Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb 1;39(2):439-47.
doi: 10.5665/sleep.5460.

Neural Reward Processing Mediates the Relationship between Insomnia Symptoms and Depression in Adolescence

Melynda D Casement  1 , Kate E Keenan  2 , Alison E Hipwell  1 , Amanda E Guyer  3 , Erika E Forbes  1
Affiliations

Neural Reward Processing Mediates the Relationship between Insomnia Symptoms and Depression in Adolescence

Melynda D Casement et al. Sleep. .

Abstract

Study objectives: Emerging evidence suggests that insomnia may disrupt reward-related brain function-a potentially important factor in the development of depressive disorder. Adolescence may be a period during which such disruption is especially problematic given the rise in the incidence of insomnia and ongoing development of neural systems that support reward processing. The present study uses longitudinal data to test the hypothesis that disruption of neural reward processing is a mechanism by which insomnia symptoms-including nocturnal insomnia symptoms (NIS) and nonrestorative sleep (NRS)-contribute to depressive symptoms in adolescent girls.

Method: Participants were 123 adolescent girls and their caregivers from an ongoing longitudinal study of precursors to depression across adolescent development. NIS and NRS were assessed annually from ages 9 to 13 years. Girls completed a monetary reward task during a functional MRI scan at age 16 years. Depressive symptoms were assessed at ages 16 and 17 years. Multivariable regression tested the prospective associations between NIS and NRS, neural response during reward anticipation, and the mean number of depressive symptoms (omitting sleep problems).

Results: NRS, but not NIS, during early adolescence was positively associated with late adolescent dorsal medial prefrontal cortex (dmPFC) response to reward anticipation and depressive symptoms. DMPFC response mediated the relationship between early adolescent NRS and late adolescent depressive symptoms.

Conclusions: These results suggest that NRS may contribute to depression by disrupting reward processing via altered activity in a region of prefrontal cortex involved in affective control. The results also support the mechanistic differentiation of NIS and NRS.

Keywords: adolescence; affective processing; depression; fMRI; insomnia; nonrestorative sleep.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Positive association between INS scores during early adolescence and reward-related BOLD response during late adolescence.
Figure 2
Figure 2
Positive association between NRS scores during early adolescence and reward-related BOLD response during late adolescence.
Figure 3
Figure 3
Positive association between late adolescent depression scores and reward-related BOLD response in the dmPFC region that was also associated with early adolescent NRS scores.
See this image and copyright information in PMC

References

    1. American Academy of Sleep Medicine. Westchester, IL: American Academy of Sleep Medicine; 2005. The International Classification of Sleep Disorders, 2nd ed.: Diagnostic and coding manual.
    1. American Psychiatric Association. Arlington, VA: American Psychiatric Association; 2000. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. text revision.
    1. Edinger JD, Bonnet MH, Bootzin RR, et al. Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine Work Group. Sleep. 2004;27:1567–96. - PubMed
    1. Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiat. 2005;66:1254–69. - PubMed
    1. Taylor DJ, Lichstein KL, Durrence HH. Insomnia as a health risk factor. Behav Sleep Med. 2003;1:227–47. - PubMed

Publication types

MeSH terms