Predicting sleep quality from stress and prior sleep - A study of day-to-day covariation across six weeks

Stress Research Institute, Stockholm University, 10691 Stockholm, Sweden.
Sleep Medicine (Impact Factor: 3.15). 05/2012; 13(6):674-9. DOI: 10.1016/j.sleep.2011.12.013
Source: PubMed


The connection between stress and sleep is well established in cross-sectional questionnaire studies and in a few prospective studies. Here, the intention was to study the link between stress and sleep on a day-to-day basis across 42 days.
Fifty participants kept a sleep/wake diary across 42 days and responded to daily questions on sleep and stress. The results were analyzed with a mixed model approach using stress during the prior day to predict morning ratings of sleep quality.
The results showed that bedtime stress and worries were the main predictors of sleep quality, but that, also, late awakening, short prior sleep, high quality of prior sleep, and good health the prior day predicted higher sleep quality.
Stress during the day predicts subsequent sleep quality on a day-to-day basis across 42 days. The observed range of variation in stress/worries was modest, which is why it is suggested that the present data underestimates the impact of stress on subsequent sleep quality.

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    • "One of these factors is subjective sleep quality: a negative relationship between stress and sleep quality was found in several cross-sectional studies (e.g., Akerstedt, Fredlund, Gillberg, & Jansson, 2002; Knudsen, Ducharme, & Roman, 2007). This effect was also shown in an everyday life study using an end-of-day measurement of stress (Akerstedt et al., 2012). Furthermore , subjective sleep quality has also been found to be a predictor of fatigue (Akerstedt et al., 2014; Lavidor, Weller, & Babkoff, 2003). "
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    ABSTRACT: We investigated whether stress may influence fatigue, or vice versa, as well as factors mediating this relationship. Fifty healthy participants (31 females, 23.6±3.2 years) completed up to 5 momentary assessments of stress and fatigue during 5 days of preparation for their final examinations (exam condition) and 5 days of a regular semester week (control condition). Sleep quality was measured by self-report at awakening. A sub-group of participants (n=25) also collected saliva samples. Fatigue was associated with concurrent stress, stress reported at the previous measurement point, and previous-day stress. However, momentary stress was also predicted by concurrent fatigue, fatigue at the previous time point, and previous-day fatigue. Sleep quality mediated the association between stress and next-day fatigue. Cortisol and alpha-amylase did not mediate the stress-fatigue relationship. In conclusion, there is a reciprocal stress-fatigue relationship. Both prevention and intervention programs should comprehensively cover how stress and fatigue might influence one another. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Jul 2015 · Biological psychology
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    • "There is large consensus that stress plays an important role in both the aetiology and persistence of sleep disturbances. For instance, sleep quality has been found to vary as a function of daily stressful life events (Vahtera et al., 2007; Mezick et al., 2009; Barclay et al., 2011a; Åkerstedt et al., 2012) and, hence, personality traits associated with stress vulnerability, like neuroticism , appear to be important predictors for sleep disturbances (Calkins et al., 2012). "
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    ABSTRACT: Abundant evidence suggests that allelic variation in the serotonin transporter-linked polymorphic region (5-HTTLPR) influences susceptibility to stress and its affective consequences due to brain serotonergic vulnerability. Based on recent assumptions, the present study examined whether the 5-HTTLPR genotype may also interact with a vulnerability to chronic stress experience (conceptualized by trait neuroticism) in order to influence sleep quality and, additionally, whether this is influenced by brain serotonergic manipulations. In a well-balanced experimental design, homozygous S-allele (n = 57) and L-allele (n = 54) genotypes with high and low chronic stress vulnerability (neuroticism) were first assessed for general past sleep quality during a month before onset of the experiment. Then subjects were assessed for sleep quality following 7 days of tryptophan (3.0g/day) or placebo intake. Although high neuroticism was significantly related to a higher frequency of stressful life events and daily hassles, it did not interact with the 5-HTTLPR genotype on general past sleep quality. However, as expected, a 7 day period of tryptophan administration was exclusively associated with better sleep quality scores in the S'/S' genotype with high trait neuroticism. Current findings suggest that 5-HTTLPR does not directly interact with stress vulnerability in order to influence sleep quality. Instead, based on current and previous findings, it is suggested that the S'/S' 5-HTTLPR genotype promotes the risk for stress-related sleep disturbances because of an increased susceptibility to the depressogenic consequences of stress. Accordingly, by way of reducing depressive symptomatology, tryptophan augmentation may particularly improve sleep quality in stress-vulnerable individuals carrying the 5-HTTLPR S-allele. © The Author 2015. Published by Oxford University Press on behalf of CINP.
    Full-text · Article · Feb 2015 · The International Journal of Neuropsychopharmacology
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    • "On days with elevated levels of stress, sleep time was significantly reduced the following night. Akerstedt et al. [30] studied the relationship between stress and sleep over a period of 6 weeks in 50 healthy adults. They found bedtime stress and worries to be the two main predictors of subjective sleep quality. "
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    ABSTRACT: Objective Our study aimed to further elucidate the mediating role of presleep arousal in the relationship between daily stress and sleep by investigating subjective sleep quality and actigraphy-assessed sleep efficiency (SE) on both within- and between-participant levels in a sample of healthy young women. Methods Multilevel modelling was applied on electronically assessed data comprising 14 consecutive nights in 145 healthy young women to assess the relationship between daily stress; presleep (somatic and cognitive) arousal; and sleep on both levels, between participants and within participants across days. Results Higher levels of daily stress were consistently and significantly associated with higher levels of somatic and cognitive arousal. Somatic arousal mediated the relationship between daily stress and worsened subjective sleep quality on the between-participant level, while cognitive arousal mediated the relationship between daily stress and worsened subjective sleep quality on the within-participants level. Unexpectedly, healthy young women showed higher SE following days with above average stress with somatic arousal mediating this relationship. Conclusions Our data corroborate the role of presleep arousal mediating the relationship between daily stress and subjective sleep quality. Interestingly this effect was restricted to somatic arousal being relevant on interindividual levels and cognitive arousal on intraindividual levels. For young and healthy individuals who experience high stress and arousal, well-established cognitive-behavioral techniques could be useful to regulate arousal and prevent worse subjective sleep quality.
    Full-text · Article · Mar 2014 · Sleep Medicine
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