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The benefit and neural mechanisms of computerized inhibitory control training for insomnia with short sleep duration

Haobo Zhang¹, Zhangwei Lv¹, Hanfei Chen¹

¹Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China.

Behaviour Research and Therapy

|May 21, 2025

Abstract

Background:

Inhibitory control (IC) impairment is characteristic of insomnia disorder with short sleep duration (ISSD), but not with normal sleep duration (INSD). IC is critical for sleep-wake regulation. This study evaluates whether computerized IC training can improve sleep in ISSD and explores related neural mechanisms using resting-state fMRI (rs-fMRI).

Methods:

Twenty ISSD patients participated in a three-week computerized IC training program (15 sessions), alongside a control group of 17 participants. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI), complemented by objective measures from overnight EEG recordings. Neuroimaging analyses focused on changes in regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuations (fALFF), and functional connectivity (FC) in brain regions associated with IC.

Results:

Computerized IC training led to significant improvements in both subjective and objective sleep quality, demonstrated by reductions in PSQI and ISI scores, as well as decreased wake time during sleep. Neuroimaging revealed increased ReHo in the left medial orbitofrontal cortex (MOFC), elevated fALFF in the right middle frontal gyrus (MFG), and enhanced FC between the MOFC and the right rectus gyrus (RG), which correlated with improvements in sleep measures.

Conclusion:

Computerized IC training appears to be an effective intervention for improving sleep in ISSD, likely by inducing functional changes in prefrontal cortex regions. These findings underscore the potential of IC-targeted treatments for ISSD and highlight the need for future research to evaluate the long-term effects of such interventions.

Trial Registration:

The study was prospectively registered on May 30, 2024, in Chinese Clinical Trials registry (ChiCTR2400085063).

Keywords:

Computerized training Inhibitory control Insomnia disorder Resting-state functional magnetic resonance imaging Short sleep duration phenotype

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