Neuroticism and sleep-onset: What is the long-term connection?
Introduction
Some people with sleep-onset problems experience symptoms resembling neuroticism. Neuroticism, also known as negative affectivity or trait anxiety (Watson & Clark, 1984), is a genetically and environmentally influenced personality trait (McCrae et al., 2001, Vernon et al., 1997). Traits predispose people to perceive and experience their environment in characteristic ways (Buss & Plomin, 1984). As such, neuroticism is a tendency toward negative emotions, cognitions, and behaviours (Jang et al., 1998, Watson et al., 1994). Likewise, sleep-onset problems have emotional (e.g., Dahl & Lewin, 2002), cognitive (e.g., Roth, 2007), and behavioural components (e.g., Perlis, Giles, Mendelson, Bootzin, & Wyatt, 1997). Similarities suggest that one problem may be important for the other.
Theoretically, processes involved in the development of insomnia, especially sleep-onset problems, are hierarchical. These are predisposing conditions, precipitating circumstances, and perpetuating factors (e.g., Drake & Roth, 2006). Processes may include biological (e.g., Espie, 2002) and genetic (Watson & Goldberg, 2006) predisposition; stressful life-event precipitation (Vahtera et al., 2007); and physiological (e.g., Perlis et al., 1997), cognitive (e.g., Harvey, 2002), and behavioural (e.g., Perlis et al., 1997) perpetuation. Potentially the association occurs on all levels.
Perhaps neuroticism predisposes some people to react toward life-stressors with negative emotions, cognitions, and behaviours incompatible with falling asleep. Predisposition alone is likely insufficient for developing sleep-onset problems (e.g., Drake & Roth, 2006). Instead, life-stressors may aggravate neuroticism, thus contributing to sleep-onset problems. On the other hand sleep-onset problems may heighten neuroticism. Typical ways people with sleep-onset problems feel, think, and react is like that for neuroticism (e.g., Dorsey and Bootzin, 1997, Freedman and Sattler, 1982, Shealy et al., 1980, Vahtera et al., 2007). Unknown is the nature of the association.
Indeed, sleep-onset problems are associated with neuroticism. College students with sleep-onset problems reported higher neuroticism compared to controls (Shealy et al., 1980). In a laboratory, university students subjectively experiencing sleep-onset problems, reported more neuroticism than students with objective sleep-onset problems (Dorsey & Bootzin, 1997). The direction of the relation is unclear.
The few studies about neuroticism and sleep-onset are cross-sectional or retrospective. Which problem precedes or precipitates the other cannot be determined with these methods. Retrospective reports have the added disadvantage of memory distortion. Neuroticism may result in sleep-onset problems, or sleep-onset problems may spur emotional instability. Only longitudinally can the long-term relation be determined.
Our aim is to examine developmental associations between these two problems. The longitudinal design enables us to examine the long-term relation between neuroticism and sleep-onset problems. Specifically, is neuroticism predictive of sleep-onset problems or vice versa? To our knowledge, this is the first study to examine the long-term connection between neuroticism and sleep-onset problems.
Section snippets
Participants
Data were from a birth to midlife cohort project at the Clinic for the Study of Children’s Development and Health at Karolinska Hospital in Stockholm, Sweden. The study began 1955 in Solna, a suburb of Stockholm. Most pregnant women in Sweden receive prenatal care. Researchers asked every fourth pregnant woman registered for prenatal care to participate in a long-term paediatric study. The resulting sample was 212 children, 122 (58%) boys and 90 (42%) girls. The sample was shown through
Discussion
Our findings suggest that neuroticism is unrelated to developing sleep-onset problems. Instead, sleep-onset problems in adolescence and young adulthood pose a risk for developing neuroticism by midlife. Adolescent sleep-onset problems appear to influence midlife neuroticism directly and indirectly through continued sleep-onset problems into young adulthood. The relation seems to go in the opposite direction than might be expected from previous assumptions.
Adolescent sleep-onset problems may
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