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How stress affects sleep and mental health: Nocturnal heartrate increases during prolonged stress and interacts with childhood trauma exposure to predict anxiety


Azza, Yasmine; Grueschow, Marcus; Karlen, Walter; Seifritz, Erich; Kleim, Birgit (2020). How stress affects sleep and mental health: Nocturnal heartrate increases during prolonged stress and interacts with childhood trauma exposure to predict anxiety. Sleep, 43(6):Epub ahead of print.

Abstract

STUDY OBJECTIVES: Stress can adversely impact sleep health by eliciting arousal increase and a cascade of endocrine reactions that may impair sleep. To date, little is known regarding continuous effects of real-world stress on physiological sleep characteristics and potential effects on stress-related psychopathology. We examined effects of stress on heart-rate (HR) during sleep and total sleep time (TST) during prolonged real-world stress exposure in medical interns. Moreover, we investigated the influence of previous stress and childhood trauma exposure on HR during sleep, TST, and its interaction in predicting anxiety.

METHODS: We examined a sample of 50 medical students prior to and during their first internship, a well described real-world stressor. Heartrate and total sleep time were continuously collected over 12 weeks non-invasively by a wrist-worn activity monitor. Prior to starting the internship, at baseline, participants reported on their sleep, anxiety and childhood trauma exposure. They also tracked stress exposure during internship and reported on their anxiety symptoms after 3 months after this professional stress.

RESULTS: Mean HR during sleep increased over time, while TST remained unchanged. This effect was more pronounced in interns exposed to childhood trauma exposure. In multilevel models, childhood trauma exposure also moderated the relation between individual HR increase and development of anxiety.

CONCLUSIONS: Prolonged stress may lead to increased HR during sleep, whereas individuals with childhood trauma exposure are more vulnerable. childhood trauma exposure also moderated the relation between individual HR increase and development of anxiety. These findings may inform prevention and intervention measures.

Abstract

STUDY OBJECTIVES: Stress can adversely impact sleep health by eliciting arousal increase and a cascade of endocrine reactions that may impair sleep. To date, little is known regarding continuous effects of real-world stress on physiological sleep characteristics and potential effects on stress-related psychopathology. We examined effects of stress on heart-rate (HR) during sleep and total sleep time (TST) during prolonged real-world stress exposure in medical interns. Moreover, we investigated the influence of previous stress and childhood trauma exposure on HR during sleep, TST, and its interaction in predicting anxiety.

METHODS: We examined a sample of 50 medical students prior to and during their first internship, a well described real-world stressor. Heartrate and total sleep time were continuously collected over 12 weeks non-invasively by a wrist-worn activity monitor. Prior to starting the internship, at baseline, participants reported on their sleep, anxiety and childhood trauma exposure. They also tracked stress exposure during internship and reported on their anxiety symptoms after 3 months after this professional stress.

RESULTS: Mean HR during sleep increased over time, while TST remained unchanged. This effect was more pronounced in interns exposed to childhood trauma exposure. In multilevel models, childhood trauma exposure also moderated the relation between individual HR increase and development of anxiety.

CONCLUSIONS: Prolonged stress may lead to increased HR during sleep, whereas individuals with childhood trauma exposure are more vulnerable. childhood trauma exposure also moderated the relation between individual HR increase and development of anxiety. These findings may inform prevention and intervention measures.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:03 Faculty of Economics > Department of Economics
04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
06 Faculty of Arts > Institute of Psychology
Dewey Decimal Classification:150 Psychology
Language:English
Date:15 June 2020
Deposited On:17 Feb 2020 12:55
Last Modified:16 Jun 2020 01:05
Publisher:American Academy of Sleep Medicine
ISSN:0161-8105
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/sleep/zsz310
PubMed ID:31863098

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