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. 2020 Mar 12;43(3):zsz250.
doi: 10.1093/sleep/zsz250.

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

Yang Yap  1 , Danica C Slavish  2 , Daniel J Taylor  3 , Bei Bei  1 , Joshua F Wiley  1
Affiliations

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

Yang Yap et al. Sleep. .

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.

Keywords: daily design; sleep continuity; sleep quantity; stress.

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Figures

Figure 1.
Figure 1.
Summary of recruitment process. The ACES study recruited from April 13, 2017, to December 5, 2017. The DESTRESS study recruited from May 22, 2018, to August 13, 2018.
Figure 2.
Figure 2.
Panel 1 shows the repeated ecological momentary assessments throughout the study period, with participants completing three surveys a day and wearing an actigraphy watch. Panel 2 illustrates the cross-lagged multilevel models testing bi-directional relations of stress and sleep. All relationships were tested prospectively and controlled for lagged outcomes (i.e. previous evening stress or previous night sleep).
Figure 3.
Figure 3.
Simple slopes plot for next-day stress by within-person actigraphic total sleep time for high and low baseline sleep complaint.
See this image and copyright information in PMC

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