Reciprocal causation relationship between rumination thinking and sleep quality: a resting-state fMRI study

Rumination thinking is a type of negative repetitive thinking, a tendency to constantly focus on the causes, consequences and other aspects of negative events, which has implications for a variety of psychiatric disorders. Previous studies have confirmed a strong association between rumination thinking and poor sleep or insomnia, but the direction of causality between the two is not entirely clear. This study examined the relationship between rumination thinking and sleep quality using a longitudinal approach and resting-state functional MRI data. Participants were 373 university students (males: n = 84, 18.67 ± 0.76 years old) who completed questionnaires at two time points (T1 and T2) and had resting-state MRI data collected. The results of the cross-lagged model analysis revealed a bidirectional causal relationship between rumination thinking and sleep quality. Additionally, the functional connectivity (FC) of the precuneus and lingual gyrus was found to be negatively correlated with rumination thinking and sleep quality. Furthermore, mediation analysis showed that rumination thinking at T1 fully mediated the relationship between FC of the precuneus-lingual and sleep quality at T2. These findings suggest that rumination thinking and sleep quality are causally related in a bidirectional manner and that the FC of the precuneus and lingual gyrus may serve as the neural basis for rumination thinking to predict sleep quality. Overall, this study provides new insights for enhancing sleep quality and promoting overall health.

The online version contains supplementary material available at 10.1007/s11571-025-10223-3.