Executive Functions in Insomnia Disorder: A Systematic Review and Exploratory Meta-Analysis

Frontiers in Psychology

article

Andrea Ballesio¹  Maria Raisa Jessica V. Aquino²  Simon D. Kyle³  Fabio Ferlazzo¹  Caterina Lombardo¹ 

[1] Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome;Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom;Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom

关键词: insomnia;    executive functions;    inhibition;    working memory;    flexibility;    prefrontal cortex;    cognition;   

DOI  :  10.3389/fpsyg.2019.00101

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Executive functions (EFs) are involved in the control of basic psychological processes such as attention and memory and also contribute to emotion regulation. Research on the presence of EFs impairments in insomnia yielded inconsistent results. Therefore, we performed a systematic review of the literature on three EFs: inhibitory control, working memory, and cognitive flexibility in adults with insomnia in order to investigate the presence and magnitude of insomnia-related EFs impairments. Methods: PubMed, Scopus, Medline, and PsycINFO were searched. Risk of bias assessment of included studies was performed by two independent researchers. Findings were summarised using both a narrative approach and meta-analysis. Cohen's d was calculated at 95% confidence interval (CI) as effect size of between groups differences. Results: Twenty-eight studies comparing adult individuals with a diagnosis of insomnia and healthy controls on neuropsychological measures of EFs were included. Narrative synthesis revealed substantial variability across study findings. Factors that were primarily hypothesised to account for this variability are: objective sleep impairments and test sensitivity. Exploratory meta-analysis showed impaired performance of small to moderate magnitude in individuals with insomnia as compared to controls in reaction times, but not accuracy rates, of inhibitory control ( d = −0.32, 95% CI: −0.52 to −0.13) and cognitive flexibility tasks ( d = −0.30, 95% CI: −0.59 to −0.01). Performance in working memory tasks was also significantly impacted ( d = −0.19, 95% CI: −0.38 to −0.00). Effects sizes were larger when insomnia was associated with objective sleep impairments, rather than normal sleep. Conclusions: We gathered evidence supporting small to moderate deficits in EFs in individuals with insomnia. Due to the small sample size results should be considered preliminary and interpreted carefully.

【 授权许可】

CC BY