Attention Bias Of Insomnia Groups Towards Emotional Information

Insomnia is a common sleep disorder that is often accompanied by negative emotions such as anxiety or depression.The dominant model in the field of insomnia cognition suggests that attention bias plays a key role in the onset and maintenance of insomnia.Meanwhile,studies have found that anxious and depressed patients tend to have an attentional bias toward negative emotional stimuli.Previous studies have focused more on the attentional bias to sleep-related stimuli in insomnia patients,and it is unclear whether negative attention bias exists in insomnia patients alone.Studying the attentional bias of negative emotions in general can help clarify whether negative emotional attentional bias plays a role in the pathological mechanisms of insomnia.Therefore,the present study first separated patients with and without concomitant mood disorders for insomnia and further explored whether attentional bias for negative emotional stimuli exists in insomnia patients alone without concomitant mood disorders.Study 1 explores the comorbidity distribution characteristics of insomnia and anxiety and depression.We collected data from 214 patients in the neurological department of the hospital,including the Insomnia Severity Index(ISI),the Generalized Anxiety Disorder Scale,and the Depression Screening Scale.The results showed that out of the 95 patients with severe insomnia(ISI >14),68% had moderate to severe anxiety or depression symptoms;out of the71 patients with mild insomnia(8 ≦ ISI ≦ 14),70% had moderate to severe anxiety or depression;among the 48 patients without insomnia(ISI <8),44% had moderate to severe anxiety or depression.The decrease in the proportion of anxiety and depression in the non-insomnia group indicates a certain relationship between insomnia and anxiety and depression.However,the severity of insomnia does not affect the proportion of anxiety and depression,indicating a separate mechanism between insomnia and anxiety and depression.Study 2 investigated whether moderate to severe insomnia patients without anxiety and depression have attention bias towards general positive and negative emotional stimuli.We used an innovative visual search paradigm that included competitive emotions(simultaneously angry and happy faces)and non-competitive emotions(only angry or happy faces)in two conditions,and adopted objective eye movement measures.The results showed that under competitive conditions,the probability of the normal group’s first eye movements falling on happy faces was higher than that of angry faces,while for the insomnia group,the probability of the first eye movements falling on angry faces was higher than that of happy faces.There was no significant difference between the insomnia group and the normal group under non-competitive conditions.The results indicate that pure insomnia patients without anxiety and depression also have a bias towards general negative emotional stimuli.In conclusion,the present study suggests that insomnia is associated with anxiety-depression but by independent mechanisms.When anxiety and depression were excluded,patients with insomnia alone also had an attentional bias toward negative emotional stimuli in general.This suggests that attentional bias to negative emotions may play a role in the pathogenesis of insomnia.