The impact of stress on sleep

Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders

Bibliographic Data

ID23339019
AuthorsDavid A Kalmbach (0000-0003-3107-0522, Sleep Disorders and Research Center Henry Ford Hospital Detroit Michigan), Jason R Anderson (0000-0003-4155-7107, Department of Psychological Sciences Kent State University Kent Ohio), Christopher L Drake (0000-0002-5486-3587, Sleep Disorders and Research Center Henry Ford Hospital Detroit Michigan, corresponding author)
Year2018
Volume27
Issue6
Pagese12710-e12710
Publication date2018-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Sleep Research (JOURNAL)
Journal identifiersISSN: 0962-1105 • E-ISSN: 1365-2869
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jsr.12710
PMID29797753
OpenAlexW2803304487
LanguageEN
Citations received67
References cited158

Sleep reactivity is the trait‐like degree to which stress exposure disrupts sleep, resulting in difficulty falling and staying asleep. Individuals with highly reactive sleep systems experience drastic deterioration of sleep when stressed, whereas those with low sleep reactivity proceed largely unperturbed during stress. Research shows that genetics, familial history of insomnia, female gender and environmental stress influence how the sleep system responds to stress. Further work has identified neurobiological underpinnings for sleep reactivity involving disrupted cortical networks and dysregulation in the autonomic nervous system and hypothalamic‐pituitary‐adrenal axis. Sleep reactivity is most pathologically and clinically pertinent when in excess, such that high sleep reactivity predicts risk for future insomnia disorder, with early evidence suggesting high sleep reactivity corresponds to severe insomnia phenotypes (sleep onset insomnia and short sleep insomnia). High sleep reactivity is also linked to risk of shift‐work disorder, depression and anxiety. Importantly, stress‐related worry and rumination may exploit sensitive sleep systems, thereby augmenting the pathogenicity of sleep reactivity. With the development of cost‐effective assessment of sleep reactivity, we can now identify individuals at risk of future insomnia, shift‐work disorder and mental illness, thus identifying a target population for preventive intervention. Given that insomniacs with high sleep reactivity tend to present with severe insomnia phenotypes, patient sleep reactivity may inform triaging to different levels of treatment. Future research on sleep reactivity is needed to clarify its neurobiology, characterize its long‐term prospective associations with insomnia and shift‐work disorder phenotypes, and establish its prognostic value for mental illness and other non‐sleep disorders.

Circadian rhythm · Insomnia · Psychiatry · Sleep (system call) · Vulnerability (computing) · Circadian rhythm and melatonin · Clinical Psychology · Internal Medicine · Medicine · Psychology · Sleep and related disorders · Sleep and Wakefulness Research

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