Overnight worsening of emotional distress indicates maladaptive sleep in insomnia

Rick Wassing; Jeroen S. Benjamins; Lucia M. Talamini; Frans Schalkwijk; Eus J.W. Van Someren

doi:10.1093/sleep/zsy268

Overnight worsening of emotional distress indicates maladaptive sleep in insomnia

Rick Wassing^*, Jeroen S. Benjamins, Lucia M. Talamini, Frans Schalkwijk, Eus J.W. Van Someren

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

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Abstract

Study Objectives

Mechanisms underlying the distress of hyperarousal in people with insomnia remain enigmatic. We investigated whether insomnia impedes the overnight adaptation to emotional distress.

Methods

We induced the distressful self-conscious emotion of shame four times across three consecutive days by exposing 64 participants to their often embarrassingly out-of-tune singing, recorded earlier during a Karaoke session. Perceived physical, emotional, and social distress was assessed with the Experiential Shame Scale.

Results

Compared to exposures followed by wakefulness, exposures followed by sleep resulted in overnight relief of physical component of shame in normal sleepers, but in a striking opposite overnight worsening in people with insomnia.

Conclusions

Our findings are the first to experimentally show that the benefits of sleep are not only lost when sleep is poor; people with insomnia experience a maladaptive type of sleep that actually aggravates physically perceived distress. Maladaptive sleep could shed new light on posttraumatic stress disorder (PTSD) and on diurnal mood fluctuation and the counterintuitive favorable effects of sleep deprivation in depression.

Original language	English
Article number	zsy268
Pages (from-to)	1-8
Number of pages	8
Journal	SLEEP
Volume	42
Issue number	4
Early online date	26 Dec 2018
DOIs	https://doi.org/10.1093/sleep/zsy268
Publication status	Published - Apr 2019

Funding

This work was supported by a ZONMW Neuropsychoanalysis fund grant 16.561.0001 and a VICI grant 453.07.001 of the Netherlands Organization of Scientific Research; by Grant 253/2012 of the Bial Foundation; and by the European Research Council grants ERC-2014-AdG-671084 INSOMNIA and ERC-2016-PoC-737634 INSOMNIA BEAT IT. Conflict of interest statement. None declared.

Funders	Funder number
Netherlands Organization of Scientific Research	253/2012
Horizon 2020 Framework Programme	671084, 737634
Horizon 2020 Framework Programme
European Research Council
Fundação Bial

Keywords

emotion regulation
insomnia
self-conscious emotion
shame
sleep

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/sleep/zsy268

Overnight worsening of emotional distress indicates maladaptive sleep in insomniaFinal published version, 1.86 MBLicence: Article 25fa Dutch Copyright Act

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title = "Overnight worsening of emotional distress indicates maladaptive sleep in insomnia",

abstract = "Study Objectives Mechanisms underlying the distress of hyperarousal in people with insomnia remain enigmatic. We investigated whether insomnia impedes the overnight adaptation to emotional distress. Methods We induced the distressful self-conscious emotion of shame four times across three consecutive days by exposing 64 participants to their often embarrassingly out-of-tune singing, recorded earlier during a Karaoke session. Perceived physical, emotional, and social distress was assessed with the Experiential Shame Scale. Results Compared to exposures followed by wakefulness, exposures followed by sleep resulted in overnight relief of physical component of shame in normal sleepers, but in a striking opposite overnight worsening in people with insomnia. Conclusions Our findings are the first to experimentally show that the benefits of sleep are not only lost when sleep is poor; people with insomnia experience a maladaptive type of sleep that actually aggravates physically perceived distress. Maladaptive sleep could shed new light on posttraumatic stress disorder (PTSD) and on diurnal mood fluctuation and the counterintuitive favorable effects of sleep deprivation in depression.",

keywords = "emotion regulation, insomnia, self-conscious emotion, shame, sleep",

author = "Rick Wassing and Benjamins, \{Jeroen S.\} and Talamini, \{Lucia M.\} and Frans Schalkwijk and \{Van Someren\}, \{Eus J.W.\}",

year = "2019",

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doi = "10.1093/sleep/zsy268",

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T1 - Overnight worsening of emotional distress indicates maladaptive sleep in insomnia

AU - Wassing, Rick

AU - Benjamins, Jeroen S.

AU - Talamini, Lucia M.

AU - Schalkwijk, Frans

AU - Van Someren, Eus J.W.

PY - 2019/4

Y1 - 2019/4

N2 - Study Objectives Mechanisms underlying the distress of hyperarousal in people with insomnia remain enigmatic. We investigated whether insomnia impedes the overnight adaptation to emotional distress. Methods We induced the distressful self-conscious emotion of shame four times across three consecutive days by exposing 64 participants to their often embarrassingly out-of-tune singing, recorded earlier during a Karaoke session. Perceived physical, emotional, and social distress was assessed with the Experiential Shame Scale. Results Compared to exposures followed by wakefulness, exposures followed by sleep resulted in overnight relief of physical component of shame in normal sleepers, but in a striking opposite overnight worsening in people with insomnia. Conclusions Our findings are the first to experimentally show that the benefits of sleep are not only lost when sleep is poor; people with insomnia experience a maladaptive type of sleep that actually aggravates physically perceived distress. Maladaptive sleep could shed new light on posttraumatic stress disorder (PTSD) and on diurnal mood fluctuation and the counterintuitive favorable effects of sleep deprivation in depression.

AB - Study Objectives Mechanisms underlying the distress of hyperarousal in people with insomnia remain enigmatic. We investigated whether insomnia impedes the overnight adaptation to emotional distress. Methods We induced the distressful self-conscious emotion of shame four times across three consecutive days by exposing 64 participants to their often embarrassingly out-of-tune singing, recorded earlier during a Karaoke session. Perceived physical, emotional, and social distress was assessed with the Experiential Shame Scale. Results Compared to exposures followed by wakefulness, exposures followed by sleep resulted in overnight relief of physical component of shame in normal sleepers, but in a striking opposite overnight worsening in people with insomnia. Conclusions Our findings are the first to experimentally show that the benefits of sleep are not only lost when sleep is poor; people with insomnia experience a maladaptive type of sleep that actually aggravates physically perceived distress. Maladaptive sleep could shed new light on posttraumatic stress disorder (PTSD) and on diurnal mood fluctuation and the counterintuitive favorable effects of sleep deprivation in depression.

KW - emotion regulation

KW - insomnia

KW - self-conscious emotion

KW - shame

KW - sleep

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Overnight worsening of emotional distress indicates maladaptive sleep in insomnia

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Keywords

UN SDGs

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