The association of sleep disturbances with endocrine and perceived stress reactivity measures in male employees

Evidence on the relationship between stress reactivity and sleep is conflicting. This study examined the association between disturbed sleep and perceived and endocrine stress reactivity independently of age, body mass index (BMI), and chronic stress. One hundred and twenty middle-aged men were exposed to the Trier Social Stress Test for Groups. The Pittsburgh Sleep Quality Index and the Perceived Stress Reactivity Scale were used to assess sleep and perceived stress reactivity, respectively. Endocrine stress reactivity was examined by assessing salivary cortisol levels. Regression analyses showed that men with disturbed sleep had blunted overall cortisol responses (b = −18.246, p = .044), but the association did not survive adjustment for age, BMI, and chronic stress. In contrast, poor sleep was associated with heightened perceived stress reactivity independently of age and BMI (b = 0.235, p = .005), but additional adjustment for chronic stress attenuated the relationship and only chronic stress remained a significant predictor of perceived stress reactivity (b = 0.470, p < .001). Cortisol and perceived stress reactivity were uncorrelated. In summary, our study indicates associations between sleep disturbances and stress reactivity were not independent of BMI and chronic stress levels, and endocrine and perceived stress reactivity were dissociated.     

Sleep in Women: A Review

Sleep complaints are common in women, and women are more likely to suffer from insomnia than men. Multiple factors across a woman's lifespan, including hormonal changes, age‐related physiological changes, psychosocial factors, the presence of sleep disorders, and physical and mental health conditions, can contribute to complaints of poor sleep in women. This article reviews the literature on the characteristics of, and contributing factors to, subjectively and objectively measured sleep during the menstrual cycle, pregnancy, and post‐partum period, as well as the menopausal transition and postmenopause. Evidence from both subjective and objective measurements supports the presence of chronic sleep fragmentation associated with pregnancy, acute sleep deprivation during labour and the immediate post‐partum periods, as well as disrupted sleep during the first few months after childbirth. While there is evidence for menstrual cycle and menopause related sleep disturbance based on women's self report, findings from objectively measured sleep have been mixed. Observational and intervention studies on the relationship between sleep and women's psychological well‐being suggest that underlying causes of sleep disturbance across a woman's lifespan are often multi‐factorial. Comprehensive assessments and targeted interventions are needed in managing sleep problems in women. Cognitive behavioural interventions have been shown to reduce sleep complaints during the perinatal and menopausal periods, and improvements in sleep are likely to lead to improvements in women's overall well‐being.     

Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Posttraumatic Stress in Combat Veterans With Insomnia

Daytime and nighttime symptoms of posttraumatic stress disorder (PTSD) are common among combat veterans and military service members. However, there is a great deal of heterogeneity in how symptoms are expressed. Clarifying the heterogeneity of daytime and nighttime PTSD symptoms through exploratory clustering may generate hypotheses regarding ways to optimally match evidence-based treatments to PTSD symptom profiles. We used mixture modeling to reveal clusters based on 6 daytime and nighttime symptoms of 154 combat veterans with insomnia and varying levels of PTSD symptoms. Three clusters with increasing symptom severity were identified (n1 = 50, n2 = 70, n3 = 34). These results suggest that, among veterans with insomnia, PTSD symptoms tend to exist on a continuum of severity, rather than as a categorical PTSD diagnosis. Hypotheses regarding possible targeted treatment strategies for veterans within each identified cluster, as well as ways to generalize these methods to other groups within the military, are discussed.     

Evaluation of the effectiveness of mindfulness-based cognitive therapy to treat chronic insomnia

IntroductionAs having positive effects on reducing distress and symptoms associated with different mental and physical disorders, many studies have focused on mindfulness-based cognitive therapy.ObjectiveIt is suggested that mindfulness-based cognitive therapy (MBCT) could help reducing insomnia by focusing on certain cognitive factors associated to insomnia.MethodA pre-experimental, pre-test protocol with a post-test and three month follow-up was used to measure the effect of a group intervention of eight sessions and 12 participants.ResultsThe intervention had a positive effect on participants’ subjective evaluation regarding their sleep and the gains were maintained after three months. However, after the intervention, no significant effect was found on the objective measures of sleep. Two factors associated to the maintenance of insomnia, such as dysfunctional beliefs and attitudes about sleep and mental control strategies were improved following treatment and these improvements were maintained during the follow-up.ConclusionThe results of this study suggest that mindfulness-based cognitive therapy might be an interesting addition in the treatment of insomnia, given that it focuses on certain cognitive factors that contribute to the maintenance of insomnia.     

The relevance of sleep and circadian misalignment for procrastination among shift workers

This daily diary study contributes to current research uncovering the role of sleep for employees’ effective self‐regulation at work. We focus on shift workers’ effective self‐regulation in terms of their general and day‐specific inclination to procrastinate, that is, their tendency to delay the initiation or completion of work activities. We hypothesized that transitory sleep characteristics (day‐specific sleep quality and sleep duration) and chronic sleep characteristics in terms of circadian misalignment are relevant for procrastination. Sixty‐six shift workers completed two daily questionnaires over the course of one work week, resulting in 332 days of analysis. Results of multilevel regression analyses showed that on days when shift workers slept better and longer—compared to days when they slept worse and shorter—they had more energy and willpower available after sleep and subsequently were less prone to procrastination. Moreover, the more work times (permanent shift) were misaligned with employees’ sleep–wake preferences (chronotype) the more pronounced was shift workers’ inclination to procrastinate at work. The present findings provide important implications for shift workers’ effective functioning at work.

Practitioner Points

• To promote shift workers’ effective functioning at work, when scheduling shift work, circadian principles should be taken into account, and work times should be aligned with workers’ chronotypes.
• Day‐specific sleep quality and duration co‐vary with procrastination at work. Thus, on days on which procrastination would be especially harmful, sleep of good quality and of sufficient duration should be obtained.

     

Relationships between two dimensions of employee perfectionism,postwork cognitive processing,and work day functioning

This daily diary study examined relations between two distinct perfectionism dimensions and work-related cognitions experienced by employees during evening leisure time. Drawing from perseverative cognitive processing theory, we hypothesized that perfectionistic concerns would be related to work-related worry and rumination during post-work evenings. In contrast, we hypothesized that a theoretically more adaptive perfectionist dimension (perfectionistic strivings) would be associated with positively valenced self-reflections about work across consecutive evenings. A sample of 148 full-time workers completed an initial survey, which included a trait perfectionism measure, reported their work-related cognitions across four consecutive evenings of a working week, rated their sleep quality immediately upon awakening on each subsequent morning, and their daily levels of emotional exhaustion and work engagement at the end of each work day. Results showed that perfectionistic concerns were indirectly negatively associated with sleep quality and work day functioning via the tendency to worry and ruminate about work. In contrast, perfectionistic strivings were indirectly positively associated with work day engagement via the propensity to experience positive thoughts about work during evening leisure time. The theoretical and practical implications of these findings are discussed.     

阻塞性睡眠呼吸暂停低通气综合征对心血管系统的影响

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是常见却又不被广泛认识的疾病,可以导致多种器官和系统的损害,特别是心血管系统的损害.随着肥胖人群的增加,OSAHS的患病率有可能继续升高,这已经是一个重要的公共卫生问题,本文就OSAHS导致心血管疾病的发病机制,对常见心血管疾病的影响进行探讨.     

Supportive psychotherapy of a psychodynamic orientation as an adjunctive treatment for drug-induced depression: A case study

Abstract

Treatment for drug-induced depression usually consists of cessation or reduction of the causative agent and psychopharmacologic management. In addition, psychotherapy can be useful as an adjunctive treatment. The author presents case material related to a young woman with an inborn physical illness, who became depressed during the course of interferon treatment for a medical complication, hepatitis virus infection. In addition to the cessation of interferon and pharmacologic management, supportive psychotherapy of a psychodynamic orientation was started in order to address the patient’s low self-esteem and anxiety about her future. During the course of psychotherapy, it was understood that the premature cessation of interferon was, to her, a narcissistic injury. It was also important to explore the meanings of her inborn illness and her guilty feelings. After reviewing various formulations of depression, the author discusses the case material from an integrative perspective, which describes vicious cycles of depression.     

The coupling of short sleep duration and high sleep need predicts riskier decision making

Abstract

Objective: To examine how risk-related decision making might be associated with habitual sleep variables, including sleep variability, sleep duration and perceived sleep need in young adults cross-sectionally and longitudinally.

Design: 166 participants completed a 7-day protocol with sleep and risk-related decision-making measures at baseline (T1) and 12 months later (T2).

Results: Habitual short sleep duration (averaging < 6?h nightly) was identified in 11.0% in our sample. After controlling for baseline demographic factors and risk-taking measures, self-reported sleep need at T1 interacted with habitual short sleep in predicting risk taking at follow-up (F_8,139=9.575, adjusted R²=.431, p<.001). T1 greater perceived sleep need predicted more risk taking among short sleepers, but decreased risk taking among normal sleepers at T2. Variable sleep timing was cross-sectionally correlated with making more Risky choices at baseline and fewer Safe choices after loss at follow up.

Conclusions: Young adults with variable sleep timing and those with short sleep duration coupled with high perceived sleep need were more likely to take risks. The moderating effects of perceived sleep need suggest that individual differences may alter the impact of sleep loss and hence should be measured and accounted for in future studies.     

Sleep hygiene behaviours: An application of the theory of planned behaviour and the investigation of perceived autonomy support,past behaviour and response inhibition

This study investigated the sleep hygiene behaviour of university students within the framework of the Theory of Planned Behaviour (TPB [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.]), and examined the predictive validity of additional variables including perceived autonomy support, past behaviour and response inhibition. A total of 257 undergraduate students from an Australian university were administered two online questionnaires at two time points. At time 1, participants completed the TPB questionnaire and the Go/NoGo task as a measure of response inhibition. A week later at time 2, participants completed a questionnaire measuring the performance of sleep hygiene behaviours. Multiple and hierarchical regression analyses showed that the TPB model significantly predicted intention and behaviour. Although intention and perceived behavioural control were statistically significant in predicting behaviour, past behaviour and response inhibition accounted for more variance when added to the TPB model. Subjective norm was found to be the strongest predictor of intention implying the importance of normative influences in sleep hygiene behaviours. Response inhibition was the strongest predictor of behaviour, reinforcing the argument that the performance of health protective behaviours requires self-regulatory ability. Therefore, interventions should be targeted at enhancing self-regulatory capacity.