Insomnia Disorder and Brain’s Default-Mode Network
Abstract
Purpose of review Insomnia disorder (ID) is a prevalent sleep disorder that significantly compromises the physical and mental health of individuals. This article reviews novel approaches in the study of brain networks and impaired function in ID through the application of modern neuroimaging techniques such as functional magnetic resonance imaging (fMRI). Recent findings The default-mode network (DMN) is presumed to be correlated with self-referential information processing, and it appears to be altered or unbalanced in insomnia. A growing body of evidence suggests the lack of deactivation of brain regions comprising the DMN when insomnia patients are at rest. Moreover, core areas of the DMN demonstrate greater activation in insomnia patients when compared to healthy controls in self-referential related tasks. Despite the few studies on the topic, underpinning the correlation between abnormal DMN activity and ID deserves further attention in the future. Implications for therapeutics are briefly outlined.
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Cortisol elevation relates positively to the degree of objective sleep disturbance, consistent with a disorder of 24-hour hyperarousal rather than simply sleep loss.
“Notably, this elevation relates positively to the degree of objective sleep disturbance, consistent with a disorder of 24-hour hyperarousal rather than simply sleep loss [25].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [25]
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“Based on the understanding of self-referential stress in patients with PI, one theory is that insomnia may be caused by the disruption or imbalance of DMN activity, and previous studies have confirmed that it appears to be altered or imbalanced in insomnia (46).”
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“Some studies discovered that when healthy controls enter deep sleep from rapid eye movement sleep, the activity of pre-DMN drops, whereas that of postDMN is enhanced [12].”
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“One of the consistent findings in CID-related fMRI research is the altered connectivity in the DMN [16, 17], a pattern also observed in various neuropsychiatric disorders such as autism [18], depression [19], and schizophrenia [20].”
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“Among these implicated pathways is the default mode network (DMN)—linked to self-referential information processing—which becomes noticeably disturbed most often in cases of insomnia (Marques et al. 2018).”
BackgroundHuang, M., Ou, Y., Li, H., Liu, F., Li, P., Zhao, J., Lang, B., & Guo, W. (2024) · General Psychiatry · doi:10.1136/gpsych-2023-101371 · Cited by 8 · see citing works
“Notably, previous studies have indicated a close correlation between abnormal DMN activity and sleep General Psychiatry disturbances in individuals with MDD. 27 Sleep disturbances may lead to enhanced DMN activity, thus forming a vicious cycle that exacerbates the severity of depressive symptoms.”
BackgroundInfluentialZeng, Y., Shu, Y., Liu, X., Li, P., Kong, L., Li, K., Xie, W., Zeng, L., Long, T., Huang, L., et al. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.987015 · Cited by 8 · see citing works
“The PCUN, PCC, IPL, and ANG are part of the default network (Marques et al., 2018), and cortical connections and functional links exist between them (Cavanna and Trimble, 2006; van Kemenade et al.”
BackgroundLinear and nonlinear features of EEG microstate associated with insomnia
Weng, L., Jülich, S. T., & Lei, X. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106645 · Cited by 8 · see citing works
Predicting insomnia severity using structure-function coupling in female chronic insomnia patients
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Altered cingulate gyrus subregions functional connectivity in chronic insomnia disorder with anxiety
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The nucleus accumbens functional connectivity in patients with insomnia using resting-state fMRI
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“When comparing the FC within the DMN region and the differential FC identified using the Thalamo cortical seed, the AUC values were 0.750 and 0.833, respectively.”
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“Individuals with insomnia disorder tend to have increased resting-state functional connectivity (FC) between spatially segregated nodes of the DMN [27,28].”
BackgroundStatic and temporal dynamic alterations of local functional connectivity in chronic insomnia
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“Several studies have found disordered structural or functional connectivity of the default mode network in CI and inferred that the default mode network disorder is associated with hyperarousal (Marques et al., 2018; Yu 2018; Suh et al., 2016).”
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“For SD, studies have consistently reported brain atrophy 106,128 and reduced functional connectivity 150–152 within the DMN. Future studies should investigate region-specific associations between Aβ and ADS/SD, as well as other neuropsychiatric symptom domains.”
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“Besides, core areas of the DMN showed greater activation in patients with CID compared with healthy controls (HCs) in self-referential-related tasks (41).”
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“However, other studies have suggested that abnormal activation in the DMN core region after SD is similar to that observed in individuals with insomnia [26,27].”
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“The precuneus, accounting for about 35% of the glucose metabolism in the default mode network [134–136], plays a crucial role in emotional regulation, episodic memory, and introspection, and its dysfunction is implicated in PI [134].”
Can weekend catch-up sleep decrease the risk of cognitive dysfunction in older adults?
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“Increasing evidence suggests that sleep deprivation, insufficient sleep, or sleep debt may impair the DMN [36–38] and even lead to the development of Alzheimer’s disease [35].”
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“4,5 Patients with insomnia often experience dif fi culties in concentrating or have delayed thinking, leading to feelings of restlessness or sadness and unease.”
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Altered functional network topology and connectivity in female nurses with shift work sleep disorder
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“12 Importantly, DMN deactivation has been associated with improved sleep health, 13 providing a potential mechanism for the sleep-promoting effects observed in clinical studies.”
Personalized functional network connectivity abnormalities in chronic insomnia disorder
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“The DMN plays a crucial role in processing self-relevant information, encompassing aspects such as episodic memory, social cognition, empathy, mind wandering, theory of mind, and decision-making (Raichle, 2015 ; Marques et al. , 2018 ; Li et al. , 2023 ).”
Hu, S., Zuo, X., Yu, D., Huang, J., Zhu, S., Li, X., Wu, M., Liu, D., Xiao, J., Zhang, M., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07379-x · Cited by 2 · see citing works
“These resting-state networks, particularly the DMN, are also closely associated with sleep disorders [18].”
The Effect of Tailored Cognitive-Behavioral Therapy for Insomnia on Brain’s Resting-State Networks
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“Several neuroimaging studies have demonstrated that abnormal DMN connectivity changes are closely related with cognitive decline, especially in diseases like schizophrenia [45], insomnia disorder [46], and Parkinson’s disease [47].”
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- Authors
- Marques, D. R., Gomes, A. A., Caetano, G., & Castelo-Branco, M.
- Affiliations
- University of Aveiro (PT)
- University of Coimbra (PT)
- University of Lisbon (PT)
- Corresponding author
- Marques, Daniel Ruivo
- Venue
- Current Neurology and Neuroscience Reports
- Published
- 2018-06-09
- Volume
- 18
- Issue
- 8
- Pages
- 45-45
- ISSN
- 1528-4042 (ISSN-L)
- 1534-6293
- OpenAlex
- W2807404538
- Cited by
- 112
- References
- 29
- Citations by year
- 2026: 16 · 2025: 25 · 2024: 18 · 2023: 19 · 2022: 14 · 2021: 9 · 2020: 4 · 2019: 5 · 2018: 2
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Neurology and Neuroscience Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- insomnia, default mode network, self-referential processing, functional MRI, sleep disorders, brain network dysfunction
- MeSH terms
- Adult, Brain, Brain Mapping, Cognition, Female, Humans, Sleep Initiation and Maintenance Disorders, Magnetic Resonance Imaging, Male, Nerve Net, Neural Pathways
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