The Role of Sleep Quality, Trait Anxiety and Hypothalamic-Pituitary-Adrenal Axis Measures in Cognitive Abilities of Healthy Individuals.

Javier Labad,Lourdes Martorell,Mikel Urretavizcaya,Neus Salvat-Pujol,Diego José Palao,Roser Nadal,José Manuel Crespo,Ángel Cabezas,José Manuel Menchón,José Antonio Monreal,Virginia Soria,Antonio Armario,Aida De Arriba-Arnau,Elisabet Vilella

doi:10.3390/ijerph17207600

Abstract

Sleep plays a crucial role in cognitive processes. Sleep and wake memory consolidation seem to be regulated by glucocorticoids, pointing out the potential role of the hypothalamic-pituitary-adrenal (HPA) axis in the relationship between sleep quality and cognitive abilities. Trait anxiety is another factor that is likely to moderate the relationship between sleep and cognition, because poorer sleep quality and subtle HPA axis abnormalities have been reported in people with high trait anxiety. The current study aimed to explore whether HPA axis activity or trait anxiety moderate the relationship between sleep quality and cognitive abilities in healthy individuals. We studied 203 healthy individuals. We measured verbal and visual memory, working memory, processing speed, attention and executive function. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Trait anxiety was assessed with the State-Trait Anxiety Inventory. HPA axis measures included the cortisol awakening response (CAR), diurnal cortisol slope and cortisol levels during the day. Multiple linear regression analyses explored the relationship between sleep quality and cognition and tested potential moderating effects by HPA axis measures and trait anxiety. Poor sleep quality was associated with poorer performance in memory, processing speed and executive function tasks. In people with poorer sleep quality, a blunted CAR was associated with poorer verbal and visual memory and executive functions, and higher cortisol levels during the day were associated with poorer processing speed. Trait anxiety was a moderator of visual memory and executive functioning. These results suggest that subtle abnormalities in the HPA axis and higher trait anxiety contribute to the relationship between lower sleep quality and poorer cognitive functioning in healthy individuals.

Highlights

Both poorer sleep quality and longer duration of sleep have been associated with impaired cognitive performance in middle-age and older adults [1,2,3]
The main aim of our study was to explore whether HPA axis activity or trait anxiety moderate the relationship between sleep quality and cognitive abilities in healthy individuals
We found that the relationship between sleep quality and cognitive performance in the Brief Visuospatial Memory Test Revised (BVMT-R) task was moderated by trait anxiety (Table S2)

Summary

Introduction

Both poorer sleep quality and longer duration of sleep have been associated with impaired cognitive performance in middle-age and older adults [1,2,3]. Individuals with poor sleep quality are more likely to experience depressive symptoms and state and trait anxiety, as well as a negative cognitive bias (enhanced recognition of negative images) and decreased sustained attention to non-emotional stimuli [7]. Trait anxiety, which is closely related to neuroticism and refers to the stable tendency to experience negative emotions, is a risk factor for major depression [9] and impairs the processing efficiency of manipulating working memory contents [10]. Other authors argue that REM sleep serves no role in the processing or consolidation of memory [14]. Sleep deprivation has been associated with impairments in memory recall depending on the emotional content of memories, as positive and neutral memories are more susceptible to disruption by sleep loss than memories for negatively valanced material [15]. The deleterious effects of sleep deprivation on cognition appear to emerge from the interaction between the task environment and specific components of cognitive functioning [16]

Methods

Results

Discussion

Conclusion