Article2012

REM Sleep Instability – A New Pathway for Insomnia?

Dieter Wilhelm Riemann · Kai Spiegelhalder · Christoph Nissen · Verena Hirscher · Chiara Baglioni · Bernd Feige

243 citations0/0 files storedPharmacopsychiatry

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Abstract

Chronic insomnia afflicts approximately 10% of the adult population and is associated with daytime impairments and an elevated risk for developing somatic and mental disorders. Current pathophysiological models propose a persistent hyperarousal on the cognitive, emotional and physiological levels. However, the marked discrepancy between minor objective alterations in standard parameters of sleep continuity and the profound subjective impairment in patients with insomnia is unresolved. We propose that "instability" of REM sleep contributes to the experience of disrupted and non-restorative sleep and to the explanation of this discrepancy. This concept is based on evidence showing increased micro- and macro-arousals during REM sleep in insomnia patients. As REM sleep represents the most highly aroused brain state during sleep it seems particularly prone to fragmentation in individuals with persistent hyperarousal. The continuity hypothesis of dream production suggests that pre-sleep concerns of patients with insomnia, i. e., worries about poor sleep and its consequences, dominate their dream content. Enhanced arousal during REM sleep may render these wake-like cognitions more accessible to conscious perception, memory storage and morning recall, resulting in the experience of disrupted and non-restorative sleep. Furthermore, chronic fragmentation of REM sleep might lead to dysfunction in a ventral emotional neural network, including limbic and paralimbic areas that are specifically activated during REM sleep. This dysfunction, along with attenuated functioning in a dorsal executive neural network, including frontal and prefrontal areas, might contribute to emotional and cognitive alterations and an elevated risk of developing depression.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 243 citations exist upstream.

References

2011Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies 2005Practice Parameters for the Indications for Polysomnography and Related Procedures: An Update for 2005 2002A cognitive model of insomnia 2009The hyperarousal model of insomnia: A review of the concept and its evidence 1992Sleep and Psychiatric Disorders 1994Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy 2009Hyperarousal and insomnia: State of the science 2001Chronic Insomnia Is Associated with Nyctohemeral Activation of the Hypothalamic-Pituitary-Adrenal Axis: Clinical Implications

Cited by

2015Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory 2023Hyperarousal in insomnia disorder: Current evidence and potential mechanisms 2015Sleep and anxiety in late childhood and early adolescence 2016Insomnia heterogeneity: Characteristics to consider for data-driven multivariate subtyping 2016Slow dissolving of emotional distress contributes to hyperarousal

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.