Emotional experience, presence and severity of insomnia and depressive symptoms. An ecological study of their effects on sleep quality

Behavioral and neuroimaging studies suggest that sleep disturbances and emotions are closely related. However, there is still no consensus regarding the role of emotions in the etiology of insomnia disorder and how daily sleep and emotions are linked. The aim of this study was to explore the relationship between emotional experience and subjective sleep quality, taking into account the presence and severity of insomnia and depressive symptoms and using an ecological momentary assessment. The sample consisted of adults reporting chronic (n=51) and subthreshold (n=134) insomnia or good sleep quality (n=66). Participants completed sleep diaries and reported their emotions both before going to sleep and after awakenings for 7 days. For each participant a night of good and a night of bad sleep quality were selected based on sleep efficiency index (SEI). Results showed that the groups differed significantly in sleep efficiency, depressive and insomnia symptoms (insomnia group reported lower SEI and higher scores of depression and insomnia severity). Secondly, pre-sleep emotions, both negative and positive, influenced the quality of sleep of the good night only in the group of participants that reported subthreshold insomnia symptoms. In other words, in transient insomnia the lower are both negative and positive emotions before going to bed the better is sleep quality. In chronic insomnia, a good sleep quality is predicted only by less severe depressive symptoms that also predict the intensity of negative affect before falling asleep in all groups