BMC Med. 2025 Nov 4;23(1):608. doi: 10.1186/s12916-025-04437-9.
ABSTRACT
BACKGROUND: Insomnia disorder is frequently associated with emotional dysregulation, but the underlying neural basis of emotion processing and its relationship to hyperarousal biomarkers, such as beta power during rapid eye movement (REM) sleep, remain unclear. In this study, we investigated the neural basis of emotional processing in patients with insomnia disorder (ID) and explored its association with electroencephalography (EEG) measures, focusing on REM sleep beta power.
METHODS: Thirty-five ID and 34 age- and gender-matched healthy controls (HC) completed questionnaires, underwent whole-night portable single-channel EEG at home, and performed an emotion-matching task under functional Magnetic Resonance Imaging (fMRI). Between-group comparisons were conducted on behavioral measures and brain activations. Partial correlations were used to examine the relationships between significantly activated brain regions during the emotion-matching task and REM sleep beta power recorded overnight.
RESULTS: Behavioral results showed that, regardless of emotional valence, ID had significantly longer mean reaction times than HC. Whole-brain analysis of variance of task fMRI revealed that, in response to happy faces, ID exhibited significantly greater activation in the right superior temporal gyrus, medial orbital frontal cortex (mOFC), superior occipital gyrus, precentral gyrus, and left paracentral lobule compared to HC. Furthermore, after controlling for depression and anxiety symptoms, a significant negative correlation was observed in ID between REM sleep beta power and right mOFC activation in response to happy faces (r = – 0.628, p = 0.005), whereas no such correlation was found in HC.
CONCLUSIONS: This study suggests that increased mOFC activation in response to positive emotional stimuli may reflect altered emotion regulation in ID. Sleep-related hyperarousal may be linked to changes in emotion processing, providing preliminary insight into the neural basis of emotional dysregulation in insomnia.
PMID:41188871 | DOI:10.1186/s12916-025-04437-9
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