Cara A. Palmer

Sleep and emotion regulation: An organizing, integrative review

A growing body of research suggests that disrupted sleep is a robust risk and maintenance factor for a range of psychiatric conditions. One explanatory mechanism linking sleep and psychological health is emotion regulation. However, numerous components embedded within this construct create both conceptual and empirical challenges to the study of emotion regulation. These challenges are reflected in most sleep-emotion research by way of poor delineation of constructs and insufficient distinction among emotional processes. Most notably, a majority of research has focused on emotions generated as a consequence of inadequate sleep rather than underlying regulatory processes that may alter these experiences. The current review utilizes the process model of emotion regulation as an organizing framework for examining the impact of sleep upon various aspects of emotional experiences. Evidence is provided for maladaptive changes in emotion at multiple stages of the emotion generation and regulation process. We conclude with a call for experimental research designed to clearly explicate which points in the emotion regulation process appear most vulnerable to sleep loss as well as longitudinal studies to follow these processes in relation to the development of psychopathological conditions.

Impact of sleep restriction versus idealized sleep on emotional experience, reactivity and regulation in healthy adolescents

Sleep loss is associated with affective disturbances and disorders; however, there is limited understanding of specific mechanisms underlying these links, especially in adolescence. The current study tested the effects of sleep restriction versus idealized sleep on adolescents’ emotional experience, reactivity and regulation (specifically cognitive reappraisal). Following 1 week of sleep monitoring, healthy adolescents (n = 42; ages 13–17 years) were randomized to 1 night of sleep restriction (4 h) or idealized sleep (9.5 h). The following day, adolescents provided self‐reports of affect and anxiety and completed a laboratory‐based task to assess: (1) emotional reactivity in response to positive, negative, and neutral images from the International Affective Picture System (IAPS); and (2) ability to use cognitive reappraisal to decrease negative emotional responses. Large effects were observed for the adverse impact of sleep restriction on positive affect and anxiety as well as a medium‐sized effect for negative affect, compared to the idealized sleep condition. Subjective reactivity to positive and neutral images did not differ between the groups, but a moderate effect was detected for reactivity to negative images whereby sleep‐restricted teens reported greater reactivity. Across both sleep conditions, use of cognitive reappraisal down‐regulated negative emotion effectively; however, sleep restriction did not impact upon adolescents’ ability to use this strategy. These findings add to a growing body of literature demonstrating the deleterious effects of sleep restriction on aspects of emotion and highlight directions for future research in adolescents.

Co-Sleeping among School-Aged Anxious and Non-Anxious Children: Associations with Sleep Variability and Timing

Little is known about the co-sleeping behaviors of school-aged children, particularly among anxious youth who commonly present for the treatment of sleep problems. The current study examined the occurrence of co-sleeping in both healthy and clinically anxious children and its associated sleep patterns. A total of 113 children (ages 6–12), 75 with primary generalized anxiety disorder and 38 healthy controls, participated along with their primary caregiver. Families completed structured diagnostic assessments, and parents reported on their child’s co-sleeping behaviors and anxiety severity. Children provided reports of anxiety severity and completed one week of wrist-based actigraphy to assess objective sleep patterns. A significantly greater proportion of anxious youth compared to healthy children co-slept, and greater anxiety severity was related to more frequent co-sleeping. Co-sleeping in anxious youth was associated with a delay in sleep timing and with greater sleep variability (i.e., more variable nightly sleep duration). All analyses controlled for child age, race/ethnicity, family income, and parental marital status. Co-sleeping is highly common in anxious school-aged children, with more than 1 in 3 found to co-sleep at least sometimes (2–4 times a week). Co-sleeping was even more common for youth with greater anxiety severity. Increased dependence on others to initiate and maintain sleep may contribute to poorer sleep in this population via shifted schedules and more variable sleep patterns.

Sleep Architecture Relates to Daytime Affect and Somatic Complaints in Clinically-Anxious but not Healthy Children.

It is increasingly clear that seminal sleep-affective relationships begin to take root in childhood, yet studies exploring how nighttime sleep characteristics relate to daytime affective symptoms, both in clinical and healthy populations of children, are lacking. The current study sought to explore these relationships by investigating whether trait-like and/or daily reports of affective and somatic symptoms of children with generalized anxiety disorder and matched controls relate to sleep architecture. Sixty-six children (ages 7–11; 54.4% female; 56.1% Caucasian; 18.2% biracial; 6.1% African American; 3% Asian; 16.7% Hispanic) participated including 29 with primary generalized anxiety disorder (without comorbid depression) and 37 healthy controls matched on age and race/ethnicity. Participants underwent structured diagnostic assessments including child-report measures and subsequently reported on their negative affect and somatic symptoms over the course of 1 week. Children also completed 1 night of polysomnography. Among children with generalized anxiety disorder only, greater amounts of slow wave sleep corresponded with less negative affect, and greater amounts of rapid eye movement sleep was related to more somatic complaints across the week. Similarly, for trait-like measures, more rapid eye movement sleep and shorter latency to rapid eye movement sleep were related to greater depressive symptoms in the anxious group only. The current findings suggest that physiologic sleep characteristics may contribute in direct ways to the symptom profiles of clinically anxious children. The functional relevance of such findings (e.g., how specific sleep characteristics serve to either increase or reduce long-term risk) is a vital direction for future research.

A Specialized Interactive Data Application for EEG- Based Sleep Studies

In this paper we present an approach for multimodal visualization of a subjects EEG recordings, specialized for sleep studies. A web application was developed and a real test case from asleep study with a clinically-anxious child (age 7, male) were exploited in order to showcase the operation and use of the tool.