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Sleep and affect: A conceptual review - PubMed

Review

Sleep and affect: A conceptual review

Maia Ten Brink et al. Sleep Med Rev. 2022 Oct.

Abstract

Everyday experience suggests that sleep and affect are closely linked, with daytime affect influencing how we sleep, and sleep influencing subsequent affect. Yet empirical evidence for this bidirectional relationship between sleep and affect in non-clinical adult samples remains mixed, which may be due to heterogeneity in both construct definitions and measurement. This conceptual review proposes a granular framework that deconstructs sleep and affect findings according to three subordinate dimensions, namely domains (which are distinct for sleep and affect), methods (i.e., self-report vs. behavioral/physiological measures), and timescale (i.e., shorter vs. longer). We illustrate the value of our granular framework through a systematic review of empirical studies published in PubMed (N = 80 articles). We found that in some cases, particularly for sleep disturbances and sleep duration, our framework identified robust evidence for associations with affect that are separable by domain, method, and timescale. However, in most other cases, evidence was either inconclusive or too sparse, resulting in no clear patterns. Our review did not find support for granular bidirectionality between sleep and affect. We suggest a roadmap for future studies based on gaps identified by our review and discuss advantages and disadvantages of our granular dimensional framework.

Keywords: Affect; Conceptual review; Framework; Granularity; Methods; Sleep; Timescales.

Copyright © 2022 Elsevier Ltd. All rights reserved.

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Figures

Fig. 1.
Fig. 1.

Bidirectional spiral depicting relationships between sleep and affect unfolding dynamically over time.

Fig. 2.
Fig. 2.

Organizing framework concept and execution. Panel A: Conceptual representation of our framework describing sleep and affect constructs (in black) as three dimensions. Domains are represented in gold and populated with six example categories. Methods are represented in blue and populated with two example categories. Timescales are represented in teal and populated with two categories. These specific categories are flexible, as represented by the ellipses, so the number and identity of categories within each dimension can change, as well as the number and identity of dimensions. In the present review, we used the following categories: 10 sleep and 14 affect domains (see Tables S2–S4 for the full set of domains used in the present review), two methods, self-report (in light blue) and behavioral/physiological signals (in bold blue); and two timescales, short-term (in light teal) and long-term (in bold teal). The diagonal gray lines represent a hypothetical study in which sleep and affect are each assessed within two categories of domain, and for each of those, two methods at two timescales, for a total of eight observations. In this example, there are seven unique associations. As an example of how to interpret each association, we draw attention to one single association (represented by a thick black line); the association is between short-term self-reported sleep duration and long-term self-reported negative valence. Panel B: Representation of the practical execution of organizing multiple studies into matrices (see Tables S2–S4) using the conceptual structure depicted in Panel A. The single association from Panel A is entered in one cell (represented as a black dot). Multiple associations from one study table (multiple black dots) as well as from different studies (different colored dots) can be entered into the table. In order to derive conclusions about associations, we analyze results from multiple studies in a given cell. Different study designs, population samples, or other categorical moderators can be expressed as different versions of this matrix.

Fig. 3.
Fig. 3.

PRISMA 2020 flow diagram for new systematic reviews that included searches of databases and registers only. Note: Two studies (indicated by an asterisk, *) that were known to the authors were not picked up by the search due to a PubMed classification error.

Fig. 4.
Fig. 4.

Summary of findings for cross-sectional associations between sleep and affect. This figure summarizes Table S2. Only columns and rows from Table S2 that contain at least three studies in one cell are included. The column and row headers represent domains (gold), methods (blue), and timescales (teal). The size of the bubble represents our confidence in the strength of the result. Low, moderate, and high confidence correspond to small, medium, and large bubbles respectively. The number in the center of the bubble represents the number of studies in a given cell. The color of the bubble represents the direction of evidence for the association. Light hues represent possible evidence for association and bold hues represent robust evidence for association. All associations are in the direction represented by their domain labels. For a positive association between duration and negative valence, for example, that means that higher negative valence is associated with longer duration.

Fig. 5.
Fig. 5.

Summary of findings for sequential studies in which affect temporally precedes sleep. This figure summarizes Table S3. Only columns and rows from Table S3 that contain at least three studies in one cell are included. The column and row headers represent domains (gold), methods (blue), and timescales (teal). The size of the bubble represents our confidence in the strength of the result. Low, moderate, and high confidence correspond to small, medium, and large bubbles respectively. The number in the center of the bubble represents the number of studies in a given cell. The color of the bubble represents the direction of evidence for the association. Light hues represent possible evidence for association and bold hues represent robust evidence for association. All associations are in the direction represented by their domain labels. For a positive association between duration and negative valence, for example, that means that higher negative valence is associated with longer duration.

Fig. 6.
Fig. 6.

Summary of findings for sequential studies in which sleep temporally precedes affect. This figure summarizes Table S4. Only columns and rows from Table S4 that contain at least three studies in one cell are included. The column and row headers represent domains (gold), methods (blue), and timescales (teal). The size of the bubble represents our confidence in the strength of the result. Low, moderate, and high confidence correspond to small, medium, and large bubbles respectively. The number in the center of the bubble represents the number of studies in a given cell. The color of the bubble represents the direction of evidence for the association. Light hues represent possible evidence for association and bold hues represent robust evidence for association. All associations are in the direction represented by their domain labels. For a positive association between duration and negative valence, for example, that means that higher negative valence is associated with longer duration. Asterisks (*) indicate that the conclusions are impacted if sleep manipulation studies are excluded.

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