The Effect of Psychosocial Stress on Sleep: A Review of Polysomnographic Evidence

Abstract

This systematic review examines the effect of diverse psychosocial stressors on polysomnographic measures of sleep. Sixty-three articles were located and categorized in terms of the types of stressors imposed. Experimental stress resulted in fairly consistent changes: decreases in slow wave sleep, REM sleep, and sleep efficiency (SE), as well as increases in awakenings. Data were limited in terms of response to non-experimental stressors, except for the case of post-traumatic stress disorder (PTSD) on sleep, where a number of reports suggest that PTSD patients have increased awakenings and decreased SE. Future research needs to define stress more precisely in terms of duration and severity and to measure its impacts on sleep in populations that differ in terms of age, comorbid illness, gender, and so forth. Without such fine-grained analyses, it is difficult to draw definitive conclusions about this important area.Sleep researchers traditionally have focused on primary sleep disorders such as sleep apnea, narcolepsy, or periodic limb movement disorder; but common knowledge has it that the stresses of daily life can perturb even healthy sleep. As Mason (1968) described, psychological stressors are potent stimuli for physiological stress responses. Most studies on psychosocial stress and its physiological effects on sleep are based solely on subjective reports. However, these subjective reports of sleep are not sufficient to evaluate physiological sleep changes as measured by polysomnography (PSG; Akerstedt, Hume, Minors, & Waterhouse, 1994;Schneider-Helmert & Kumar, 1995). What really happens in sleep physiology after exposure to stressors? Although the gold standard of measurement of sleep is PSG, there are relatively little data concerning the effects of ordinary or severe stress on polysomnographically examined sleep. This article systematically reviews the diverse literature in this area.Stress is notorious for being difficult to define. It encompasses all kinds of stimuli of varying amounts of aversiveness and duration (Dimsdale, Irwin, Keefe, & Stein, 2005). Kecklund and Akerstedt (2004b) grouped stressors conceptionally into physical versus psychological or social, acute versus chronic, and high intensity versus low intensity.Copyright © Lawrence Erlbaum Associates, Inc. Correspondence should be addressed to Joel E. Dimsdale, University of California, San Diego, 9500 Gilman D., La Jolla, CA 92093-0804. jdimsdale@ucsd.edu. NIH Public Access Author ManuscriptBehav Sleep Med. Author manuscript; available in PMC 2014 December 15. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAlthough there are numerous animal models of social stress, it is still challenging to generalize psychosocial stress responses in animals to those in humans. This review focuses on psychosocial stressors; other types of stressors such as environmental manipulations (e.g., temperature), exercise, or intentionally imposed sleep disruption are not covered in this article.It is possible that different types...

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