and neural consequences of chronic sleep disruption on the ability to effectively regulate emotions, which can then be used as targets for the development of new therapies. My training plan adeptly complements both the technical and theoretical aspects needed to successfully navigate the proposed project and my trajectory of future research. The selected activities will provide the opportunity to develop expertise in the design of longitudinal sleep studies, fMRI data processing and analysis, theoretical understanding of Insomnia Disorder and its relationship to psychiatric presentations, and how to design and implement large-scale RCTs. Through this award, I will receive the necessary data and training to establish myself as an independent investigator and prepare for future R01 submissions investigating the variance in emotional dysregulation due to sleep disruption relevant to a host of psychiatric conditions.