Nerve Cells Associated with Sleep Targeted in Anxiety Disorders

By Rick Naurert PhD
September 13th, 2021
Medically reviewed by Paul Sietes, MD.

Nerve Cells Associated with Sleep Targeted in Anxiety Disorders    New research suggests a group of cells activated during rapid eye movement (REM) sleep is critical for the regulation of emotional memory processing.

Boston University School of Medicine (BUSM) researchers say their finding could one day help lead to the development of effective behavioral and pharmacological therapies to treat anxiety disorders, such as post-traumatic stress disorder, phobias and panic attacks.

The research findings are published in the Journal of Neuroscience.

Experts explain that there are two main stages of sleep — REM and non-REM — and both are necessary to maintain health and to regulate multiple memory systems, including emotional memory.

Non-REM sleep is associated with repair and maintenance as the body repairs tissue and improves the function of the body’s immune system.

During REM sleep, the brain becomes more active and the muscles of the body become paralyzed. Dreaming generally occurs during REM sleep, as well as physiological events including saccadic eye movements and rapid fluctuations of respiration, heart rate and body temperature.

One particular hallmark  of REM sleep is the appearance of phasic pontine waves (P-waves). The P-wave is a unique brain wave generated by the activation of a group of cells involving the neurotransmitter glutamate. This particular group is  in the brainstem in a structure called the pons.

Researchers say the memories of fearful experiences can lead to enduring alterations in emotion and behavior and sleep plays a natural emotional regulatory role after stressful and traumatic events.

Persistence of sleep disturbances, particularly of REM sleep, is predictive of developing symptoms of anxiety disorders.

A core symptom of these disorders frequently reported by patients is the persistence of fear-provoking memories that they are unable to extinguish.

Current intervention frequently includes exposure therapy, which involves controlled re-exposure to the original fearful experience. This modality is considered one of the most effective evidence-based treatments for anxiety disorders.

Exposure therapy produces a new memory, called an extinction memory, to coexist and compete with the fearful memory when the fearful cue/context is re-encountered.

The strength of the extinction memory determines the efficacy of exposure therapy. A demonstrated prerequisite for the successful development of an extinction memory is adequate sleep, particularly REM sleep, after exposure therapy.

However, adequate or increased sleep alone does not universally guarantee its therapeutic efficacy.

“Given the inconsistency and unpredictability of exposure therapy, we are working to identify which process(es) during REM sleep dictate the success or failure of exposure therapy,” said Subimal Datta, Ph.D., director and principal investigator at the Laboratory of Sleep and Cognitive Neuroscience and the study’s lead author.

The researchers used contextual fear extinction training, which works to turn off the conditioned fear, to study which brain mechanisms play a role in the success of exposure therapy.

The study results showed that fear extinction training increased REM sleep. Surprisingly, however, only 57 percent of subjects retained fear extinction memory, meaning that they did not experience the fear, after 24 hours.

There was a tremendous increase of phasic P-wave activity among those subjects. In 43 percent of subjects, however, the wave activity was absent and they failed to retain fear extinction memory, meaning that they re-experienced fear.

“The study results provide direct evidence that the activation of phasic P-wave activity within the brainstem, in conjunction with exposure therapy, is critical for the development of long-term retention of fear extinction memory,” said Datta.

In addition, the study indicates the important role that the brainstem plays in regulating emotional memory.

Researchers call for future studies to explore how to activate this mechanism in order to help  develop potential pharmacological treatments; these could complement exposure therapy to better treat anxiety and other psychological disorders.

Source: Boston University Medical Center

Abstract image of the brain photo by shutterstock.

Dr. Rick Naurert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Naurert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.