The aim of this prospective quasi-experimental study was to assess the role of coping style as a factor moderating the relationship between stress and sleep. Sleep of 36 students was assessed by means of actigraphy and daily logs during low-stress and high-stress periods.
The high-stress period was the week that the students were evaluated for acceptance to graduate programs in clinical psychology. The low-stress period was a regular academic week. The students’ ways of coping were assessed during the baseline low-stress period using the COPE inventory. Data analysis revealed that a high emotion-focused coping score was significantly predictive of reduction in sleep time from the low- to the high-stress period. These results suggest that coping style is a key factor in assessing the relationship between stress and sleep.
Key words: sleep, stress, actigraphy, coping
Research on the effects of stress on sleep has yielded confusing and inconsistent results. Many studies have associated stress with sleep difficulties in infants, children, and adults (Cartwright & Wood, 1991; Healey et al., 1981; Lavie, 2001; Lundh & Broman, 2000; Pillar, Malhotra, & Lavie, 2000; Ross, Ball, Sullivan, & Caroff, 1989; Sadeh, 1996; Van Reeth et al., 2000; Waters, Ad- ams, Binks, & Varnado, 1993). These sleep problems included difficulty falling asleep, fragmented sleep, and recurrent and fre- quent nightmares. A few studies have also shown that induced stress can increase arousal and delay sleep onset (Gross & Bork- ovec, 1982; Van Egeren, Haynes, Franzen, & Hamilton, 1983). However, other studies have failed to detect these disruptions or have documented more resilient sleep in association with stressful conditions or posttraumatic stress disorder (Dagan, Zinger, & Lavie, 1997; Lavie, Carmeli, Mevorach, & Liberman, 1991; Pillar et al., 2000).
Stress theories offer some rationale for these seemingly incon- sistent findings. Analysis of the relevant sleep and stress literature (Sadeh, 1996; Sadeh & Gruber, 2002) has led to the identification of two distinct modes of relevant response of the sleep–wake system: (a) the “turn on” response of the “alarm phase” (Selye, 1983), which is compatible with hypervigilance and incompatible with sleep, and (b) the “shut off” response of the stage of exhaus- tion (Selye, 1983), which leads to reduced activity, preservation of energy, and is compatible with extended sleep. The shut off response is also compatible with the conservation-withdrawal hy- pothesis (Engel & Schmale, 1972), which suggests that under conditions of severe and uncontrollable stress the organism tends to withdraw from activity and preserve energy until the circum- stances change.
These two response modes or biobehavioral systems appear to relate to key factors or principal ways of coping in the coping literature (Folkman & Lazarus, 1980; Skinner, Edge, Altman, & Sherwood, 2003). The conceptualization of ways of coping relies on three different aims for the individual’s behavioral and cogni- tive efforts: (a) problem-focused coping (PFC) focuses on manag- ing or altering the problem causing the distress, (b) emotion- focused coping (EFC) is aimed at regulating emotional responses to the problem, and (c) disengagement (DE) is aimed at disengag- ing from the threatening stimuli and related thoughts and emotions.
Analysis of the sleep and stress lite
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