Anger is a multi-dimensional concept ranging from feeling irritable to violent aggression. A growing body of literature suggests the relevance of sleep in regard to anger. The current study aims to review previous studies on the association between anger and diverse aspects of sleep including sleep disruption, chronotype, sleep disorders and sleep deprivation. An association between sleep and anger has been observed starting in the early stage of life, with sleep of infants or toddlers affecting emotional and behavioral aspects of anger. However, the association between anger and sleep is not clear in adolescents and might be due to the effects of psychosocial factors on both sleep and anger during adolescence. Subjective but not objective sleep disturbances of adults have been also associated with anger. Evening types showed more anger, which might be mediated by psychological characteristics or social jet lag of evening people. Increased anger has also been found in those with insomnia, sleep apnea, or experimental sleep-deprivation. Previous studies have reported that diverse sleep disturbances are related to anger. Future study assessing the various sleep or circadian indices and considering the multidimensional aspects of anger are needed.
과민성(irritability), 공격성(aggression), 적대감(hostility) 등
다양한 정서와 행동을 포괄하는 분노의 특성으로 인해, 분노에 대한 조작적 정의는 연구마다 다소 차이가 있으며, 분노를 구성하는 하위 증상을 함께 다루는 연구가 많다. 대표적인 분노 관련 하위 증상으로는 과민성(irritability), 공격성(aggression), 적대감(hostility) 등이 있다(Anderson과 Bushman 2002). 과민성은 ‘쉽게 짜증내고 분노가 유발되는 상태’로 정의하며(American Psychiatric Association 2013), 종종 ‘화난 기분(angry mood)’과 같은 뜻으로 사용한다(Safer 등 2009).
분노 증상은 주로 자기보고설문으로 측정한다. 상태-특성 분노표현척도(State-Trait Anger Expression Inventory-2, STAXI-2)는 분노를 ‘분노 특성’과 ‘분노 표현’ 두 소척 도로 측정한다(Spielberger 1999). ‘분노 특성’ 소척도는 분노 기질(angry temperament)과 분노 반응, ‘분노 표현’ 소척도는 분노 내면화(anger-in), 분노 외현화(anger-out), 분노 통제(anger-control) 세 영역으로 나뉘어 분노의 다양한 특성을 다룬다.
Adan A, Lachica J, Caci H, Natale V. Circadian typology and temperament and character personality dimensions. Chronobiol Int 2010;27:181-193.
Adolphs R. Recognizing emotion from facial expressions: psychological and neurological mechanisms. Behav Cog Neurosci Rev 2002;1:21-62.
Alfano CA, Gamble AL. The role of sleep in childhood psychiatric disorders. Paper presented at: Child & youth care forum;2009.
Anderson CA, Bushman BJ. Human aggression. Ann Rev Psy 2002;53:27-51.
Anderson CA, Bushman BJ. The effects of media violence on society. Science 2002;295:2377-2379.
Anderson CA, Carnagey NL. Violent Evil and the General Aggression Model. Social Psy Good & Evil 2004:168-192.
Association AP. Diagnostic and statistical manual of mental disorders. BMC Med 2013;17:133-137.
Aydin A, Selvi Y, Besiroglu L, Boysan M, Atli A, Ozdemir O, et al. Mood and metabolic consequences of sleep deprivation as a potential endophenotype' in bipolar disorder. J Affect Dis 2013; 150:284-294.
Barker LF, Ireland JL, Chu S, Ireland CA. Sleep and its association with aggression among prisoners: quantity or quality? Int J Law Psychiatry 2016;47:115-121.
Baron RA, Richardson DR. Human Aggression (2nd ed.). Boston: Allyn & Bacon;1994
Biggs SN, Nixon GM, Horne RS. The conundrum of primary snoring in children: what are we missing in regards to cognitive and behavioural morbidity? Sleep Med Rev 2014;18:463-475.
Biggs SN, Tamanyan K, Walter LM, Weichard AJ, Davey MJ, Nixon GM, et al. Overweight and obesity add to behavioral problems in children with sleep-disordered breathing. Sleep Med 2017;39:62-69.
Biggs SN, Walter LM, Jackman AR, Nisbet LC, Weichard AJ, Hollis SL, et al. Long-term cognitive and behavioral outcomes following resolution of sleep disordered breathing in preschool children. PLoS One 2015;10:e0139142.
Brissette I, Cohen S. The contribution of individual differences in hostility to the associations between daily interpersonal conflict, affect, and sleep. Personal & Soc Psy Bull 2002;28:1265-1274.
Buijs FN, Leon-Mercado L, Guzman-Ruiz M, Guerrero-Vargas NN, Romo-Nava F, Buijs RM. The circadian system: a regulatory feedback network of periphery and brain. Physiology 2016;31:170-181.
Buss AH & Perry M. The aggression questionnaire. J Pers Soc Psychol 1992;63:452.
Cai W, Rambaud J, Teboul M, et al. Expression levels of estrogen receptor $\beta$ are modulated by components of the molecular clock. Mole Cell Biol 2008;28:784-793.
Carney CE, Harris AL, Moss TG, Edinger JD. Distinguishing rumination from worry in clinical insomnia. Behav Res Therap 2010;48:540-546.
Chrobak AA, Tereszko A, Dembinska-Krajewska D, Arciszewska A, Siwek M, Dudek D, et al. Morningness-eveningness and affective temperaments assessed by the Temperament Evaluation of Memphis, Pisa and San Diego-Autoquestionnaire (TEMPS-A). Chronobiol Int 2017;34:57-65.
Cronlein T, Langguth B, Eichhammer P, Busch V. Impaired recognition of facially expressed emotions in different groups of patients with sleep disorders. PloS One 2016;11:e0152754.
Daniela T, Alessandro C, Giuseppe C, Fabio M, Cristina M, Michele F. Lack of sleep affects the evaluation of emotional stimuli. Brain Res Bull 2010;82:104-108.
Dinges DF, Pack F, Williams K, Gillen KA, Powell JW, Ott GE, et al. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep 1997;20:267-277.
Duffy JF, Willson HJ, Wang W, Czeisler CA. Healthy older adults better tolerate sleep deprivation than young adults. J Am Geriatri Soc 2009;57:1245-1251.
Engin E, Keskin G, Dulgerler S, Bilge A. Anger and alexithymic characteristics of the patients diagnosed with insomnia: a control group study. J Psychiatry Mental Health Nurs 2010;17:692-699.
Erwin BA, Heimberg RG, Schneier FR, Liebowitz MR. Anger experience and expression in social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitive-behavioral treatment. Behav Therapy 2003;34:331-350.
Feldman JM, Lehrer PM, Hochron SM. The predictive value of the Toronto Alexithymia Scale among patients with asthma. J Psychosomat Res 2002;53:1049-1052.
Franzen PL, Buysse DJ, Dahl RE, Thompson W, Siegle GJ. Sleep deprivation alters pupillary reactivity to emotional stimuli in healthy young adults. Biol Psy 2009;80:300-305.
Freitag L, Ireland JL, Niesten IJ. Exploring the relationship between sleep quality, emotional well-being and aggression levels in a European sample. J Aggression, Conflict, Peace Res 2017;9:167-177.
Gottschalk LA, Gleser GC, Springer KJ. Three hostility scales applicable to verbal samples. Arch of Gen Psychiatry 1963;9:254-279.
Guadagni V, Burles F, Valera S, Hardwicke-Brown E, Ferrara M, Campbell T, et al. The relationship between quality of sleep and emotional empathy. J Psychophysiol 2017;31:158-166.
Hintsanen M, Puttonen S, Smith K, Tornroos M, Jokela M, Pulkki-Raback L, et al. Five-factor personality traits and sleep: Evidence from two population-based cohort studies. Health Psy 2014;33:1214.
Hisler G, Krizan Z. Anger tendencies and sleep: Poor anger control is associated with objectively measured sleep disruption. J Res Personality 2017;71:17-26.
Hwang JY, Kang SG, Gwak AR, Park J, Lee YJ. The associations of morningness-eveningness with anger and impulsivity in the general population. Chronobiol Int 2016;33:200-209.
Kalmbach DA, Pillai V, Roth T, Drake CL. The interplay between daily affect and sleep: A 2-week study of young women. J Sleep Res 2014;23:636-645.
Kang JI, Park CI, Sohn SY, Kim HW, Namkoong K, Kim SJ. Circadian preference and trait impulsivity, sensation-seeking and response inhibition in healthy young adults. Chronobiol Int 2015; 32:235-241.
Killgore WD, Kahn-Greene ET, Lipizzi EL, Newman RA, Kamimori GH, Balkin TJ. Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills. Sleep Med 2008;9:517-526.
Killgore WD. Self-reported sleep correlates with prefrontal-amygdala functional connectivity and emotional functioning. Sleep 2013;36:1597-1608.
Kim S, Kim S. Assessment and understanding of chronotype. Sleep Med Psychophysio 2019;26:5-15.
King JA, Tenney J, Rossi V, Colamussi L, Burdick S. Neural substrates underlying impulsivity. Ann NY Acad Sci 2003;1008:160-169.
Ko CH, Takahashi JS. Molecular components of the mammalian circadian clock. Human Mol Gen 2006;15:R271-R277.
Koh KB, Kim CH, Park JK. Predominance of anger in depressive disorders compared with anxiety disorders and somatoform disorders. J Clin Psychiatry 2002;64:486-492.
Kohyama J. Neural basis of brain dysfunction produced by early sleep problems. Brain Sci 2016;6:5.
Krizan Z, Hisler G. Sleepy anger: Restricted sleep amplifies angry feelings. J Exp Psychol Gen 2019;148:1239-1250.
Kroese FM, Evers C, Adriaanse MA, de Ridder DT. Bedtime procrastination: A self-regulation perspective on sleep insufficiency in the general population. J Health Psy 2016;21:853-862.
Kyle SD, Beattie L, Spiegelhalder K, Rogers Z, Espie CA. Altered emotion perception in insomnia disorder. Sleep 2014;37:775-783.
Lachmund E, DiGiuseppe R, Fuller JR. Clinicians' diagnosis of a case with anger problems. J Psychiatric Res 2005;39:439-447.
Leerssen J, Wassing R, Ramautar JR, Stoffers D, Lakbila-Kamal O, Perrier J, et al. Increased hippocampal-prefrontal functional connectivity in insomnia. Neurobiol Learn Mem 2019;160:144-150.
Lemola S, Schwarz B, Siffert A. Interparental conflict and early adolescents' aggression: Is irregular sleep a vulnerability factor? J Adolescence 2012;35:97-105.
Lim J, Dinges DF. A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psych Bull 2010;136:375.
Linden M, Baumann K, Rotter M, Schippan B. Posttraumatic embitterment disorder in comparison to other mental disorders. Psychotherapy & Psychosomat 2008;77:50-56.
Magee CA, Gordon R, Caputi P. Distinct developmental trends in sleep duration during early childhood. Pediatrics 2014;133:e1561-e1567.
Mather M. The emotion paradox in the aging brain. Ann NY Acad Sci 2012;1251:33-49.
Meaklim H, Swieca J, Junge M, Laska I, Kelly D, Joyce R, et al. The DSM-5 Self-rated level 1 cross-cutting Symptom Measure identifies high levels of coexistent psychiatric symptomatology in patients referred for insomnia treatment. Nat Sci Sleep 2018;10:377-383.
Minkel JD, Banks S, Htaik O, Moreta MC, Jones CW, McGlinchey EL, et al. Sleep deprivation and stressors: evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion 2012;12:1015-1020.
Muro A, Goma-i-Freixanet M, Adan A, Cladellas R. Circadian typology, age, and the alternative five-factor personality model in an adult women sample. Chronobiol Int 2011;28:690-696.
O'Brien LM, Lucas NH, Felt BT, Hoban TF, Ruzicka DL, Jordan R, et al. Aggressive behavior, bullying, snoring, and sleepiness in schoolchildren. Sleep Med 2011;12:652-658.
Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002;6:97-111.
Owens JA, Belon K, Moss P. Impact of delaying school start time on adolescent sleep, mood, and behavior. Arch Pediatr Adolesc Med 2010;164:608-614.
Posternak MA, Zimmerman M. Anger and aggression in psychiatric outpatients. J Clinicl Psychiatry 2002;63:665-672.
Potegal M, Stemmler G, Spielberger C. International Handbook of Anger: Constituent and Concomitant Biological, Psychological, and Social Processes: Springer-Verlag New York;2010.
Rajaratnam SM, Barger LK, Lockley SW, Shea SA, Wang W, Landrigan CP, et al. Sleep disorders, health, and safety in police officers. JAMA 2011;306:2567-2578.
Randler C, Rahafar A, Arbabi T, Bretschneider R. Affective state of school pupils during their first lesson of the day-Effect of morningness-eveningness. Mind Brain Educ 2014;8:214-219.
Randler C, Vollmer C. Aggression in young adults-a matter of short sleep and social jetlag? Psychological Rep 2013;113:754-765.
Riedel BW, Lichstein KL. Insomnia and daytime functioning. Sleep Med Rev 2000;4:277-298.
Rief W, Heuser J, Fichter MM. What does the Toronto Alexithymia Scale Tas-R measure?. J Clini Psych 1996;52:423-429.
Rosales-Lagarde A, Armony JL, del Rio-Portilla Y, Trejo-Martinez D, Conde R, Corsi-Cabrera M. Enhanced emotional reactivity after selective REM sleep deprivation in humans: an fMRI study. Front Behav Sci 2012;6:25.
Safer DJ. Irritable mood and the diagnostic and statistical manual of mental disorders. Child and Adolescent Psychiatry & Mental Health 2009;3:35.
Sasson N, Tsuchiya N, Hurley R, Couture SM, Penn DL, Adolphs R, et al. Orienting to social stimuli differentiates social cognitive impairment in autism and schizophrenia. Neuropsychologia 2007;45:2580-2588.
Schmidt RE, Harvey AG, Van der Linden M. Cognitive and affective control in insomnia. Front Psychol 2011;2:349.
Schwarz J, Akerstedt T, Lindberg E, Gruber G, Fischer H, Theorell-Haglow J. Age affects sleep microstructure more than sleep macrostructure. J Sleep Res 2017;26:277-287.
Schwarz J, Axelsson J, Gerhardsson A, Tamm S, Fischer H, Kecklund G, et al. Mood impairment is stronger in young than in older adults after sleep deprivation. J Sleep Res 2019;28:e12801.
Segawa M. Epochs of development of the sleep-wake cycle reflect the modulation of the higher cortical function particular for each epoch. Sleep Biol Rhythms 2006;4:4-15.
Short MA, Louca M. Sleep deprivation leads to mood deficits in healthy adolescents. Sleep Med 2015;16:987-993.
Spielberger CD. Professional Manual for the State-Trait Anger Expression Inventory-2 (STAXI-2). Odessa, FL: Psychological Assessment Resources;1999.
Spielberger CD. State-Trait Anger Expression Inventory. The Corsini Encyclopedia of Psychology 2010.
Spilsbury JC, Babineau DC, Frame J, Juhas K, Rork K. Association between children's exposure to a violent event and objectively and subjectively measured sleep characteristics: a pilot longitudinal study. J Sleep Res 2014;23:585-594.
Street NW, McCormick MC, Austin SB, Slopen N, Habre R, Molnar BE. Sleep duration and risk of physical aggression against peers in urban youth. Sleep Health 2016;2:129-135.
Tsuchiyama K, Terao T, Wang Y, Hoaki N, Goto S. Relationship between hostility and subjective sleep quality. Psychiatry Res 2013;209:545-548.
Van Der Helm E, Gujar N, Walker MP. Sleep deprivation impairs the accurate recognition of human emotions. Sleep 2010;33:335-342.
Van Der Helm E, Yao J, Dutt S, Rao V, Saletin JM, Walker MP. REM sleep depotentiates amygdala activity to previous emotional experiences. Curr Biol 2011;21:2029-2032.
Veenema AH, Koolhaas JM, Kloet de ER. Basal and stress-induced differences in HPA axis, 5-HT responsiveness, and hippocampal cell proliferation in two mouse lines. Ann N Y Acad Sci 2004;1018:255-265.
Vogler N, Perkinson-Gloor N, Brand S, Grob A, Lemola S. Sleep, aggression, and psychosocial adjustment in male prisoners. Swiss J Psy 2014;73:167-176.
Watson D, Clark LA. The Panas-X. Manual for the positive and negative affect schedule-expanded form. The University of Iowa;1994.
Wilkowski BM, Robinson MD. The anatomy of anger: An integrative cognitive model of trait anger and reactive aggression. J Pers 2010;78:9-38.
Winkler D, Pjrek E, Kasper S. Anger attacks in depression-evidence for a male depressive syndrome. Psychother Psychosom 2005;74:303-307.
Yoo SS, Gujar N, Hu P, Jolesz FA, Walker MP. The human emotional brain without sleep-a prefrontal amygdala disconnect. Curr Biol 2007;17:R877-R878.
Zohar D, Tzischinsky O, Epstein R, Lavie P. The effects of sleep loss on medical residents' emotional reactions to work events: a cognitive-energy model. Sleep 2005;28:47-54.
Zschoche M, Schlarb AA. Is there an association between insomnia symptoms, aggressive behavior, and suicidality in adolescents? Adolesc Health Med Ther 2015;6:29-36.