Andrea Ballesio

Insomnia and Emotion Regulation: Recent Findings and Suggestions for Treatment

Recent findings suggest that insomnia and emotion regulation are closely connected. Insomnia is widely associated with medical and psychiatric conditions as well as with impaired quality of life and emotional functioning. Additionally empirical evidence suggests that emotional dysregulation plays a crucial role in the onset and maintenance of psychopathological disorders. Although these seem to interact, very few studies investigated the relationship between disturbed sleep and problems in emotion regulation. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been demonstrated to be effective in comorbid insomnia. However, emotion regulation skills are not included in this intervention. After reviewing the recent findings of the literature, we aim to discuss future directions for the inclusion of emotion regulation training in the treatment of insomnia disorder.

Is poor sleep associated with obesity in older adults? A narrative review of the literature

IntroductionTo address the worldwide epidemic of obesity, a sizable literature implicates sleep problems in the onset of obesity in younger populations. However, less is known about how this process may operate among older adults, which is of concern, given demographic shifts that have resulted in a much higher proportion of developed nations around the world reaching late life.MethodsWe offer a current review of the literature studying older adults and examining associations between sleep quality and obesity in this population. We consider both subjective and objectively measured sleep as well as both cross-sectional and longitudinal studies offering stronger causal inference.ResultsWe discuss seemingly contradictory literature showing that shorter sleep duration as well as longer sleep duration are associated with obesity risk, then review studies that tested for non-linear relationships and reported a U-shape pattern, suggesting that too much or too little sleep is detrimental. Besides sleep duration, we discuss evidence showing that other forms of sleep dysfunction related to night-time awakenings, REM sleep, slow-wave sleep, and daytime sleepiness, which are indicators of sleep quality, are also linked to obesity. Specific psychological and physiological mediators and moderators, suggesting possible mechanisms whereby sleep problems may affect obesity in older adults, are described.ConclusionWe conclude by discussing areas, where additional research could help clarify this association, considering such factors as medical comorbidities common in late life, and health-related behaviors that may stem from poor sleep (such as disordered eating behavior). Such insights will have great value for clinical practice.Level of evidenceLevel V, narrative review.

Commentary: The Relationship between Sleep Complaints, Depression, and Executive Functions on Older Adults

Executive functions are a set of top-down higher order cognitive processes that are vulnerable to sleep loss (Gorgoni et al., 2014) and impaired in individuals with depression (Snyder et al., 2015). The co-occurrence of impaired executive functions, sleep disturbance and depressive symptoms in elderly samples indicates that the three conditions may be interrelated (Yu et al., 2016). Nevertheless, to date few studies investigated the relationships between these three variables. The present commentary aims to draw attention to some factors that may be considered for advancing knowledge in this field, starting from findings reported by de Almondes et al. (2016) in the article recently published in “Frontiers in Psychology.”

The effects of one night of partial sleep deprivation on executive functions in individuals reporting chronic insomnia and good sleepers

BACKGROUND AND OBJECTIVES The aim of the present study was to investigate the effects of a partial sleep deprivation night on executive functions in participants reporting chronic insomnia and good sleepers using a Task Switching paradigm. METHODS Sixteen participants reporting symptoms of chronic insomnia and sixteen good sleepers were tested after a night of habitual sleep and after a night of partial sleep deprivation (5 h of sleep allowed). The Switch Cost (SC) and the Backward Inhibition (BI) were computed as measures of switching attention and response inhibition, respectively. RESULTS We observed a marginally significant interaction Night × Group on SC (F(1,29) = 4.06, p = 0.053), η2 = 0.123. Fishers least significant difference (LSD) post-hoc revealed a smaller SC after the sleep deprived night relative to the habitual night for the good sleepers (p = 0.027; M = 192.23 ± 201.81 vs M = 98.99 ± 141.16). Differently, participants with insomnia did not show any change after the two nights. LIMITATIONS Several limitations must be acknowledged including the use of a convenient sample of university students and the use of a single task of cognitive performance. CONCLUSIONS We found that SC was smaller in the good sleepers after a night of partial sleep deprivation compared to a habitual night, indicating a better switching performance. The insomnia group showed no differences in performance after the two experimental nights. Several factors may account for these results, including increased levels of arousal and cognitive effort during task execution.

Poor Cognitive Inhibition Predicts Rumination About Insomnia in a Clinical Sample

ABSTRACT Objective/Background: According to the Cognitive Model of Insomnia disorder, rumination about lack of sleep and its diurnal consequences plays a crucial role in maintaining insomnia. Consolidated evidence shows that rumination is related to poor executive functions, which are cognitive control processes impacted by insomnia. Despite this evidence, no studies so far investigated the relationship between executive functions and rumination in individuals with insomnia. The aim of this pilot study was to cover this gap by investigating whether poor executive functions are associated with rumination in a sample of individuals with a diagnosis of insomnia disorder. Participants: Thirty young adults (22.67 ± 3.68 years, 73.3% females) diagnosed with insomnia disorder by clinical psychologists with expertise in behavioral sleep medicine completed the study. Methods: Measures of insomnia, depression, emotion regulation, and rumination about the daytime consequences of insomnia were collected. Executive functions were assessed using a Task Switching paradigm, measuring cognitive inhibition and set-shifting with cognitive flexibility. Results: Hierarchical multiple regression analysis revealed that higher depression (β = 0.781, p < 0.001) and cognitive reappraisal (β = 0.329, p = 0.016), and poorer cognitive inhibition (β = −0.334, p = 0.014), significantly predicted higher rumination. Conclusions: Rumination about symptoms of insomnia in a clinical sample is associated with impaired inhibitory but not switching capacities above and beyond the role played by traditional predictors such as depression and emotion regulation strategies. If replicated, present preliminary results suggest the need to target cognitive inhibition deficits in insomnia treatment.