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Decreased regional brain activity in response to sleep‐related sounds after cognitive behavioral therapy for psychophysiological insomnia
Author(s) -
Kim Nambeom,
Kang SeungGul,
Lee Yu Jin,
Kim Seog Ju,
Kim Soohyun,
Choi JaeWon,
Oh Seong Min,
Park Juhyun,
Gwak Ah Reum,
Kim HangKeun,
Jeong DoUn
Publication year - 2019
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/pcn.12822
Subject(s) - brain activity and meditation , insomnia , functional magnetic resonance imaging , psychology , cognitive behavioral therapy for insomnia , fight or flight response , audiology , primary insomnia , neuroscience , cognition , electroencephalography , medicine , sleep disorder , psychiatry , cognitive behavioral therapy , biochemistry , chemistry , gene
Aim Patients with psychophysiological insomnia (PI) experience hyperarousal, especially as a reaction to sound stimuli. In the current study, we explored brain activity changes in response to sleep‐related sounds (SS) in patients with insomnia after cognitive behavioral therapy for insomnia (CBT‐I). Methods In 14 drug‐free PI patients, regional brain activity in response to SS, and to white noise sound (NS) as neutral stimuli, was investigated before and after individual CBT‐I using functional magnetic resonance imaging. Blood oxygen level‐dependent (BOLD) signals to SS and NS were compared before and after CBT‐I. In addition, the association between clinical improvement after CBT‐I and changes in brain activity in response to SS and NS was analyzed. Results Compared with baseline, regional brain activity in response to SS after CBT‐I decreased in the left middle temporal and left middle occipital gyrus. In regression analysis, a reduction in the Dysfunctional Beliefs and Attitudes about Sleep (DBAS) Scale score after CBT‐I was associated with decrease in brain activity in response to SS in both thalami. However, brain activity in response to NS showed no BOLD signal changes and no association with DBAS change. Conclusion Cortical hyperactivity, which may cause hyperarousal in PI, was found to decrease after CBT‐I. CBT‐I targeting changes in beliefs and attitudes about sleep may induce its therapeutic effects by reducing thalamic brain activity in response to sleep‐related stimuli.