# A Novel Use of a Sleep Intervention to Target the Emotion Regulation Brain Network and Treat Depression and Anxiety

> **NIH NIH R61** · STANFORD UNIVERSITY · 2020 · $944,204

## Abstract

PROJECT SUMMARY/ABSTRACT
Background: Several lines of evidence suggest that insomnia contributes to emotionally distressing
depressive mood symptoms through disruption of brain networks that regulate emotional functions. Of
particular concern, insomnia is associated with an increased risk for suicide, even when accounting for the
presence of other depressive symptoms. However, we do not yet know to what degree that the emotion
regulation brain network is modified by the restoration of sleep, or whether the degree to which a sleep
intervention engages these neural targets mediates reductions in depressive symptoms and suicidality.
Objective: This proposal investigates the impact of a proven sleep intervention on engagement of the emotion
regulation brain network as a putative mechanistic target. DESIGN/METHODS: In the R61 phase, a
mechanistic trial will demonstrate feasibility and establish whether the emotion regulation brain network is
modified (the target is engaged) when patients show improvements in insomnia symptoms following a proven
psychosocial sleep intervention. Participants will be 70 adults experiencing elevated depressive symptoms and
clinically meaningful insomnia. Depressive symptoms and insomnia will be assessed prior to, and weekly while
receiving six Cognitive Behavioral Therapy for Insomnia (CBT-I) sessions across a period of eight weeks. CBT-I
improves sleep patterns through a combination of sleep restriction, stimulus control, mindfulness training,
cognitive therapy targeting dysfunctional beliefs about sleep, and sleep hygiene education. Emotion regulation
network neural targets will be assayed prior to and following completion of CBT-I treatment. If the Go milestone
criteria are met, the R33 phase (years 3-5) will include a 2-arm randomized controlled trial. We will enroll new
participants (n=150) and randomize them in a 1:1 ratio to the CBT-I or to the credible control treatment for
insomnia group. Participants will complete a refined measurement protocol based on the R61 phase study.
Specific aims: R61 aims are to demonstrate (1) feasibility and (2) that CBT-I modifies emotion regulation
network function according to pre-specified Go milestone criteria. R33 aims are to (1) confirm target
engagement by testing the hypothesis that compared with an active control condition, CBT-I participants will
show significant change in the emotion regulation network targets that met the Go Criteria of Study 1 in the
direction of normalization, at the end of treatment, (2) examine the relationships of target engagement to
treatment outcomes by study group, and (3) test whether emotion regulation network measures at baseline
predict depressive symptom and suicidality reduction. IMPACT: Characterizing these associations may offer
the potential to gain a deeper understanding of the neurobiological mechanisms underlying depression in the
presence of insomnia. Our results will advance an evidence-based mechanistic approach to treating, and
ul...

## Key facts

- **NIH application ID:** 9956431
- **Project number:** 1R61MH120245-01A1
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Andrea Goldstein-Piekarski
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $944,204
- **Award type:** 1
- **Project period:** 2020-07-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9956431

## Citation

> US National Institutes of Health, RePORTER application 9956431, A Novel Use of a Sleep Intervention to Target the Emotion Regulation Brain Network and Treat Depression and Anxiety (1R61MH120245-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9956431. Licensed CC0.

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