Emotional responses and emotion regulation in persistent insomnia

Most etiological theories of insomnia suggest that emotional arousal is among the factors that can predispose or perpetuate the disorder (e.„g. Espie, 2002). Increasing evidence is available indicating that negative emotions have disruptive effects on sleep quality while the role of positive emotions is still under debate (e.„g. Baglioni et al., 2010). The presentation will address the issue of which emotional responses characterize persistent insomnia and whether they are related to the strategy used for regulating emotions. To this issue three studies will be described. The first study evaluated psychophysiological responses (facial EMG over the zygomatic and corrugator muscles, Heart Rate and CVT) to stimuli pertinent or not with the insomnia symptoms and differing for valence (negative, positive, neutral). Results evidenced that, as compared to the control group, people with persistent insomnia show lower activation of the corrugator muscles during the presentation of sleep related positive stimuli. This response was interpreted as indicative of craving for a good sleep. The second study replicated results of the first one and evidenced that people with persistent insomnia use more than the control group the suppression as strategy for regulating emotions. The third study aimed at evaluating, through a diary method, whether positive and negative emotions experienced before going to sleep is predictive of the quality of sleep during the subsequent night in people with insomnia symptoms and healthy controls. Furthermore, it assessed whether the emotion experienced and the quality of sleep is related to the strategy used for regulating emotions. Clinical implications of these relationships will be discussed.