Worried sleep: 24-h monitoring in high and low worriers

Abstract

Background: Commonly used trait measures might not accurately capture the relationship between worry and sleep difficulties in real life.

Methods: In a 24-h ambulatory monitoring study, high and low trait worriers maintained a log of worry and sleep characteristics while actigraphy, heart rates (HR), skin conductance (SC), and ambient temperature were recorded.

Results: Worrying in bed on the night of the recording was associated with longer self-reported and actigraphic nocturnal awakenings, lower actigraphic sleep efficiency, higher HR, lower HR variability, elevated SC level, and more non-specific SC fluctuations compared to not worrying in bed. High trait worriers had higher HR during waking and sleep, and reported shorter total sleep time and poorer sleep quality.

Conclusions: While trait worry is mainly associated with subjective sleep difficulties, worrying in bed impairs sleep according to both subjective and objective sleep parameters, including heightened sympathetic and reduced parasympathetic activation.

Keywords: Ambulatory monitoring; Cardiac; Electrodermal; Heart rate; Heart rate variability; Skin conductance; Sleep; Worry.