The mediating roles of emotional reactivity and regulation in the relationship between insomnia, depression, and anxiety

Abstract

Insomnia is bidirectionally related to mood disturbances. Emotional reactivity and regulation are often proposed as mechanisms explaining the relationship between insomnia and mood disorders. However, previous studies of the potential mediating effects of emotional reactivity and regulation were primarily cross-sectional. Hence, two studies were conducted to evaluate the prospective associations among insomnia, mood disturbances, and emotional reactivity and regulation. Study 1 investigated the mediating effects of emotional reactivity and regulation in the relationship between sleep disturbances and depression in a two-week daily study on sixty individuals with insomnia at baseline. It was hypothesized that sleep disturbances on one night would predict more next-day depressive symptoms and vice versa, mediated by reduced positive reactivity, heightened negative reactivity, less frequent use of adaptive regulating strategies, and more frequent use of maladaptive strategies. The results showed that self-report sleep quality on one night predicted next-day depressive symptoms and vice-versa, mediated by negative reactivity. The second study was a three-wave, three-month longitudinal study. The participants were nine hundred and twenty-four individuals with insomnia. It was hypothesized that insomnia symptoms would have a bidirectional relationship with depressive symptoms in three months, mediated by reduced positive reactivity, heightened negative reactivity, less frequent use of adaptive regulating strategies, and more frequent use of maladaptive strategies. The insomnia-anxiety relationship was also examined in Study 2. Insomnia symptoms and anxiety symptoms were hypothesized to be bidirectionally related, with their relationship uniquely mediated by negative reactivity and threat-related regulating strategies. The results showed that depressive symptoms predicted insomnia symptoms (but not vice versa) via negative emotional reactivity, rumination, and catastrophizing; and that insomnia symptoms and anxiety symptoms predicted each other via negative reactivity and rumination. These novel findings highlighted the importance of targeting these emotional processes in assessing and treating individuals with insomnia and mood disorders.