Linking chronic stress to insomnia symptoms in older adults: The role of stress co-occurrence during the pandemic.
Wan-Chin Kuo, Anne L Ersig, Fatih Kunkul and 2 others
PMID 36445114WHAT IT FOUND
Frequent co-occurring upsetting stressors were linked to more reports of difficulty starting sleep, nocturnal awakening, and nonrestorative sleep in older adults.
Early morning awakening did not show the same pattern. Ask about multiple stressors.
Key findings
01Self-health issues were the most frequently reported upsetting chronic stressor (36%), followed by family health issues (27%), financial stress (14%), and relationship stress (11%).
02Older adults in the frequent stress co-occurrence class all reported at least two upsetting chronic stressors, and 59% reported at least three.
03After adjustment, frequent stress co-occurrence was associated with higher odds of difficulty initiating sleep (OR = 1.51, p = 0.010), nonrestorative sleep (OR = 1.38, p = 0.042), and frequent nocturnal awakening (OR = 1.38, p = 0.048).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that stress co-occurrence caused insomnia or that insomnia caused stress. Sleep symptoms were self-reported, and the Jenkins items did not specify a fixed recall period. The stressor list did not include pandemic stressors such as social isolation, or structural racism and environmental injustice. Occupational stress was coded as absent for people not working for pay, so lifetime work stress may be missed. The sample spanned ages 55 to 99, so stress and sleep patterns may differ between younger-old and old-old adults. The analysis did not measure when each stressor began or how long it lasted, so stress proliferation over time could not be quantified.
Declared interests
The authors declared no conflicts of interest. Funding was from Sigma Theta Tau International, the National Institutes of Health, and the Midwest Nursing Research Society.
The easy way to misread this
Do not conclude that frequent stress co-occurrence causes insomnia or that treating stressors will improve sleep. The study measured stress and sleep symptoms at the same time and did not test an intervention.