Sleep and anxiety: From mechanisms to interventions

Anxiety is the most common mental health problem worldwide. Epidemiological studies show that sleep disturbances, particularly insomnia, affect ∼50% of individuals with anxiety, and that insufficient sleep can instigate or further exacerbate it. This review outlines brain mechanisms underlying sleep...

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Bibliographic Details
Published in:Sleep medicine reviews Vol. 61; p. 101583
Main Authors: Chellappa, Sarah L., Aeschbach, Daniel
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01.02.2022
Subjects:
Adenosine
Anxiety
Anxiety - psychology
Anxiety - therapy
Anxiety Disorders - therapy
Cognitive Behavioral Therapy
Functional magnetic resonance imaging
Humans
Molecular brain imaging
Neurology
Sleep
Sleep - physiology
Sleep Initiation and Maintenance Disorders - therapy
Sleep interventions
Sleep loss
Sleep Medicine
Adenosine
Sleep interventions
Sleep
Sleep loss
Functional magnetic resonance imaging
Anxiety
Molecular brain imaging
ISSN:1087-0792, 1532-2955, 1532-2955
Online Access:Get full text
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Summary:Anxiety is the most common mental health problem worldwide. Epidemiological studies show that sleep disturbances, particularly insomnia, affect ∼50% of individuals with anxiety, and that insufficient sleep can instigate or further exacerbate it. This review outlines brain mechanisms underlying sleep and anxiety, by addressing recent human functional/structural imaging studies on brain networks underlying the anxiogenic impact of sleep loss, and the beneficial effect of sleep on these brain networks. We discuss recent developments from human molecular imaging studies that highlight the role of specific brain neurotransmitter mechanisms, such as the adenosinergic receptor system, on anxiety, arousal, and sleep. This review further discusses frontline sleep interventions aimed at enhancing sleep in individuals experiencing anxiety, such as nonbenzodiazepines/antidepressants, lifestyle and sleep interventions and cognitive behavioral therapy for insomnia. Notwithstanding therapeutic success, up to ∼30% of individuals with anxiety can be nonresponsive to frontline treatments. Thus, we address novel non-invasive brain stimulation techniques that can enhance electroencephalographic slow waves, and might help alleviate sleep and anxiety symptoms. Collectively, these findings contribute to an emerging biological framework that elucidates the interrelationship between sleep and anxiety, and highlight the prospect of slow wave sleep as a potential therapeutic target for reducing anxiety.
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ISSN:1087-0792
1532-2955
1532-2955
DOI:10.1016/j.smrv.2021.101583