Cited by 112Sleep and related disordersFunctional Brain Connectivity StudiesSleep and Wakefulness Research

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Insomnia Disorder and Brain’s Default-Mode Network

Marques, Daniel Ruivo, Gomes, Ana Allen, Caetano, Gina, Castelo-Branco, Miguel·2018·Current Neurology and Neuroscience Reports

DOI 10.1007/s11910-018-0861-3

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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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BackgroundInfluential
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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.”
MethodInfluential
Transcranial Magnetic Stimulation of the Default Mode Network to Improve Sleep in Individuals With Insomnia Symptoms: Protocol for a Double-Blind Randomized Controlled Trial
Hildebrand, L. L., Huskey, A., Dailey, N. S., Jankowski, S., Henderson-Arredondo, K., Trapani, C., Patel, S. I., Chen, Y.-C., Chou, Y., & Killgore, W. D. S. (2024) · JMIR Research Protocols · doi:10.2196/51212 · Cited by 6
“Individuals with insomnia disorder tend to have increased resting-state functional connectivity (FC) between spatially segregated nodes of the DMN [27,28].”
Background
Static and temporal dynamic alterations of local functional connectivity in chronic insomnia
Li, J., Li, S., Zeng, S., Wang, X., Liu, M., Xu, G., & Ma, X. (2024) · Brain Imaging and Behavior · doi:10.1007/s11682-024-00928-0 · Cited by 6
“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).”
Objective and subjective measures of prior sleep–wake behavior predict functional connectivity in the default mode network during NREM sleep
Wilson, R. S., Mayhew, S. D., Rollings, D. T., Goldstone, A., Hale, J. R., & Bagshaw, A. P. (2018) · Brain and Behavior · doi:10.1002/brb3.1172 · Cited by 6
Relationship Between Chronicity and Severity of Tinnitus and Sleep-Related Issues
Han, S., Seo, H. W., Lee, S. H., & Chung, J. H. (2025) · Otology & Neurotology · doi:10.1097/mao.0000000000004552 · Cited by 5
Resting-state brain change on treatment improvement in insomnia disorder: A coordinate-based meta-analysis
Lv, Z., Fan, Y., Zhang, H., Yang, S., Weng, L., & Lei, X. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106601 · Cited by 5
Anxious–depressive symptoms and sleep disturbances across the Alzheimer disease spectrum
Chai, Y., Kojori, E. S., Saykin, A. J., & Yu, M. (2025) · Nature Mental Health · doi:10.1038/s44220-025-00416-4 · Cited by 8
“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.”
Improved Regional Homogeneity in Chronic Insomnia Disorder After Amygdala-Based Real-Time fMRI Neurofeedback Training
Li, Z., Liu, J., Chen, B., Wu, X., Zou, Z., Gao, H., Wang, C., Zhou, J., Qi, F., Zhang, M., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.863056 · Cited by 5
“Besides, core areas of the DMN showed greater activation in patients with CID compared with healthy controls (HCs) in self-referential-related tasks (41).”
Background
Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway
Klonteig, S., Scarth, M., & Bjørnebekk, A. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05516-6 · Cited by 7
Altering Temporal Dynamics of Sleepiness and Mood During Sleep Deprivation: Evidence from Resting-State EEG Microstates
Bai, D., Fan, X., Xiang, C., & Lei, X. (2025) · Brain Sciences · doi:10.3390/brainsci15040423 · Cited by 4
“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].”
Multimodal integration of homotopic connectivity and transcriptomic signatures in major depressive disorder with sleep disorder comorbidity
Li, M., Ding, Y., Ou, Y., Li, H., Liu, F., Lv, D., Li, P., Lang, B., & Guo, W. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07084-9 · Cited by 4
Dynamic functional connectivity differences between insomnia and comorbid insomnia with depression: A neuroimaging study of brain stability
Lv, Z., Zhang, H., Fan, Y., Wei, Y., Zhang, Z., Yuan, H., Zhu, L., & Lei, X. (2025) · Biological Psychology · doi:10.1016/j.biopsycho.2025.109071 · Cited by 3
Structural rather than functional brain alterations that characterize the differences between major depressive disorder and primary insomnia: a comparative meta-analysis
Du, W. D., Tang, B., Gao, Z., Li, X., Liu, N., Tang, X., Zhang, Q., Lu, P., Zhang, W., & Lui, S. (2025) · BMC Medicine · doi:10.1186/s12916-025-04442-y · Cited by 4
“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?
Hsiao, C., Huang, W.-C., Hsueh, M., Chang, C.-C., Liao, Y., & Lin, K. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03074-5 · Cited by 3
“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].”
Visualization Analysis of Acupuncture for the Treatment of Insomnia: A Scoping Literature Review Based on an International Database
Wang, S., Yang, G.-H., Chi, H., Li, A., Sun, X.-C., Cao, D.-N., Li, N., Chen, L., Zhu, J.-Y., Yue, J., et al. (2024) · Medical Acupuncture · doi:10.1089/acu.2023.0128 · Cited by 3
“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.”
Functional Connectivity Alterations Associated with COVID-19-Related Sleep Problems: A Longitudinal Resting-State fMRI Study
Chen, H.-B., Li, L., Sun, Y.-K., Liu, Y., Chen, W., Liu, P., Liao, Y., & Xie, A. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s488911 · Cited by 3
Altered functional network topology and connectivity in female nurses with shift work sleep disorder
Yang, H., Gu, S., Wang, S.-F., Liu, J., Wang, S., Chen, H. I., Chen, L., Song, C.-M., Li, Q., Dai, Z., et al. (2025) · Frontiers in Systems Neuroscience · doi:10.3389/fnsys.2025.1639981 · Cited by 3
Evaluation of alpha neurofeedback training to enhance sleep in remitted depression and anxiety sufferers with persistent insomnia
Lu, T., Hsieh, T.-H., Wang, Y.-H., Shaw, F., Chen, P. S., & Liang, S. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116401 · Cited by 5
Dynamic Characteristics of State Transitions Composed of Neural Activity in the Brain by Circadian Rhythms
Iinuma, Y., Nobukawa, S., Nishimura, H., & Takahashi, T. (2022) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc48229.2022.9871057 · Cited by 3
Prediction of treatment efficacy in the suanzaoren decoction and estazolam for chronic insomnia disorder, along with brain function and cognitive changes before and after treatment, and potential gene expression profiles
Li, T., Han, Y., Yan, H., Lv, D., Yao, P., Chen, L., Yuan, Y., Zhao, J., Guo, W., Guo, Z., et al. (2025) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2025.104563 · Cited by 2
Sleep habits, brain functional networks, and type 2 diabetes risk: cohort studies from North American and Asian populations and mediating Mendelian randomization analyses
Hu, F., Gong, Q., Xiong, L., Zhao, W., Li, L., & Zheng, Y. (2025) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-025-01777-7 · Cited by 2
Mechanistic Insights from Neurophysiological Studies of OM Chanting, Pranayama and Yoga Nidra on Sleep Quality
Kamaraj, V. K., Boopalan, D., Venkatachalam, Y. K., Senthil, K., & Kuppusamy, M. (2025) · Annals of Neurosciences · doi:10.1177/09727531251386644 · Cited by 2
“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
Li, X., Zhai, Y., Qin, T., Zhang, Z., Zhao, Z., Deng, H., Yang, S., Zhang, J., & Gong, L. (2026) · Psychoradiology · doi:10.1093/psyrad/kkag001 · Cited by 2
“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 ).”
Diagnosis of adolescent depression with sleep disorder based on network topological attributes and functional connectivity
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
“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
Marques, D. R., Gomes, A. A., Clemente, V., dos Santos, J. M., Duarte, I. C., Caetano, G., & Castelo-Branco, M. S. (2020) · Sleep and Vigilance · doi:10.1007/s41782-020-00086-5 · Cited by 2
Self-citation
Polysomnographically mediated cognitive improvements in individuals with insomnia symptoms following continuous theta-burst stimulation of the default mode network
Huskey, A., Fisher, J. M., Hildebrand, L., Negelspach, D. C., Henderson-Arredondo, K., Jankowski, S., Patel, S., Chou, Y.-H., Dailey, N., & Killgore, W. D. (2024) · Frontiers in sleep · doi:10.3389/frsle.2024.1424083 · Cited by 1
Altered connection properties of the left dorsolateral superior frontal gyrus in de novo drug-naïve insomnia disorder
Wang, H., Ma, X., Xu, X., Ning, Q., Qiao, B., Yang, B.-F., Sun, N., Xu, D., & Tang, X. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1568557 · Cited by 1
Reduced switching between brain states in insomnia: evidence from modeling of fMRI brain dynamics
Jespersen, K. V., Stevner, A. B. A., Kringelbach, M. L., Someren, E. J. W. V., Vidaurre, D., & Vuust, P. (2025) · Cerebral Cortex · doi:10.1093/cercor/bhaf314 · Cited by 3
Effect of acupuncture Baihui acupoint-Yintang acupoint-Neiguan acupoint combined with conventional Western medicine treatment on cerebral blood flow in insomnia patients: a 3D-ASL functional magnetic resonance imaging study
Wang, W., Lv, X., Xie, S., Jiang, T., & Zhou, J. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1679885 · Cited by 1
Cognitive training at home for clinically defined insomnia: effects on sleep and psychological functioning
Tapia, J. L., Duñabeitia, J. A., & Puertas, F. J. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1725773 · Cited by 1
Adolescent Insomnia Disorder – Problematic Internet Use Nexus: A Convergent Developmental Trajectory – Bridging Neuroimaging Biomarkers, Molecular Susceptibility, and Environmental-Neurocognitive Cascades
Zeng, Z., Jiang, J., Wang, M., Huang, Y., Maes, M. H. J., & Li, J. (2026) · Psychology Research and Behavior Management · doi:10.2147/prbm.s581502 · Cited by 1
“23,40 This shared failure in dynamic network reconfiguration underlies persistent hyperarousal states in ID 21,22 and may contribute to cue reactivity and loss of control in PIU.”
Beyond Hot Flashes: The Cognitive Dimension of Sleep Disruption in Menopause and Sexual Function
Toricelli, M., Ishikura, I. A., Hachul, H., Tufik, S., & Andersen, M. L. (2026) · Current Sexual Health Reports · doi:10.1007/s11930-026-00421-3 · Cited by 2
Abnormal functional connectivity strength in age-related macular degeneration patients: a fMRI study
Cai, Y.-H., & Huang, X. (2023) · Neuroreport · doi:10.1097/wnr.0000000000001962 · Cited by 1
“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].”
Background
Multiparameter resting-state functional magnetic resonance imaging as an indicator of neuropsychological changes in Binswanger’s disease with mild cognitive impairment
Zhang, H., Zhang, L., Lü, J., Yue, J., Yuan, Z., Hu, J., Yao, Q., Fu, Y., Chen, G., Fang, J., et al. (2025) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2025.1522591 · Cited by 1
Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice.
Song, S., Irfan, M., Tahir, Z., Garrison, K. A., & Ziskind, S. (2026) · Current Sleep Medicine Reports · doi:10.1007/s40675-026-00370-2
Linking Structure–Function Coupling and Chronic Insomnia Severity in Female PatientsPreprint
Wu, D., Jiang, G., Xu, G., Tian, J., & Ma, X. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4182309
Sleep pathology and use of anabolic androgen steroids among male weightlifters in NorwayPreprint
Klonteig, S., Scarth, M., & Bjørnebekk, A. (2023) · doi:10.31234/osf.io/ntdsu
Aberrant structural and functional alterations in patients with insomnia comorbid anxiety: A combined voxel-based morphometry and functional connectivity studyPreprint
Xu, M., Li, B., Wang, S., Chen, C., Liu, Z., Ji, Y., Liu, K., & Niu, Y. (2023) · Research Square · doi:10.21203/rs.3.rs-3268385/v1
Functional magnetic resonance imaging of the brain in patients with insomnia: a prospective study
Trushina, L. I., Borshevetskaya, A. A., Grishchenkov, A. S., Sviryaev, Y. V., Викторович, Б. М., Gordeev, A. D., Efimtsev, A. Y., & Труфанов, Г. Е. (2024) · Diagnostic radiology and radiotherapy · doi:10.22328/2079-5343-2024-15-1-67-77
Below the surface
Bresser, T. (2024) · doi:10.5463/thesis.621
Effects of sleep quality on the default mode network and on anxiety-depression symptoms in premenstrual syndrome
Qin, H., Zhang, Y., Li, S., Ou, Y., Lin, S., Lai, Y., Zhang, Q., Lai, Z., Chen, Y., Wu, Y., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07126-2 · Cited by 1
“A growing body of evidence suggests that deactivation of brain regions comprising the DMN occurs when patients without sleep disturbances are at rest [39]which may lead to decreased rsFC within the DMN.”
Interpretable spatio-temporal graph learning for resting-state functional MRI based classification of Chronic Insomnia Disorder
Zhou, W., Li, H., Luo, W., Gong, L., & Peng, B. (2025) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2025.109237

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
ORCID: Marques, Daniel Ruivo
Gomes, Ana Allen
Caetano, Gina
Castelo-Branco, Miguel
Venue: Current Neurology and Neuroscience Reports
Publisher: Springer Science and Business Media LLC
Published: 2018-06-09
Volume: 18
Issue: 8
Pages: 45-45
ISSN: 1528-4042 (ISSN-L)
1534-6293
DOI: 10.1007/s11910-018-0861-3
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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Insomnia Disorder and Brain’s Default-Mode Network

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