Overnight worsening of emotional distress indicates maladaptive sleep in insomnia
Open accessAbstract
STUDY OBJECTIVES: Mechanisms underlying the distress of hyperarousal in people with insomnia remain enigmatic. We investigated whether insomnia impedes the overnight adaptation to emotional distress. METHODS: We induced the distressful self-conscious emotion of shame four times across three consecutive days by exposing 64 participants to their often embarrassingly out-of-tune singing, recorded earlier during a Karaoke session. Perceived physical, emotional, and social distress was assessed with the Experiential Shame Scale. RESULTS: Compared to exposures followed by wakefulness, exposures followed by sleep resulted in overnight relief of physical component of shame in normal sleepers, but in a striking opposite overnight worsening in people with insomnia. CONCLUSIONS: Our findings are the first to experimentally show that the benefits of sleep are not only lost when sleep is poor; people with insomnia experience a maladaptive type of sleep that actually aggravates physically perceived distress. Maladaptive sleep could shed new light on posttraumatic stress disorder (PTSD) and on diurnal mood fluctuation and the counterintuitive favorable effects of sleep deprivation in depression.
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Maladaptive sleep periods associated with insomnia may worsen traumatic exposures compared to those without insomnia; instead of sleep resolving emotional distress, the maladaptive sleep periods increased the distress.
“Wassing et al. [27] demonstrated that maladaptive sleep periods associated with insomnia may worsen the traumatic exposures compared to those without insomnia; thus, instead of sleep resolving emotional distress, the maladaptive sleep periods increased the distress.”
From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [27]
The Discussion reports that sleep after a shame-inducing exposure increased subsequent physical distress in participants with insomnia, whereas it reduced physical distress in normal sleepers. The study used recordings of participants’ own singing, not traumatic exposures; its relevance to PTSD is presented as a possibility rather than a tested finding. (LLM, conf=0.88)
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- Authors
- Wassing, R., Benjamins, J. S., Talamini, L. M., Schalkwijk, F., & Van Someren, E. J. W.
- Affiliations
- Netherlands Institute for Neuroscience (NL)
- University of Amsterdam (NL)
- Institute for Psychotherapy, Amsterdam, The Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Corresponding author
- Wassing, Rick
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-12-26
- Volume
- 42
- Issue
- 4
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2905988748
- Cited by
- 78
- References
- 57
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 12 · 2023: 14 · 2022: 9 · 2021: 7 · 2020: 12 · 2019: 3
- FWCI
- 7.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- KNAW research portal (Royal Academy of Art and Sciences (KNAW)) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- ZONMW Neuropsychoanalysis (16.561.0001)
- Netherlands Organization of Scientific Research (253/2012)
- Bial Foundation
- European Research Council (ERC-ADG-2014–671084, ERC-PoC-201X-931306)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- insomnia, emotional distress, shame, hyperarousal, self-conscious emotions, sleep deprivation, post-traumatic stress disorder, depression
- MeSH terms
- Psychological Distress, Adult, Depression, Emotions, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Shame, Sleep, Stress Disorders, Post-Traumatic, Wakefulness
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