Interaction of Sleep and Emotion across the Menstrual Cycle

With twice the lifetime risk of developing mood and anxiety disorders (i.e., affective disorders) women exhibit unique psychiatric vulnerability. Reproductive hormones are postulated as a mechanism of heightened risk based on their neurological ties to emotion centers in the brain and established role in several specific mood disorders. Even in healthy women, increases in negative emotion and emotional reactivity are observed during the perimenstrual (i.e., late luteal and early follicular) phase of the monthly menstrual cycle. Similarly, poor quality sleep, which is known to negatively alter mood and aspects of emotion processing, occurs at higher rates during the perimenstrual compared to other menstrual phases. The role and potential contribution of sleep disruption in the manifestation and expression of monthly emotional changes, however, has not been systematically examined. The objective of this project was to evaluate how sleep-wake patterns interact with menstrual phase to predict positive and negative aspects of emotional processing; thereby shaping affective risk. A total of 51 females ages 18-35 completed continuous sleep monitoring (actigraphy, daily diaries) and emotional tracking (ecological momentary assessment) over two menstrual months. Data were collected from April – December 2020, during which time the novel coronavirus was surging in the US. For this reason, pandemic-related stress was included as a covariate in all models. Results indicated that daily reports of anger and sleep disturbance were highest in the perimenstrual phase. When the interaction of poor sleep and menstrual phase was considered, however, positive emotion variables showed the greatest variation, such that when sleep was more disrupted during the perimenstrual phase, positive emotions decreased to a greater extent than when these variables were considered alone. These findings suggest that one mechanism through which menstrual phase increases affective risk may be through sleep’s relationship with positive emotion.