Accumulation of Daily Life Stress and Its Effect on Sleep Quality Público
Oberholtzer, Zachary (Spring 2021)
Abstract
Introduction: Sleep quality is important for overall health. Poor sleep quality is associated with adverse health outcomes such as cardiovascular disease, obesity, and type 2 diabetes. Evidence shows that stress is associated with poor sleep quality, but there has been little work examining the accumulation of stress in relation to sleep quality. The goal of this study is to examine the frequency of daily life stress and the frequency of specific stressors on sleep quality among adults in the United States.
Methods: Participants (N=673) from the Midlife in the United States study were surveyed between 2004-2009. Frequency of daily stress, number of days with stress, and frequency of specific stressors were measured using daily questionnaires collected over 8-days. Sleep quality was assessed based on a modified version of the Pittsburgh Sleep Quality Index (PSQI), with higher scores indicating worse sleep quality. A PSQI score >5 defined poor sleep quality. Linear and Poisson regression models with robust variance were fit to test associations between accumulation of stress defined as the number of stress encounters, number of days with stress or frequency of stressors (e.g., arguments/disagreements, work or school stress, home stress, stressful events happening to friends/family, or discrimination) with sleep quality (categorical and continuous).
Results: The analytic sample had an average age of 56.3 years (SD: 11.8), was 41.5% male, and was 86.5% white. Poor sleep quality was common, with 44.7% of the sample having a PSQI score above 5. On average, participants experienced 4.3 (SD: 3.3) stress occurrences across the 8 days on average (range: 0-40). A unit increase in the number of stress encounters, was associated with a higher prevalence of poor sleep quality [PR=1.05, 95% CI (1.03, 1.08)] and a higher PSQI score [β=0.17, 95% CI (0.08, 0.24)]. As the number of days with stress increased, there was a lower prevalence of poor sleep quality [PR=0.92, 95% CI (0.88, 0.96)] and a lower PSQI score [β =-0.27, 95% CI (-0.40, -0.13)]. As the number of occurrences of stressful events happening to others and arguments increased, there was a higher PSQI score, [β =0.40, 95% CI (0.05, 0.76)] and [β =0.25, 95% CI (0.01, 0.49)], respectively. As the number of occurrences of home life stress and arguments increased, there was a higher prevalence of poor sleep quality, [PR=1.08, 95% CI (1.01, 1.17)] and [PR=1.09, 95% CI (1.01, 1.17)] respectively. The number of occurrences of work/school stress and discrimination were not associated with poor sleep quality after adjustment for covariates.
Discussion: The results suggests that frequent exposure to stress (across a week) is associated with poor sleep quality. Frequent occurrences of arguments/disagreements, home life stress, and stressful events happening to others were associated with poor sleep quality. Intervening on stress may help to improve sleep quality. Future research should test these associations with a more diverse study population with a prospective design.
Table of Contents
Table of Contents
Chapter 1: Introduction……………………………………………………………………………1
Chapter 2: Methods………………………………………………………………………………..4
2.1: Study Design/Participants…………………………………………………………….4
2.2: Sleep Quality………………………………………………………………………….5
2.3: Daily Stress…………………………………………………………………………...6
2.4: Covariates………………………………………………………………………….....7
2.5: Data Analysis…………………………………………………………………………8
Chapter 3: Results…………………………………………………………………………………9
Chapter 4: Discussion……………………………………………………………………………11
Chapter 5: Appendix……………………………………………………………………………..19
Chapter 6: Works Cited………………………………………………………………………….23
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