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

Donna Ewing, Miranda Manassei, Cassandra Gould van Praag, Andrew Philippides, Hugo Critchley, Sarah Garfinkel

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)163-172
Number of pages10
JournalBiological Psychology
Publication statusPublished - 26 May 2017

Bibliographical note

© 2017 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (


  • Interoception
  • Interoceptive accuracy
  • Interoceptive sensibility
  • Interoceptive awareness
  • Sleep quality
  • Anxiety
  • Depression


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