The relationship of sleep and anxiety in anxious subjects

doi:10.1016/0301-0511(83)90058-3

Biological Psychology

Volume 16, Issues 1–2, February–March 1983, Pages 119-126

https://doi.org/10.1016/0301-0511(83)90058-3 Get rights and content

Abstract

The present study provided polysomnographic corroboration of the frequently reported rela- tionship between anxiety and subjective sleep disturbance. When compared to normals, anxious individuals were found to have significantly less sleep period time, total sleep time, percent stage REM and percent stage 4; shorter latency to stage REM; and greater percent stage 1. Partial correlations (holding depression constant) showed significant positive relationships between anxiety rating and number of awakenings, latency to stage 1, and percent stage 2. A significant negative relationship was found between anxiety and percent stage 4, and a nonsignificant negative trend was found between anxiety and latency to stage REM. Overall there was a tendency toward less sleep and lighter sleep in subjects with anxiety, thus validating subjective reports. The decreased latency to stage REM and its negative relation to anxiety, raised the possibility that this variable may not be specifically indicative of depression.

References (22)

S.M. Haynes et al.
Insomnia: Sleep patterns and anxiety level
Journal of Psychosomatic Research
(1974)
D.J. Kupfer et al.
Interval between onset of sleep and rapid-eye movement sleep as an indicator of depression
Lancet
(1972)
H.W. Agnew et al.
The first night effect: An EEG study of sleep
Psychophysiology
(1966)
F. Baekland et al.
Effects of a stressful presleep experience on electroencephalograph-ecorded sleep
Psychophysiology
(1968)
E.J. Beaumaster et al.
The sleep of skydivers: A study of stress
Psychophysiology
(1978)
M.H. Bonnet et al.
Effect of two experimental sets on sleep structure
Perceptual and Motor Skills
(1976)
L.E. Derogatis et al.
The Hopkins Symptom Checklist (HSCL): A measure of primary sympton dimensions
Modern Problems in Pharmacopsychiatry
(1974)
F.G. Foster et al.
EEG sleep in generalized anxiety disorder
Sleep Research
(1977)
R. Freedman
Psychological and physiological characteristics of sleep onset insomniacs
Sleep Research
(1976)
R. Greenberg et al.
REM sleep and the analytic process: A psychophysiologic bridge
Psychoanalytic Quarterly
(1975)

R. Greenberg et al.

War neuroses and the adaptive function of REM sleep

British Journal of Medical Psychology

(1972)

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Changes in hormonal levels associated with enforced interval copulation and anxiety in sexually inexperienced and experienced male rats
2017, Physiology and Behavior
Citation Excerpt :
This increase may be associated with the excitation and alert [12,14] states that male rats need to meet the demand involved in sexual performance [5]. It has also been suggested that increased CORT concentrations indicate a condition of stress or anxiety in males when they are not allowed to ejaculate [42,43] however, our data showed that this increase was significantly higher in the males with sexual experience that reached ejaculation. Hence, these data confirm the participation of CORT levels in the activation and alert states required for sexual behavior.
This study evaluated the effect of sexual experience on anxiety and hormonal levels associated with the performance of sexual behavior. Two groups of male rats, one with, the second without, sexual experience, were exposed to four different copulatory conditions: ad libitum copulation until ejaculation (ADC-E); enforced interval copulation until ejaculation (EIC-E); ad libitum copulation up to 3 intromissions (ADC-3I); and enforced interval copulation up to 3 intromissions (EIC-E3I). At the end of each condition the animals were subjected to an open-field test to measure anxiety, before being sacrificed to measure corticosterone (CORT) and testosterone (T) levels. The sexually-inexperienced males showed less hyperactivity, lower sexual motivation, and higher anxiety levels. Only in the ADC-E and EIC-E conditions did both the inexperienced and experienced rats have a higher number of entries to the central squares of the open-field test. Both the sexually-inexperienced and experienced male rats showed an increase in CORT levels, but only the latter had increased T levels under all copulatory conditions. These findings reveal that the anxiolytic effect of mating is dependent on previous sexual experience and the degree of control that the male rats had during sexual interaction. The changes in the levels of both hormones could be part of the physiological process necessary to satisfy the demands involved in sexual performance and open filed. These data provide further insight into the role of sexual experience in mediating the release of CORT and T, as well as the anxiolytic effects of ejaculation.
Examining the Relationship Between Worry and Sleep: A Daily Process Approach
2016, Behavior Therapy
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Fourth, our results may not generalize to nonanxious populations. Anxious individuals’ sleep characteristics differ from those of nonanxious individuals (Rosa, Bonnet, & Kramer, 1983), and state anxiety is significantly correlated with sleep onset latency among insomniacs but not among normal sleepers (Chambers & Kim, 1993). Given that we examined the relationship between worry and sleep among high trait worriers, it is quite possible that the relationship between these variables is different for individuals who do not experience high levels of worry.
There is growing evidence suggesting that worry and sleep are intimately linked. However, the relationship between these two phenomena over the course of a day remains largely unstudied. It is possible that (a) worry predicts sleep disturbance that night, (b) sleep disturbance predicts worry the following day, or (c) there is a bidirectional relationship between worry and sleep disturbance. The present study examined the daily relationship between worry (both during the day and immediately prior to sleep onset) and sleep in 50 high trait worriers who were randomly assigned to one of two interventions aimed at reducing worry as part of a larger study. A daily process approach was utilized wherein participants completed daily reports of sleep and worry during a 7-day baseline period followed by a 14-day intervention period. Results of repeated measures multilevel modeling analyses indicated that worry experienced on a particular day predicted increased sleep disturbance that night during both the baseline and intervention weeks. However, there was no evidence of a bidirectional relationship as sleep characteristics did not predict worry the following day. Additionally, the type of intervention that participants engaged in did not affect the daily relationship between worry and sleep. Results of the present study are consistent with the cognitive model of insomnia (Harvey, 2002) and highlight the importance of addressing and treating worry among individuals with high trait worry and sleep disturbance.
Polysomnographic sleep patterns of non-depressed, non-medicated children with generalized anxiety disorder
2013, Journal of Affective Disorders
Citation Excerpt :
A previous study of anxious children (Forbes et al., 2008) did not find evidence of REM sleep alteration, however differences could be explained by a singular focus on GAD which is associated with a greater frequency of sleep disruption than other anxiety disorders (Alfano et al., 2006; Alfano et al., 2010). It is also important to note that although REM abnormalities have generally not been identified in adults with GAD (Rosa et al., 1983; Saletu et al., 1994; Fuller et al., 1997; Reynolds et al., 1983), methodological limitations of this research, including the use of inpatient samples, sub-clinical GAD symptoms, and/or former DSM GAD criteria which demonstrated poor diagnostic reliability, should be considered (Andrews et al., 2010). On the other hand, there is limited evidence to suppose that the pathophysiology of GAD is identical across the developmental spectrum and that the disorder reflects the same condition at different ages.
Polysomnographic (PSG) studies of children with psychiatric illness have primarily focused on depressed samples. Children with generalized anxiety disorder (GAD) report high rates of sleep problems yet investigation of objective sleep patterns in non-depressed children with GAD are unavailable. Identification of unique clinical features linking early GAD with sleep disturbance, including possible HPA activation during the pre-sleep period, is needed to inform effective treatments.
Thirty non-medicated, pre-pubescent children (ages 7–11 years) were assessed including 15 children with GAD and 15 matched healthy controls. Anxious children had GAD as their primary diagnosis and did not meet criteria for secondary mood disorders. All participants underwent structured diagnostic assessment and laboratory-based polysomnography (PSG). State anxiety and salivary cortisol were assessed prior to light out on the PSG night.
Children with GAD showed significantly increased sleep onset latency and reduced latency to rapid eye movement (REM) sleep compared to controls. Marginal differences in the form of reduced sleep efficiency and increased total REM sleep also were found in the GAD group. Pre-sleep anxiety and cortisol levels did not differ between the two groups.
A small sample size, time-limited assessment of cortisol, and possible first night effects should be considered.
Results of this study provide initial evidence of PSG-based differences in children with GAD compared to controls. Follow-up studies are needed to explore the course of sleep alterations and whether targeting sleep problems early in the course of GAD might improve clinical outcomes.
Anxiety correlates with somatic symptoms and sleep status at high altitudes
2013, Physiology and Behavior
Citation Excerpt :
Most data obtained from questionnaires were not normally distributed. Rosa [39] found that anxious individuals had significantly less total sleep time. In addition, many people with insomnia feel sleepy in the daytime, and ESS provides a measurement for the sleepiness in the day.
High altitude exposure results in many physical and psychological discomforts, with anxiety and sleep disturbances being the most common ones. This cross-sectional study was performed to explore the relationship between anxiety, somatic symptoms, and sleep status at high altitude. A sample of 426 young males between 18 and 24 years old ascended from low-level land to 3600 m, where they acclimated for 40 days, before ascending to 4400 m. Questionnaires including the Louise Lake Score (LLS, for diagnosis of acute mountain sickness [AMS]), the Self-rating Anxiety Scale (SAS), the Epworth Sleepiness Scale (ESS), and the Athens Insomnia Scale (AIS) were administered immediately before departure from 3600 m (40th day) and the day after arrival at 4400 m (20 days after the first data collection). Physiological parameters were also measured. We observed that 49 of 426 and 51 of 329 people were diagnosed with anxiety according to SAS at 3600 and 4400 m, respectively. Physical symptoms were more severe in subjects with anxiety, and the severity of anxiety was significantly positively correlated to the severity of insomnia and increased heart rate (HR). Overall, these data indicate that after 40 days acclimatization in 3600 m, anxious persons have more severe somatic symptoms. When ascending to higher altitudes, these individuals are more likely to develop AMS, show more severe symptoms, and are prone to insomnia and more serious daytime sleepiness. Insomnia and elevated HR are indicators of anxiety severity.
Assessing Sleep Problems of Older Adults
2010, Handbook of Assessment in Clinical Gerontology, Second Edition
This chapter reviews the process of age-associated changes in sleep and the multiple causes of sleep disorders in older adults. It examines causal factors of sleep problems and then outlines assessment strategies and specific approaches and measures used to assess sleep. Case examples illustrate how various issues manifest in clinical practice. It concludes with a discussion of trends in the assessment of sleep problems in the context of demographic changes, such as age shifts in the population and increased ethnic diversity, as well as economic factors and technological advances. Experiencing poor sleep appears inevitable with advanced age, and sleep problems tend to compromise a person's quality of life more when they occur in the last decades of life. In a study of 9000 participants over age 65, 80% reported having sleep complaints and more than half reported that they had chronic sleep difficulties. Such high rates of sleep problems appear to reflect physical ailments and psychopathology more than aging per se. As such, the development of a sleep problem for an older adult may signal the need for medical and psychological treatment. Insomnia, which is reported to be experienced by 20–40% of older adults, is associated with shorter survival. Mortality due to common causes of death is up to two times higher for older adults with sleep disorders compared to those who sleep well.
Hormonal responses to different sexually related conditions in male rats
2006, Hormones and Behavior
Plasma levels of corticosterone (C) and testosterone (T) increase after sexual activity in males of several species. However, the physiological significance of these increases has not been elucidated. In the present study, hormonal response to different conditions linked to sexual activity was assessed. In the first experiment, plasma levels of C and T were assessed both in sexually experienced and naive male rats after the following conditions: (A) control group, without sexual stimulation; (B) males exposed to ovariectomized females; (C) males exposed to intact, non-receptive females; (D) males exposed to receptive females with the vagina obstructed, to avoid intromission; (E) males exposed to receptive females: but separated by a grid that prevents physical contact; (F) males exposed to receptive females during 30 min. In a second experiment, experienced male rats were allowed to repeatedly copulate until reaching the criteria for sexual exhaustion, and 24 h later, they were allowed to copulate. Once sexually related conditions ended, males were killed and their blood was obtained. C and T plasma levels were assessed by HPLC with ultraviolet (UV) detection. Results indicate that T did not increase significantly in naive male in any sexual condition, while in the experienced males, significant increases were observed with the mere presence of a receptive female and also after ejaculation. These increases were significantly larger in experienced males. On the other hand, C also increased in all sexual conditions, both in experienced and naive rats; however, the increase observed was larger in experienced males. Regarding sexual satiety, both C and T increased after copulating ad libitum to satiety. T increased almost three-fold compared to control, while C increased two-fold. No significant changes were observed in either one of the steroids 24 h after sexual exhaustion, even though males remained with a receptive female during an hour. These results show that sexual experience has an important influence on the hormonal response to sexual activity. C rises could be directly related to sexual arousal involved in the different sexual conditions, while T rises seem to have a direct relationship with both the motivation and execution aspects of masculine sexual behavior.

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^☆: This research was supported by the Upjohn Company.

^†: Now at the Veterans Administration Hospital, Loma Linda, CA 92357, U.S.A.

^††: Now at the Department Psychiatry, University of Mississippi Medical School, Jackson, MS 39216, U.S.A.

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The relationship of sleep and anxiety in anxious subjects☆

Abstract

Journal of Psychosomatic Research

Lancet

The first night effect: An EEG study of sleep

Psychophysiology

Effects of a stressful presleep experience on electroencephalograph-ecorded sleep

Psychophysiology

The sleep of skydivers: A study of stress

Psychophysiology

Effect of two experimental sets on sleep structure

Perceptual and Motor Skills

The Hopkins Symptom Checklist (HSCL): A measure of primary sympton dimensions

Modern Problems in Pharmacopsychiatry

EEG sleep in generalized anxiety disorder

Sleep Research

Psychological and physiological characteristics of sleep onset insomniacs

Sleep Research

REM sleep and the analytic process: A psychophysiologic bridge

Psychoanalytic Quarterly

War neuroses and the adaptive function of REM sleep

British Journal of Medical Psychology