Perceived stress correlates with disturbed sleep: A link connecting stress and cardiovascular disease

Abstract

The association between stress and cardiovascular disease (CVD) risk is becoming established. A mechanistic link clarifying the intermediate steps between the experience of stress and the development of CVD would support this association. We sought to examine the role of perceived stress as a factor associated with disturbed sleep with the goal of providing an explanation for the stress-CVD connection. We performed a cross-sectional analysis of data recorded by subjects at entry to our CVD prevention program. Data collection included questionnaire surveys, anthropometrics, and a CVD-relevant laboratory panel. Of 350 consecutively enrolled subjects (mean age 54.4 ± 12.4 [SD] years, 138 men, 39%), 165 (47%) scored above the mean for stress measures. These high-stress subjects displayed an increased cardiovascular risk profile including elevated body mass index (mean ± SD 31.1 ± 5.9 vs. 29.0 ± 5.9, r(s) = 0.175), increased waist circumference (102 ± 17 cm vs. 98 ± 14, r(s) = 0.135), and elevated high-sensitivity serum C-reactive protein (0.384 mg/dl vs. 0.356, r(s) = 0.109). High-stress subjects also demonstrated greater daytime sleepiness (Epworth Sleepiness Scale: 10.4 ± 5.0 vs. 7.8 ± 4.8, r(s) < 0.316), greater fatigue (fatigue scale: 5.4 ± 2.2 vs. 3.4 ± 2.4, r(s) = 0.484), poorer sleep quality (Pittsburgh Sleep Quality Index: 8.5 ± 4.4 vs. 5.9 ± 4.0, r(s) = 0.416), and shorter sleep duration (20 min less/24 h, r(s) = negative 0.177) with a higher risk for sleep apnea (60% at high risk vs. 40%, p = 0.003) than low-stress subjects. High stress was associated with significant disturbances in sleep duration and sleep quality. Stress levels also correlated with daytime consequences of disturbed sleep. The stress-sleep connection may be an important mechanistic mediator of the association between stress and CVD.

Poor sleep as a pathophysiological pathway underlying the association between stressful experiences and the diurnal cortisol profile among children and adolescents

“…Further, consistent with findings from adult studies, greater perceived stress was associated with both poorer sleep quality and shorter sleep duration (Kashani et al, 2012;Lund et al, 2010). Interestingly, perceived stress accounted for substantially more variance in sleep quality than sleep duration, suggesting that the quality, not the quantity of youth's sleep is more susceptible to the adverse effects of perceived stress.…”

“…Experimental findings based on animal studies show that chronic stress exposure results in adverse sleep architecture changes, including decreased slow-wave sleep, decreased REM sleep latency, and increased REM sleep (Adrien et al, 1991;Cheeta et al, 1997). In adults, greater report of perceived stress over the past month was associated with poorer sleep quality and shorter sleep duration (Kashani et al, 2012;Lund et al, 2010). In youth, cross-sectional findings show that greater exposure to stressful life events over the past year adversely affects both subjectively-reported and objectively-measured sleep.…”

Evaluation of job stress and morale at a federal law enforcement agency's district facilities.

“…Job stress is associated with fatigue. For example, Kashani et al [2012] found that individuals experiencing high stress had more daytime sleepiness, greater fatigue, poorer sleep quality, and shorter sleep duration than those who experienced low stress. Fatigue is associated with depression [Slaven et al 2011] and can also impair job performance [Dawson and Reid 1997].…”

The 2017–2018 Psi Chi Presidential Initiative: Help Helped Me

“…Shortened and disturbed sleep has been associ ated with increased risk for cardiovascular disease (Dimsdale et al, 2000;Kashani, Eliasson, & Varnalis, 2012). Furthermore, increased levels of perceived stress are correlated with shortened total sleep time, suboptimal sleep scores on a variety of sleep quality questionnaires, increased fatigue, and an average of 20 minutes less sleep (Kashani et al, 2012).…”

“…Sleep patterns have a significant impact on cardiovascular disease because of their connection to nocturnal dipping. Increased sleep disturbance limits the time spent asleep, resulting in higher nocturnal BPs and higher risk for cardiovascular disease later in life (Kashani et al, 2012).…”