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Xie Y, Feeney BC. A narrative review of mechanisms linking romantic relationship experiences to sleep quality. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae049. [PMID: 39114477 PMCID: PMC11303874 DOI: 10.1093/sleepadvances/zpae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 07/04/2024] [Indexed: 08/10/2024]
Abstract
Although a significant body of research has revealed associations between romantic relationship experiences and sleep quality, there has not been clarity regarding the mechanisms underlying such associations. Toward this end, we review the existing studies that have tested mechanisms linking romantic relationship experiences to sleep quality. Guided by both theory and existing research, we organize our review around five key categories of mechanisms that may explain associations between romantic relationship experiences and sleep quality: emotional/affective responses, self-perceptions, social perceptions, self-regulation, and biological functioning. Our review of the literature indicates strong evidence in support of the mediating effects of emotional/affective mechanisms (e.g. emotions and mood states) in explaining associations between various aspects of romantic relationships (e.g. relationship satisfaction, partner conflicts, and attachment orientation) and sleep quality. Although there is ample theoretical support for the other mechanisms proposed, and although all proposed mechanisms have been separately linked to both romantic relationship experiences and sleep quality, few studies have directly tested them, pointing to profitable directions for future research. Understanding underlying mechanisms will enable the development of wise, process-based interventions that target specific mechanisms to improve couple members' sleep quality and romantic relationship functioning.
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Affiliation(s)
- Yuxi Xie
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Brooke C Feeney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
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Coppola AM, Mehl MR, Tackman AM, Dawson SC, O’Hara KL, Sbarra DA. Sleep Efficiency and Naturalistically-Observed Social Behavior Following Marital Separation: The Critical Role of Contact with an Ex-partner. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2023; 40:1920-1942. [PMID: 37637857 PMCID: PMC10448982 DOI: 10.1177/02654075221135855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Marital disruption is associated with increased risk for a range of poor health outcomes, including disturbed sleep. This report examines trajectories of actigraphy-assessed sleep efficiency following marital separation as well as the extent to which daily social behaviors and individual differences in attachment explain variability in these trajectories over time. One hundred twenty-two recently-separated adults (N = 122) were followed longitudinally for three assessment periods over five months. To objectively assess daily social behaviors and sleep efficiency, participants wore the Electronically Activated Recorder (EAR) during the day (for one weekend at each assessment period) and an actiwatch at night (for seven days at each assessment period). Greater time spent with an ex-partner, as assessed by the EAR, was associated with decreased sleep efficiency between participants (p = .003). Higher attachment anxiety was also associated with decreased sleep efficiency (p = .03), as was the EAR-observed measure of "television on." The latter effect operated both between (p = .004) and within participants (p = .005). Finally, study timepoint moderated the association between EAR-observed measure of "television on" and sleep efficiency (p = .007). The current findings deepen our understanding of sleep disturbances following marital separation and point to contact with an ex-partner and time spent with the television on as behavioral markers of risk.
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Sbarra DA, Whisman MA. Divorce, health, and socioeconomic status: An agenda for psychological science. Curr Opin Psychol 2021; 43:75-78. [PMID: 34298203 DOI: 10.1016/j.copsyc.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/03/2022]
Abstract
This brief review article discusses marital dissolution and health with a focus on two specific themes. First, we introduce and discuss the search for plausible causal pathways that link the end of marriage to distal health outcomes. Second, we suggest that the socioeconomic status disruptions that follow divorce represent a plausible causal pathway and emphasize the need for more psychological science in this area of study. Although there is substantial literature that demonstrates that divorced adults, especially divorced women, experience significant financial disruptions, the research in this area remains broad and largely the province of family sociology and demography. Research is needed to better understand adults' psychological and behavioral responses to changes in their financial situation after the end of marriage.
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Affiliation(s)
- David A Sbarra
- Department of Psychology, University of Arizona, Tucson, AZ, USA.
| | - Mark A Whisman
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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Sleep dissatisfaction and insufficient sleep duration in the Italian population. Sci Rep 2020; 10:17943. [PMID: 33087728 PMCID: PMC7578786 DOI: 10.1038/s41598-020-72612-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/31/2020] [Indexed: 12/13/2022] Open
Abstract
To investigate the prevalence and possible determinants of sleep quality and quantity, we used data from a cross-sectional study conducted in 2019 on a sample of 3120 subjects, representative of the general Italian adult population. Sleep dissatisfaction was reported by 14.2% and insufficient sleep (duration) by 29.5% of adults. Sleep dissatisfaction and insufficient sleep were directly related with age (p for trend < 0.001), and inversely related with socioeconomic class (p for trend < 0.001) and income (p for trend < 0.001). Sleep dissatisfaction was higher among women (odds ratio, OR 1.30; 95% confidence interval, CI 1.05–1.60). Insufficient sleep was inversely related to education (p for trend < 0.001) and more frequent in current compared to never smokers (OR 1.32; 95% CI 1.08–1.61). Sleep dissatisfaction was higher among divorced/separated compared with married subjects (OR 1.75; 95% CI 1.20–2.58) and lower among subjects living with children aged 0–14 years (OR 0.48, 95% CI 0.33–0.70). Pet owners more frequently had sleep dissatisfaction (OR 1.35, 95% CI 1.08–1.68) and insufficient sleep (OR 1.46, 95% CI 1.23–1.73). In Italy, self-perceived sleep problems appear to be increasing. Sleep problems can contribute to aggravating health disparities in the society. The unfavourable relationship with pets (and the favourable ones with children) should be confirmed by longitudinal studies.
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Fiório CE, Cesar CLG, Alves MCGP, Goldbaum M. Prevalência de hipertensão arterial em adultos no município de São Paulo e fatores associados. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200052. [DOI: 10.1590/1980-549720200052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/09/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Analisar o comportamento da prevalência de hipertensão arterial no município de São Paulo e seus fatores associados. Métodos: O presente trabalho utilizou os dados do Inquérito de Saúde no Município de São Paulo (ISA Capital), estudo transversal de base populacional executado no município de São Paulo. Foram utilizados dados de 1.667 e de 3.184 indivíduos em 2003 e 2015, respectivamente, com idade de 20 anos e mais. Fizeram-se análises descritivas das prevalências de hipertensão arterial com respectivos intervalos de 95% de confiança. Análises simples e múltiplas foram realizadas para analisar possíveis associações com as variáveis socioeconômicas, demográficas e de estilo de vida por meio de regressão de Poisson. Resultados: A prevalência de hipertensão arterial passou de 17,2% em 2003 para 23,2% em 2015. Os fatores associados à hipertensão foram: sexo feminino; idade (60 anos e mais); situação conjugal (casados, separados e viúvos); ter religião; baixa escolaridade; ter nascido no estado de São Paulo (exceto capital); estado nutricional (baixo peso, sobrepeso e obesidade); e ex-fumantes. Conclusão: A prevalência de hipertensão autorreferida aumentou significativamente no período estudado em São Paulo. Considerando o impacto dessa doença na sociedade, conhecendo sua atual prevalência e identificando seus principais fatores associados, evidencia-se a necessidade de intensificar atividades que contribuam para a prevenção desse agravo, atenuando os danos aos indivíduos e gastos públicos.
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Abstract
This article reviews evidence from several lines of work to describe how marriage and divorce can provoke health-relevant immune alterations, including ways that marital closeness can be perilous for health and divorce can be beneficial. The multiple stresses of a troubled relationship are depressogenic, and the development of a mood disorder sets the stage for psychological and biological vulnerability. Depression provides a central pathway to immune dysregulation, inflammation, and poor health; gender-related differences in depression and inflammation can heighten risk for women compared to men. Sleep and obesity can simultaneously feed off depression as they promote it. In addition, spousal similarities in health behaviors, gene expression, immune profiles and the gut microbiota offer new ways to consider the health advantages and risks of marriage and divorce, providing new perspectives on couples' interdependence, as well as new directions for research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Wilson SJ, Jaremka LM, Fagundes CP, Andridge R, Peng J, Malarkey WB, Habash D, Belury MA, Kiecolt-Glaser JK. Shortened sleep fuels inflammatory responses to marital conflict: Emotion regulation matters. Psychoneuroendocrinology 2017; 79:74-83. [PMID: 28262602 PMCID: PMC5419294 DOI: 10.1016/j.psyneuen.2017.02.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/24/2016] [Accepted: 02/13/2017] [Indexed: 12/14/2022]
Abstract
Sleep problems can boost inflammation and may jeopardize interpersonal functioning, risks that may be magnified in couples. This observational study examined the effects of self-reported recent sleep duration on couples' inflammation, inflammatory responses to a problem discussion, interpersonal behavior, and use of emotion regulation strategies (emotion expression, cognitive reappraisal) during conflict. People who slept less had higher stimulated interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) production after the marital problem discussion than those who slept more. However, using emotion expression and cognitive reappraisal strategies during conflict protected couples who slept less from inflammatory reactivity. Specifically, people's short sleep did not relate to inflammatory increases when they expressed their own feelings more or when their partner reappraised or expressed their emotions more. When both partners slept less, couples interacted in a more hostile way than when at least one partner slept more. These data point to the combination of short sleep and marital conflict as a novel path to heightened inflammation, a risk that partners' emotion regulation strategies may counteract. The study also highlights the role of short sleep in more negative or punishing marital behavior.
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Affiliation(s)
- Stephanie J Wilson
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, United States.
| | - Lisa M Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, United States
| | | | - Rebecca Andridge
- College of Public Health, Division of Biostatistics, The Ohio State University, United States
| | - Juan Peng
- College of Public Health, Division of Biostatistics, The Ohio State University, United States
| | - William B Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, United States; Department of Internal Medicine, OSUMC, United States
| | - Diane Habash
- School of Health and Rehabilitation Sciences, OSUMC, United States
| | | | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, United States; Department of Psychiatry and Behavioral Health, OSUMC, United States
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Impact of Narrative Expressive Writing on Heart Rate, Heart Rate Variability, and Blood Pressure After Marital Separation. Psychosom Med 2017; 79:697-705. [PMID: 28481761 PMCID: PMC5508977 DOI: 10.1097/psy.0000000000000475] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Divorce is a common stressor that is associated with increased risk for poor long-term physical and mental health. Using an experimental design, the current study examined the impact of expressive writing (EW) on average heart rate (HR), HR variability (HRV), and blood pressure (BP) 7.5 months later. METHODS Participants from a community sample of recently separated adults (N = 109) were assigned to one of three conditions: traditional EW, narrative EW, or a control writing condition, and were assessed three times for an average of 7.5 months. Each study visit included 27 minutes of physiological assessment; the primary outcomes at each assessment were mean-level HR, HRV, BP scores averaged across six different tasks. RESULTS Participants in the traditional EW condition did not significantly differ from control participants in their later HR, HRV, or BP. However, relative to control participants, those in the narrative EW condition had significantly lower HR (B = -3.41, 95% confidence interval = -5.76 to -1.06, p = .004) and higher HRV 7.5 months later (B = 0.41, 95% confidence interval = 0.16 to 0.74, p = .001). When comparing narrative EW participants to those in the traditional EW and control writing as a single group, these effects remained and were moderately sized, Cohen d values of -0.61 and 0.60, respectively, and durable across all task conditions when analyzed in independent models. The writing condition groups did not differ in their later BP. CONCLUSIONS Narrative EW decreased HR and increased HRV after marital separation but did not affect BP. We discuss the possible disconnect between psychology and physiology in response to EW, as well as possible future clinical applications after marital separation.
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Bourassa KJ, Hasselmo K, Sbarra DA. Heart Rate Variability Moderates the Association Between Separation-Related Psychological Distress and Blood Pressure Reactivity Over Time. Psychol Sci 2016; 27:1123-35. [PMID: 27302071 DOI: 10.1177/0956797616651972] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 05/03/2016] [Indexed: 01/20/2023] Open
Abstract
Divorce is a stressor associated with long-term health risk, though the mechanisms of this effect are poorly understood. Cardiovascular reactivity is one biological pathway implicated as a predictor of poor long-term health after divorce. A sample of recently separated and divorced adults (N = 138) was assessed over an average of 7.5 months to explore whether individual differences in heart rate variability-assessed by respiratory sinus arrhythmia-operate in combination with subjective reports of separation-related distress to predict prospective changes in cardiovascular reactivity, as indexed by blood pressure reactivity. Participants with low resting respiratory sinus arrhythmia at baseline showed no association between divorce-related distress and later blood pressure reactivity, whereas participants with high respiratory sinus arrhythmia showed a positive association. In addition, within-person variation in respiratory sinus arrhythmia and between-persons variation in separation-related distress interacted to predict blood pressure reactivity at each laboratory visit. Individual differences in heart rate variability and subjective distress operate together to predict cardiovascular reactivity and may explain some of the long-term health risk associated with divorce.
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Abstract
OBJECTIVE Social relationships play a vital role in health and well-being, and it follows that loss experiences can be highly stressful for some people. This article reviews what is known about the association between marital separation, divorce, and health outcomes. METHODS Key findings in the area of divorce and health are discussed, and the review outlines a series of specific questions for future research. In particular, the article integrates research in social epidemiology with research in social psychophysiology. The former approach provides a broad-based estimate of the association between marital status and health outcomes, whereas the latter approach studies mechanisms of action and individual differences associated with increased risk for poor outcomes. RESULTS The experience of separation or divorce confers risk for poor health outcomes, including a 23% higher mortality rate. However, most people cope well and are resilient after their marriage or long-term relationship ends. Despite the fact that resilience is the most common response, a small percentage of people (approximately 10%-15%) struggle quite substantially, and it seems that the overall elevated adverse health risks are driven by the poor functioning of this group. Several candidate mechanisms and novel (ambulatory) assessment techniques that may elucidate the poor outcomes among people who adapt poorly to separation are discussed. CONCLUSIONS To increase knowledge on the association between divorce and health, three primary areas require more research: a) genetic and third variable explanations for divorce-related health outcomes, (b) better studies of objective social behavior after separation, and (c) increased attention to interventions targeting high-risk adults.
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Sbarra DA, Hasselmo K, Bourassa KJ. Divorce and Health: Beyond Individual Differences. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2015; 24:109-113. [PMID: 25892857 PMCID: PMC4399802 DOI: 10.1177/0963721414559125] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper reviews what is known about the association between marital dissolution and health outcomes in adults. Two of the major empirical findings in the literature-that most people do well following marital separation and that this life event increases risk for poor outcomes-appear to be in contrast. This paper provides an individual differences framework for reconciling these competing perspectives and suggests that the bulk of the risk for poor outcomes following marital dissolution is carried by a minority of people. Research focusing on at-risk populations is beginning to shed light on mechanisms of action, the processes that explain why and how marital separation and divorce are associated with ill health. The paper outlines a series of future directions that go beyond individual differences to study these mechanisms.
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