Deficits in brain default mode network connectivity mediate the relationship between poor sleep quality and anxiety severity

Nov 21, 2023Sleep

Weaker connections in the brain's resting network link poor sleep quality to worse anxiety

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

180 participants were analyzed to explore the neural markers of chronic insomnia disorder (CID) with and without anxiety.

Both CID patient groups exhibited decreased local brain connectivity in the medial prefrontal cortex.
Disrupted functional connectivity was observed between the precuneus and other brain regions in both CID groups.
Only the CID patients with anxiety showed altered long-range brain connectivity in the precuneus.
The anterior and posterior default mode networks demonstrated dysconnectivity specifically in the CID patients with anxiety.
Mediation analysis suggested that disruptions in brain connectivity may link poor sleep quality to increased anxiety symptoms.

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STUDY OBJECTIVES: Chronic insomnia disorder (CID) is a prevalent sleep disorder that frequently cooccurs with anxiety. The association between insomnia and anxiety has been established; however, the neurobiological basis of this relationship remains unclear. This study aimed to investigate the neural markers of CID patients with and without anxiety and to determine whether specific neural connectivity mediates the relationship between insomnia and anxiety.

METHODS: This study included 180 participants, comprising CID patients with anxiety (CID-A), CID patients without anxiety (CID-NA), and good sleep controls. All participants completed self-reported measures of sleep quality and anxiety severity and underwent functional magnetic resonance imaging. Brain functional integration was measured using functional connectivity density (FCD) and resting-state functional connectivity (rsFC). Correlation and mediation analyses were used to examine the relationships among brain connectivity, sleep quality, and anxiety severity.

RESULTS: The CID-NA and CID-A groups showed decreased local FCD in the medial prefrontal cortex (mPFC) and disrupted rsFC between the precuneus and other brain regions. Only the CID-A group exhibited altered long-range FCD in the precuneus and the rsFC between the anterior default mode network (DMN, e.g. mPFC) and posterior DMN (e.g. precuneus). Mediation analysis revealed DMN dysconnectivity underlying the association between poor sleep quality and anxiety symptoms.

CONCLUSIONS: This study identified shared and distinct brain circuit disruptions in the CID-NA and CID-A groups, with deficits in DMN connectivity as a potential neural mechanism through which disrupted sleep augments anxiety. These findings may facilitate the development of personalized therapies for insomnia and associated anxiety problems.

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Deficits in brain default mode network connectivity mediate the relationship between poor sleep quality and anxiety severity

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