The role of objective sleep in implicit and explicit affect regulation : A comprehensive review

Impairments in sleep and affect regulation are evident across a wide range of mental disorders. Understanding the sleep factors that relate to affect regulatory difficulties will inform mechanistic understanding and aid in treatment. Despite rising interest, some research challenges in this area include integrating across different clinical and non-clinical literatures investigating the role of sleep architecture (measured with polysomnography) and experimentally manipulated sleep, as well as integrating more explicit versus implicit affect regulation processes. In this comprehensive review, we use a unifying framework to examine sleep's relationship with implicit-automatic regulation and explicit-controlled regulation, both of which are relevant to mental health (e.g., PTSD and depression). Many studies of implicit-automatic regulation (e.g., fear extinction and safety learning) demonstrate the importance of sleep, and REM sleep specifically. Studies of explicit-controlled regulation (e.g., cognitive reappraisal and expressive suppression) are less consistent in their findings, with results differing depending on the type of affect regulation and/or way that sleep was measured or manipulated. There is a clear relationship between objective sleep and affect regulation processes. However, there is a need for 1) more studies focusing on sleep and explicit-controlled affect regulation; 2) replication with the same types of regulation strategies; 3) more studies experimentally manipulating sleep to examine its impact on affect regulation and vice versa in order to infer cause and effect; and 4) more studies looking at sleep's impact on next-day affect regulation (not just overnight change in affect reactivity).
CC BY-NC-ND 4.0Corresponding author: 4150 Clement St. (116P), San Francisco, CA, 94121, USA. E-mail address: laura.straus@ucsf.edu (L.D. Straus).LDS is supported by the Department of Veterans Affairs Clinical Science Research and Development Award: IK2CX002032. P.S. was supported by research grants from Emil Aaltonen Foundation (Finland), Alfred Kordelin Foundation (Finland), and the Finnish Cultural Foundation. MtB was supported by research fellowships from the National Science Foundation, P.E.O. International, and the American Association of University Women. PJC is supported by Veterans Affairs RR&D Merit Award 1 I01 RX003623-01.