Sleep: An Important Factor in Stress-Health Models

A growing body of literature supports the notion that psychological stress negatively impacts physical health. In parallel to this programme of stress/health investigations, researchers are demonstrating the deleterious health effects of poor sleep. The current study simultaneously examines the association of both stress and sleep with health. Two hundred and eighteen subjects completed an anonymous survey packet that included stress, sleep and health measures. Psychological stress (as assessed by both life-events and by self-perceived stress), daytime sleepiness and poor sleep quality, but not sleep quantity, were all negatively associated with health. A regression model that integrated both stress measures was a statistically significant predictor of health. Adding the sleep measures to the stress-health model accounted for a statistically significantly greater proportion of the variance in health scores, with the stress + sleep model accounting for 39-56 per cent of the variance in health scores depending on the health measure used. These results suggest that studies of stress and health may benefit from the inclusion of sleep measures and that, from a practical standpoint, poor sleep might be best understood not simply as a sequela of psychological stress but rather as a factor that should be actively addressed as part of the treatment programme. Copyright (C) 2010 John Wiley & Sons, Ltd.