Sleep and the heart: Interoceptive differences linked to poor experiential sleep quality in anxiety and depression

- Poor sleep quality differentially impacts interoception across diagnoses.
- For all diagnoses, poor sleep quality was linked with poor interoceptive accuracy.
- For all diagnoses, poor sleep was linked with enhanced interoceptive sensibility.
- For depression and mixed diagnoses, poor sleep impaired metacognitive awareness.

Interoception is the sense through which internal bodily changes are signalled and perceived. Individual differences in interoception are linked to emotional style and vulnerability to affective disorders. Here we test how experiential sleep quality relates to dimensions of interoceptive ability. 180 adults (42 'non-clinical' individuals, 138 patients accessing mental health services) rated their quality of sleep before performing tests of cardiac interoception. Poor sleep quality was associated with lower measures of interoceptive performance accuracy, and higher self-report measures of interoceptive sensibility in individuals with diagnoses of depression and/or anxiety. Additionally, poor sleep quality was associated with impaired metacognitive interoceptive awareness in patients with diagnoses of depression (alone or with anxiety). Thus, poor sleep quality, a common early expression of psychological disorder, impacts cardiac interoceptive ability and experience across diagnoses. Sleep disruption can contribute to the expression of affective psychopathology through effects on perceptual and interpretative dimensions of bodily awareness.