1
|
Schmidt LI, Baetzner AS, Dreisbusch MI, Mertens A, Sieverding M. Postponing sleep after a stressful day: Patterns of stress, bedtime procrastination, and sleep outcomes in a daily diary approach. Stress Health 2024; 40:e3330. [PMID: 37846558 DOI: 10.1002/smi.3330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/26/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
Sleep problems and stress are common among students and are associated with negative effects on academic performance as well as mental and physical health risks, but studies exploring mediating factors between stress and sleep on a daily basis are scarce. This study aimed to investigate the relationship of daily stress, Bedtime procrastination (BP) (i.e., postponing bedtime without external reasons), and sleep outcomes controlling for trait factors such as self-control. N = 96 students at a German university (M = 22.2 years, SD = 4.0) wore a sleep-tracking wearable (Fitbit Charge HR) for two weeks to assess sleep duration and to calculate the gap between the intended time to go to sleep and the objectively measured time of falling asleep. Stress, intended time to go to sleep, and sleep quality were assessed via daily diaries. Established questionnaires were used to measure trait self-control, trait BP, and smartphone addiction. Multilevel analyses indicated that more stress experienced during the day was associated with more BP (b = 2.32, p = 0.008), shorter sleep duration (b = -3.46, p = 0.003), and lower sleep quality (b = 1.03, p = 0.005) after controlling for several trait factors. The association of daily stress with sleep outcomes (quality and duration) was partly mediated by BP. Our findings indicate that BP might be one factor that contributes to stress-linked decreases in sleep duration and quality. Potential reasons for stress-related later time to fall asleep-like higher physiological arousal or stress-related worries-should be investigated in future studies.
Collapse
Affiliation(s)
- Laura I Schmidt
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Anke S Baetzner
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Marina I Dreisbusch
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Alica Mertens
- School of Social Science, University of Mannheim, Mannheim, Germany
| | | |
Collapse
|
2
|
Türkarslan KK, Canel Çınarbaş D. Insomnia Severity Predicts Psychiatric Symptoms: A Cross-Sectional Study Investigating the Partial Mediations of Worry and Rumination. Psychiatry 2024; 87:179-193. [PMID: 38758524 DOI: 10.1080/00332747.2024.2347100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect and emotion dysregulation, poor sleep and insomnia can contribute to the initiation and maintenance of mental disorders. The aim of this cross-sectional study was to investigate the relationship between insomnia severity and overall psychiatric symptoms (anxiety, depression, obsessive-compulsive symptoms, somatization, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism), and the mediational roles of worry and rumination in this relationship. METHOD The data was collected from a community sample of 1444 participants (females 69.39%, Mage = 27.95, SD = 9.37) who completed self-report measures of insomnia severity, worry, rumination, and psychiatric symptoms. The mediational roles of worry and rumination were tested with mediation analysis using the PROCESS Macro. RESULTS It was found that insomnia severity (β = 0.20, p < .001) significantly predicted psychiatric symptoms directly and via worry and rumination (β = 0.33, p < .001), meaning that worry and rumination partially mediated the relationship between insomnia severity and psychiatric symptoms. The findings were similar after controlling for smoking status, daily screen time, coffee consumption in the evening, weekly exercise frequency, and pre-sleep screen time. CONCLUSIONS Interventions targeting the reduction of insomnia severity and maladaptive emotion regulation strategies (e.g., worry and rumination), as well as the enhancement of adaptive emotion regulation strategies (e.g., positive refocusing and mindfulness), may alleviate the adverse effects of insomnia on psychiatric symptoms.
Collapse
|
3
|
Benham G, Charak R, Cano-Gonzalez I, Mena Teran J, Kenemore J. Recent Stressful Life Events and Perceived Stress as Serial Mediators of the Association between Adverse Childhood Events and Insomnia. Behav Med 2024:1-12. [PMID: 38634227 DOI: 10.1080/08964289.2024.2335175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
Insomnia is common in college students and linked to poorer mental and physical health. There is growing evidence that adverse childhood experiences (ACEs) may contribute to insomnia in adulthood. However, beyond the need for additional replication of these findings, there is a need to identify underlying mechanisms that plausibly connect the two experiences. Based on a serial mediation model, the current study examined the role of two theoretically informed mediators: recent stressful life events and perceived stress. A cross-sectional survey of 2,218 college students at a large university in the southwestern United States was conducted between August 2020 and December 2021. The sample was predominantly Hispanic (96%) and female (73%), with a mean age of 20.7 years. Standardized measures of adverse childhood experiences, recent stressful life events, perceived stress, and insomnia were administered to participants online. Almost 20% of participants reported having experienced four or more adverse childhood experiences and 63% met the threshold for insomnia. Reporting four or more ACEs was associated with significantly greater insomnia severity, and this relationship was serially mediated by both recent stressful life events and perceived stress. However, recent stressful life events appeared to be the most powerful mediator. The results of the current study indicate that recent exposure to stressful life events serves as a plausible mechanism linking early adversity during childhood to adult insomnia and could therefore serve as a potential target for intervention. The findings suggest that students would benefit from university-wide efforts to reduce the number and/or intensity of common stressors.
Collapse
Affiliation(s)
- Grant Benham
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Joceline Mena Teran
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Jordan Kenemore
- Department of Psychological Science, The University of Texas Rio Grande Valley
| |
Collapse
|
4
|
Hildebrand L, Huskey A, Dailey N, Jankowski S, Henderson-Arredondo K, Trapani C, Patel SI, Chen AYC, Chou YH, Killgore WDS. Transcranial Magnetic Stimulation of the Default Mode Network to Improve Sleep in Individuals With Insomnia Symptoms: Protocol for a Double-Blind Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e51212. [PMID: 38277210 PMCID: PMC10858423 DOI: 10.2196/51212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/24/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Cortical hyperarousal and ruminative thinking are common aspects of insomnia that have been linked with greater connectivity in the default mode network (DMN). Therefore, disrupting network activity within the DMN may reduce cortical and cognitive hyperarousal and facilitate better sleep. OBJECTIVE This trial aims to establish a novel, noninvasive method for treating insomnia through disruption of the DMN with repetitive transcranial magnetic stimulation, specifically with continuous theta burst stimulation (cTBS). This double-blind, pilot randomized controlled trial will assess the efficacy of repetitive transcranial magnetic stimulation as a novel, nonpharmacological approach to improve sleep through disruption of the DMN prior to sleep onset for individuals with insomnia. Primary outcome measures will include assessing changes in DMN functional connectivity before and after stimulation. METHODS A total of 20 participants between the ages of 18 to 50 years with reported sleep disturbances will be recruited as a part of the study. Participants will then conduct an in-person screening and follow-on enrollment visit. Eligible participants then conduct at-home actigraphic collection until their first in-residence overnight study visit. In a double-blind, counterbalanced, crossover study design, participants will receive a 40-second stimulation to the left inferior parietal lobule of the DMN during 2 separate overnight in-residence visits. Participants are randomized to the order in which they receive the active stimulation and sham stimulation. Study participants will undergo a prestimulation functional magnetic resonance imaging scan and a poststimulation functional magnetic resonance imaging scan prior to sleep for each overnight study visit. Sleep outcomes will be measured using clinical polysomnography. After their first in-residence study visit, participants conduct another at-home actigraphic collection before returning for their second in-residence overnight study visit. RESULTS Our study was funded in September 2020 by the Department of Defense (W81XWH2010173). We completed the enrollment of our target study population in the October 2022 and are currently working on neuroimaging processing and analysis. We aim to publish the results of our study by 2024. Primary neuroimaging outcome measures will be tested using independent components analysis, seed-to-voxel analyses, and region of interest to region of interest analyses. A repeated measures analysis of covariance (ANCOVA) will be used to assess the effects of active and sham stimulation on sleep variables. Additionally, we will correlate changes in functional connectivity to polysomnography-graded sleep. CONCLUSIONS The presently proposed cTBS protocol is aimed at establishing the initial research outcomes of the effects of a single burst of cTBS on disrupting the network connectivity of the DMN to improve sleep. If effective, future work could determine the most effective stimulation sites and administration schedules to optimize this potential intervention for sleep problems. TRIAL REGISTRATION ClinicalTrials.gov NCT04953559; https://clinicaltrials.gov/ct2/show/NCT04953559. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51212.
Collapse
Affiliation(s)
- Lindsey Hildebrand
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Alisa Huskey
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Natalie Dailey
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Samantha Jankowski
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | | | | | - Salma Imran Patel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United States
| | | | - Ying-Hui Chou
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | | |
Collapse
|
5
|
Hairston IS, Portal L, Carmon T. Positive rumination can (also) interfere with sleep: A study in a non-clinical sample. Front Psychiatry 2022; 13:889810. [PMID: 36016976 PMCID: PMC9396259 DOI: 10.3389/fpsyt.2022.889810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED It is postulated that negative ruminations perpetuate insomnia symptoms by increasing arousal. Less is known about the role of positive rumination. In this study, we set out to test the association between positive and negative ruminations and insomnia symptoms in a non-clinical sample, asking whether reappraisal and suppression moderate the relationship between rumination types and symptoms of insomnia. METHODS A convenience sample of 354 participants (59% women), ages 18-50, responded to online questionnaires regarding symptoms of insomnia (Insomnia Severity Index [ISI]), Emotion Regulation Questionnaire that provides separate scales for Reappraisal and Suppression, Negative Rumination (Ruminative Response Scale), Positive Rumination and Dampening (Responses to Positive Affect questionnaire), and general health and demographics. RESULTS About 30% of respondents had moderate to severe symptoms of insomnia according to the ISI. The primary hypothesis was tested using three moderation models, where rumination type, emotion regulation styles, and interaction terms were predictors, and ISI scores were the outcome variable. Negative rumination positively predicted ISI (β = 0.56, p < 0.001), while the interaction terms with Reappraisal (β = 0.02, p = 0.575) and Suppression (β = 0.07, p = 0.092) were not significant. Dampening also positively predicted ISI (β = 0.56, p < 0.001), with the interaction term with Reappraisal nearly significant (β = -0.09, p = 0.060), but not with Suppression (β = 0.08, p =0.098). Positive rumination negatively predicted ISI (β = -0.12, p = 0.021), this relationship was reversed with emotion regulation factors in the model (β = 0.11, p = 0.094), where the interaction with Reappraisal (β = 0.13, p = 0.020) and Suppression (β = -0.13, p = 0.024) were both significant. DISCUSSION Positive Rumination weakly and negatively correlated with ISI, but the combination with Reappraisal was associated with more insomnia symptoms. By contrast, Dampening was associated with more insomnia symptoms, with minimal to no moderating effects. These observations are interpreted in the context of the role of emotion regulation strategies and sleep, and their potential clinical implications.
Collapse
Affiliation(s)
- Ilana S Hairston
- Psychology Department, Tel Hai Academic College, Kiryat Shmona, Israel.,The Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Haifa, Israel
| | - Lilach Portal
- Psychology Department, Tel Hai Academic College, Kiryat Shmona, Israel.,Psychology Department, The Max Stern Yezreel Valley College, Kiryat Shmona, Israel
| | - Tal Carmon
- Psychology Department, Tel Hai Academic College, Kiryat Shmona, Israel
| |
Collapse
|
6
|
Magal N, Rab SL, Goldstein P, Simon L, Jiryis T, Admon R. Predicting Chronic Stress among Healthy Females Using Daily-Life Physiological and Lifestyle Features from Wearable Sensors. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2022; 6:24705470221100987. [PMID: 35911618 PMCID: PMC9329827 DOI: 10.1177/24705470221100987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022]
Abstract
Background Chronic stress is a highly prevalent condition that may stem from different
sources and can substantially impact physiology and behavior, potentially
leading to impaired mental and physical health. Multiple physiological and
behavioral lifestyle features can now be recorded unobtrusively in
daily-life using wearable sensors. The aim of the current study was to
identify a distinct set of physiological and behavioral lifestyle features
that are associated with elevated levels of chronic stress across different
stress sources. Methods For that, 140 healthy female participants completed the Trier inventory for
chronic stress (TICS) before wearing the Fitbit Charge3 sensor for seven
consecutive days while maintaining their daily routine. Physiological and
lifestyle features that were extracted from sensor data, alongside
demographic features, were used to predict high versus low chronic stress
with support vector machine classifiers, applying out-of-sample model
testing. Results The model achieved 79% classification accuracy for chronic stress from a
social tension source. A mixture of physiological (resting heart-rate,
heart-rate circadian characteristics), lifestyle (steps count, sleep onset
and sleep regularity) and non-sensor demographic features (smoking status)
contributed to this classification. Conclusion As wearable technologies continue to rapidly evolve, integration of
daily-life indicators could improve our understanding of chronic stress and
its impact of physiology and behavior.
Collapse
Affiliation(s)
- Noa Magal
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Sharona L Rab
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | | | - Lisa Simon
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Talita Jiryis
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel.,The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| |
Collapse
|