Stress affects some people's sleep more than others, but everyone can become more resilientWhy does stress cause insomnia in some people while other people can park their stress outside the bedroom door? No one has a comprehensive answer to this question; too many things are involved.

But researchers at Henry Ford Hospital say that—in addition to sleep reactivity, a trait-level quality that predisposes some of us to insomnia—situational factors and responses to stress determine who’s likely to develop insomnia and who isn’t. Here’s more about their research on stress and sleep and thoughts about how to keep stress from ruining the night.

How Investigators Got Their Information

The study they conducted was aimed at identifying factors that cause sleep to go from good to bad. They used data collected from good sleepers participating in the Evolution of Pathways to Insomnia Cohort study.

First, the researchers determined that none of the 2,892 participants qualified for an insomnia diagnosis at the beginning of the study. Next, participants took several pencil-and-paper tests designed to assess relationships between stress and sleep. A year later, the group took the same battery of tests a second time to ascertain how their lives and their sleep had changed.

Impact of Stress on Sleep

By the end of the year, 262 study participants, or 9.1%, had developed insomnia disorder.* The number, severity, and duration of stressors had a significant impact on participants’ sleep. The odds of developing insomnia increased

  • by 19% for every additional stressor participants reported
  • by 4% for every one-point increase participants gave to stressors on a severity scale
  • by 2% for every 1-month increase in the duration of stress.

None of this is surprising, but it’s interesting to see quantitative data coming out of a prospective study.

Response to Stress

Many insomniacs say that what keeps them awake is a mind that keeps going and going at night. In this study, participants had to report how much they thought about the stress they were experiencing by assigning a numerical value to statements like this: “I thought about it when I didn’t mean to.”

The tendency to engage in intrusive thinking following stress exposure was a significant predictor of who would and wouldn’t develop insomnia, accounting for 69% of the total effect of stress exposure on insomnia. The inclination to ruminate has long been known to perpetuate insomnia. The results of this study suggest that rumination may also precipitate insomnia.

Coping Strategies Matter, Too

But vulnerability to insomnia isn’t just a matter of genes and traits and happenstance. How we cope with stress can also amplify or mitigate its effects on sleep. The authors note that thought suppression, a strategy insomniacs often use to hold intrusive thoughts at bay, usually backfires. It tends not to empty the mind but rather to heighten cognitive arousal.

They also report that under conditions of stress, the following coping strategies are predictors of insomnia:

  • substance use
  • giving up based on a belief that nothing can be done to ease the situation
  • self-distraction

But regarding self-distraction (which I believe actually helps me when I’m feeling too aroused for sleep), the authors acknowledge that the literature on this coping style is mixed. Some studies suggest it’s effective in times of stress and others suggest it’s of little or no benefit.

So What to Do?

What not to do is pretty clear from the above. Better strategies for managing stress (and its negative effects on your sleep) are these:

  1. Make sure you have a physical outlet for your stress: daily exercise, or a mind-body practice such as yoga, qi gong, and tai chi.
  2. Try mindful stress reduction. Early studies suggest that it helps reduce stress.
  3. Resist the urge to go it alone. Research has shown that spending time with friends and supportive family members reduces stress.
  4. Increase predictability where you can. If sporadic late night phone calls from your mother stress you out, ask her to refrain from calling after 7 p.m.
  5. Do what you can to increase your sense of control (except in extreme situations where you really have no control). Shorten your to-do list by getting rid of nonessential commitments; negotiate for someone else to cook the turkey this year; and when a stressor feels overwhelming, sit down with a paper and pencil and break the problem into smaller parts. This way, you can actively work to ease or resolve the situation in a step-by-step fashion, which will likely help your sleep.

When you’re stressed out, do you find that distraction helps or hurts your sleep?

* Insomnia disorder was defined in this study as (a) trouble falling or staying asleep, or nonrefreshing sleep, at least 3 times a week for at least 1 month, and (b) daytime distress or impairment.

Posted by Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.

5 Comments

  1. Hi Lois Maharg,

    Very comprehensive article. Thank you for posting.

    Stress is with us all the time…attack us in the day…haunt us at the night..

    Always feel exhausted but at the same time struggling with a restless mind.

    There comes the tossing..

    Never go it alone is 1000% true. Talk to your best friends is a way out. As a man..sometimes we try to be tough and reluctant to share our stress. Especially to our partner.

    But for me..talk to someone who have fight stress successfully has been effective.

    Coincidentally I just post article on work stress today.

    Haha is all about stress. But making stress work for us is very challenging. Ongoing learning. Cheers.

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    Reply

    1. Distraction absolutely helps me get back to sleep, stressed or not. My number one weapon I’ve discovered this year is to always have a decent novel on the go. When I wake up and don’t go straight back to sleep, I focus my mind on my current novel. Trying to remember the names of the characters and various aspects of the plot etc help to take my mind away from real world – the absolute worst thing for me is to start thinking about anything real. There are other tips out there for distraction techniques, but this one works best for me. Doing the same with films or TV shows work for some people. I won’t claim 100% success, but it’s the best tool I’ve found so far.

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      1. Hi Lesley,

        Your number one distraction strategy is the same as mine: novels. For me, novels with complex characters and interesting lives are the best of the best. Mentally, I carry them to bed with me almost as though they’re real people whose world is somehow mine. Thinking about them (and not me and my problems!) is usually relaxing enough to help me fall asleep.

        Like

      2. Hi Lesley,

        For the novel thing, I used a similar method… the horror movies.

        While lying in the bed, I picture myself as the never-die main lead in the story, struggling to fight a bunch of monster and trying to escape…on the way… I will turn any objects into a barrier to stop the monster, or I will hide into some place (that is impossible for me to hide), for e.g., a cupboard or toilet bowl, which I will be taken to another dimension, something like twlight zone…

        This sound crazy but it take my mind away off the work stress. I sink deeper and slowly zzz…

        It is funny, horror things drives me to sleep, one man’s sleep destroyer is another man’s sleep inducer.

        Like

    2. Hi West,

      I’m glad you liked the blog, and thank you for the compliment!

      I’ve heard and observed that it’s hard for some men to feel comfortable talking about their feelings, even though keeping them inside is such a burden. Being female and by nature liking to socialize with other people, I haven’t felt such pressure to keep my feelings to myself.

      Where I get into trouble is when I’ve got a long list of things to do and feel I don’t have enough time to get them done. Suddenly all I can focus on is getting all those things done—and spending time with friends and family sort of falls by the wayside. I have to remind myself in times of stress to reach out to others even when I’m feeling overextended. Relating to others always helps to calm me down.

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      Reply

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