Elsevier

Biological Psychology

Volume 77, Issue 2, February 2008, Pages 217-222
Biological Psychology

Financial strain is a significant correlate of sleep continuity disturbances in late-life

https://doi.org/10.1016/j.biopsycho.2007.10.012Get rights and content

Abstract

Although psychological stress has been associated with disturbed sleep in younger populations, little is known about the stress–sleep relationship in late-life. In the present study, we evaluated relationships among a chronic stressor, ongoing financial strain, and sleep in a heterogenous sample (n = 75) of community-dwelling elders (mean age = 74.0 years). Self-report measures included ongoing financial strain, mental health, physical health and subjective sleep quality. Sleep duration, continuity, and architecture were measured by polysomnography (PSG). Analysis of variance and regression were used to test the hypothesis that ongoing financial strain is a significant correlate of disturbed sleep in the elderly. Covariates included age, sex, mental health and physical health. Analyses revealed that ongoing financial strain is a significant correlate of PSG-assessed sleep latency, wakefulness after sleep onset, and sleep efficiency. After adjusting for the effects of age, sex, mental health, and physical health on sleep, ongoing financial strain was associated with lower sleep efficiency (p < .01). Our results show that chronic stress, as measured by ongoing financial strain, is a significant correlate of sleep disturbances in the elderly, even after adjusting for factors known to impact sleep in late-life.

Introduction

The elderly are at increased risk for disturbed sleep, which may adversely affect health, functioning and quality of life (Chevalier et al., 1999, Dew et al., 2003, Groeger et al., 2004, Kojima et al., 2000, Newman et al., 2000, Riemann and Voderholzer, 2003, Spiegel et al., 2002). Sleep disturbances in the elderly may be related to normal aging processes such as neuroanatomic changes in sleep and arousal systems (Nofzinger and Keshavan, 2002) and/or diminished transduction of circadian rhythm signals to the sleep system (Bliwise et al., 1983, Monk and Kupfer, 2000). Others have proposed that age-related changes in sleep are the result of pathological processes such as medical and psychiatric morbidity, and that normal aging processes are less important (Ohayon et al., 2004, Roberts et al., 1999, Vitiello et al., 2002). A greater understanding of the processes that influence sleep in the elderly is important for identifying individuals at risk, designing effective treatment strategies, and, ultimately, improving health and functioning during the later years of life.

Although fewer studies have considered the role of psychological stress in late-life sleep disturbances (Hall et al., 1997, McDermott et al., 1997), psychological stress has been shown to play a significant role in the onset and maintenance of primary insomnia in younger samples (Drake et al., 2004, Linton, 2004, Morin et al., 2003). Psychological stress has been similarly associated with subjective sleep complaints, reports of shorter sleep duration, PSG-assessed sleep continuity disturbances and reductions in slow-wave sleep, as well as increased indices of physiological hyperarousal during sleep across the adult life span (Akerstedt et al., 2002, Davidson et al., 1987, Geroldi et al., 1996, Hall et al., 2000, Kecklund and Akerstedt, 2004, Nakata et al., 2001, Nakata et al., 2004, Ohayon, 2005, Roberts et al., 2000). Although some researchers have hypothesized that a general negative affective bias associated with depression accounts for the effects of naturalistic stress on sleep, empirical data suggest that psychological stress may impact sleep independently of symptoms of depression (Hall et al., 1997, Hall et al., 2000, Hall et al., 2004, Hall et al., 2007, Kecklund and Akerstedt, 2004).

In the present study, we modeled relationships among concurrent measures of chronic stress, mental health, physical health, and sleep in a heterogenous sample of community-dwelling elders. In particular, ongoing financial strain was used as a measure of chronic stress, given the prevalence and salience of financial strain in the elderly (Centers for Disease Control and Prevention, 2004, Kubzansky et al., 2000). We hypothesized that ongoing financial strain would be a significant correlate of disturbed sleep in the elderly, above and beyond the effects of age, mental health and physical health on sleep.

Section snippets

Methods

Participants were drawn from five component projects that comprise the “Aging Well, Sleeping Efficiently: Intervention Studies” (AgeWise) program project (AG020677). The unifying theme of the AgeWise program project is the hypothesis that sleep is related to health and functioning in the elderly and behavioral interventions that target late-life sleep disturbances will have positive effects on health and functioning. Component projects each focused on a specific late-life challenge including

Results

Background and sleep characteristics of the study sample are shown in Table 1. The sample age range was 61–85 years, roughly one-third of whom were male. Participants’ physical and mental health ratings were comparable to age-normed values for the general US population (Ware et al., 1994). One-fourth of the sample endorsed experiencing ongoing financial strain (bereaved elders = 22%; caregivers = 26%; patients with insomnia = 30%; healthy “Old, Old” = 21%). On average, participants took approximately 25

Discussion

Ongoing financial strain was associated with sleep continuity disturbances in a heterogenous sample of community-dwelling elders. After adjusting for the effects of age, sex, project, mental health and physical health on sleep, ongoing financial strain was significantly associated with poorer overall sleep efficiency. Elders experiencing ongoing financial strain took longer to fall asleep and spent an average of 88 min awake after sleep onset, as compared to 69 min of wakefulness among elders who

Acknowledgements

This research was supported by grants from the National Institutes of Health (AG020677, AG019362, HL076852, RR00056). The authors would like to thank the AgeWise subjects for their generous participation and the AgeWise staff for their dedication to this program project. In addition, the authors thank our colleagues Patricia Houck, Jean Miewald, Annette Wood and Mary Fletcher for their assistance with data management and analyses.

References (46)

  • D. Riemann et al.

    Primary insomnia: a risk factor to develop depression?

    Journal of Affective Disorders

    (2003)
  • M.V. Vitiello et al.

    Sleep complaints cosegregate with illness in older adults: clinical research informed by and informing epidemiological studies of sleep

    Journal of Psychosomatic Research

    (2002)
  • D.A. Belsley et al.

    Regression Diagnostics: Identification Influential Data and Sources of Collinearity

    (1980)
  • D.L. Bliwise et al.

    Nightly variation in sleep-related respiratory disturbance in older adults

    Experimental Aging Research

    (1983)
  • J.T. Bromberger et al.

    A longitudinal study of the effects of pessimism, trait anxiety, and life stress on depressive symptoms in middle-aged women

    Psychological Aging

    (1996)
  • Centers for Disease Control and Prevention

    Self-reported frequent mental distress among adults

    Morbidity Mortality Weekly Report

    (2004)
  • H. Chevalier et al.

    Evaluation of severe insomnia in the general population: results of a European multinational survey

    Journal of Psychopharmacology

    (1999)
  • L.M. Davidson et al.

    Chronic stress, catecholamines, and sleep disturbance at Three Mile Island

    Journal of Human Stress Summer

    (1987)
  • M.A. Dew et al.

    Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up

    Psychosomatic Medicine

    (2003)
  • C. Drake et al.

    Vulnerability to stress-related sleep disturbance and hyperarousal

    Sleep

    (2004)
  • J.D. Edinger et al.

    Sleep in the laboratory and sleep at home: comparisons of older insomniacs and normal sleepers

    Sleep

    (1997)
  • C. Geroldi et al.

    Principal lifetime occupation and sleep quality in the elderly

    Gerontology

    (1996)
  • J.A. Groeger et al.

    Sleep quantity, sleep difficulties and their perceived consequences in a representative sample of some 2000 British adults

    Journal of Sleep Research

    (2004)
  • Cited by (102)

    • Social and economic impact (65)

      2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second Edition
    • Transformational Leadership, HRM practices and burnout during the COVID-19 pandemic: The role of personal stress, anxiety, and workplace loneliness

      2022, International Journal of Hospitality Management
      Citation Excerpt :

      Indeed, financial problems lead to conflicts between partners which can lead to several negative outcomes. For instance, increased levels of financial stress results in poor sleep quality (Hall et al., 2008) and reduced well-being (Agrigoroaei et al., 2017). Considering Greece, the case is even worse.

    View all citing articles on Scopus
    View full text