Bi-directional relations between stress and self-reported and actigraphy-assessed sleep: a daily intensive longitudinal study

Abstract

Study Objectives Stress is associated with poor and short sleep, but the temporal order of these variables remains unclear. This study examined the temporal and bi-directional associations between stress and sleep and explored the moderating role of baseline sleep complaints, using daily, intensive longitudinal designs. Methods Participants were 326 young adults (Mage = 23.24 ± 5.46), providing >2,500 nights of sleep altogether. Prospective total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were measured using actigraphy and sleep diaries. Perceived stress was reported three times daily between: 11:00–15:00, 15:30–19:30, and 20:00–02:00. Sleep complaints were measured at baseline using the PROMIS sleep disturbance scale. Within- and between-person sleep and stress variables were tested using cross-lagged multilevel models. Results Controlling for covariates and lagged outcomes, within-person effects showed that higher evening stress predicted shorter actigraphic and self-reported TST (both p < .01). Conversely, shorter actigraphic and self-reported TST predicted higher next-day stress (both p < .001). Longer self-reported SOL and WASO (both p < .001), as well as lower actigraphic (p < .01) and self-reported SE (p < .001), predicted higher next-day stress. Between-person effects emerged only for self-reported TST predicting stress (p < .01). No significant results were found for the moderating role of baseline sleep complaints. Conclusions Results demonstrated bi-directional relations between stress and sleep quantity, and a consistent direction of worse sleep quantity and continuity predicting higher next-day stress. Results highlighted within-individual daily variation as being more important than between-individual differences when examining sleep and daytime functioning associations.

Toward a Better Understanding of the Reciprocal Relations Between Adolescent Psychological Need Experiences and Sleep

“…In addition to symptoms of stress predicting poor sleep, we also acknowledge that the reverse pathway is equally plausible; specifically, that poor sleep at night may predict symptoms of stress the next day. In line with this reasoning, a number of previous studies have shown poor sleep to predict daily stress (e.g., Hisler et al, 2019;Yap et al, 2019), presumably because sleep disturbance lowers an individual's capacity to cope with daily stressors, which in turn may perhaps interfere with their responsiveness to opportunities for need satisfaction and exacerbate need frustration throughout the day. Thus, in addition to fatigue, it is equally plausible that symptoms of stress may also play an intervening role in the association between adolescents' sleep at night and their need-based experiences throughout the following day.…”

Sleep in the Social World of College Students: Bridging Interpersonal Stress and Fear of Missing Out with Mental Health

“…In studies of undergraduate students, those who reported poorer sleep quality or reduced sleep quantity also endorsed elevated rates of depression and/or anxiety [10,13], and those who met criteria for insomnia reported increased rates of stress, fatigue, mental health, hypnotic and stimulant use, and decreased quality of life [12]. A recent longitudinal study found that chronic stress, as well as symptoms of depression, were predictive of sleep onset insomnia and hypersomnia among second-year college students [14], another longitudinal study of college students found that stress and sleep problems were bidirectional [15], and multiple studies have demonstrated that mood disorder diagnoses are often preceded by and predicted by poor sleep [16,17]. The association between stress, disrupted sleep and mental health deserves further research attention in college populations.…”

“…Third, mediation models were tested with data collected at one point in time, therefore directionality cannot be determined. Evidence from a longitudinal study suggests that stress and poor sleep quality have a complex bidirectional relationship [15]. Findings of another longitudinal study found that insomnia may be a premorbid risk for incident depression, or self-report of depression [17].…”

Psychological Stress: A Predisposing and Exacerbating Factor in Periodontitis

“…Sleep apnea is associated with the activation of the HPA axis and higher cortisol levels compared to persons without a sleep disorder [81]. Reductions in sleep time have been shown to be associated with higher reported stress levels the next day [82]. Conversely, chronic stress has been associated with reduced time spent in REM sleep [83,84].…”