Examining Daily Associations Among Sleep, Stress, and Blood Pressure Across Adulthood

Background Sleep can have consequential effects on people's health and well-being, and these effects may vary among younger and older adults. Purpose The goal of the present study was to investigate how sleep relates to physiologic and stress responses in daily life across adulthood. Methods We used an Ecological Momentary Assessment method in a large sample of participants (N = 4,359; M-age = 46.75, SD = 12.39; 69.30% male, 29.85% female) who completed morning sleep diaries, reported subjective stress, and recorded their heart rate and blood pressure for 21 days. Sleep was assessed with self-reports of duration, efficiency, and quality. Results Using multilevel modeling, between-person analyses showed that sleep duration, efficiency, and quality were negatively related to morning heart rate and stress, such that people who slept longer, more efficiently, or better experienced lower heart rate and stress compared to those who slept shorter, less efficiently, or worse. Within-person analyses showed that sleep duration, efficiency, and quality predicted morning heart rate, blood pressure (though less consistently), and stress. That is, people experienced lower heart, blood pressure, and stress following nights when they slept longer, more efficiently, or better than they typically did. These within-person relationships were moderated by age, such that the effects of better and longer sleep on lower morning heart rate, blood pressure, and stress were stronger among younger than older adults. Conclusion These findings suggest that daily variations in sleep show immediate associations with stress and physiologic responses, but these daily variations have a stronger relationship among younger compared to older adults. Lay Summary We examined how sleep influences people's blood pressure and well-being among younger and older adults. Participants (N = 4,359) completed questionnaires in the morning over the course of 21 days and reported how well and how long they slept that night and how stressed they felt. They also recorded their heart rate and blood pressure using an optic sensor on their phones. Our analyses showed that people who slept longer, more efficiently, or better experienced lower levels of heart rate and stress on average compared to those who slept shorter, less efficiently, or worse. In addition, we examined how changes in sleep influenced stress, heart rate, and blood pressure for a given individual. These analyses showed that people experienced lower heart rate, lower blood pressure, and less stress following nights when they slept longer, more efficiently, or better than they typically did. These relationships varied by age such that the beneficial effects of sleep were more pronounced among younger than older adults. That is, receiving a particularly good night of sleep tends to be beneficial for younger adults, whereas older adults may not be influenced as strongly by the quality and duration of their sleep.