Bidirectional Associations Between Loneliness, Emotional Support, and Sleep in Daily Life.

OBJECTIVE: Evidence suggests a link between positive social relationship perceptions and improved sleep (e.g., quality, efficiency) across the life span. Less work has probed the directionality of these relationships. Here, we report findings from the first study to examine bidirectional between- and within-person associations between loneliness and emotional support with daily life measures of sleep. METHODS: Participants were 389 healthy adults aged 40 to 64 years (61% female) who completed hourly surveys assessing loneliness and perceptions of emotional support over the course of 4 days. Measures of actigraphy-assessed sleep and nightly sleep quality were also assessed for 7 to 10 days. RESULTS: Individuals with lower average daily loneliness showed higher sleep quality and efficiency than individuals with higher loneliness (r = -0.19, p < .001; r = -0.14, p = .008, respectively), and greater average emotional support was likewise linked with better sleep quality (r = 0.18, p < .001). Controlling for neuroticism attenuated the effects of average loneliness on sleep. Within-person analyses showed unexpected bidirectional effects. Specifically, days in which people felt relatively lonelier were followed by nights with greater sleep efficiency (γ = 1.08, p = .015), and nights when people reported relatively poorer sleep quality were followed by days with greater emotional support (γ = -0.04, p = .013). These unexpected findings are probed in exploratory analyses. CONCLUSIONS: Individuals with higher loneliness and lower emotional support report poorer sleep quality and efficiency, on average. Day-to-day fluctuations in perceptions of social relationships may affect the following night's sleep, and vice versa.

Behavioral-Social Rhythms and Cardiovascular Disease Risk in Retired Night Shift Workers and Retired Day Workers.

OBJECTIVE: Stability in the timing of key daily routine behaviors such as working/doing housework, sleeping, eating, and engaging in social interactions (i.e., behavioral-social rhythms) contributes to health. This study examined whether behavioral-social rhythms were associated with cardiovascular disease (CVD) risk factors in retired night shift workers and retired day workers and explored whether past night shift work exposure moderated this association. METHODS: A total of 154 retired older adults participated in this study. Multiple logistic regression models were used to examine associations between behavioral-social rhythms and CVD risk factors. Independent variables included Social Rhythm Metric (SRM)-5 score and actigraphy rest-activity rhythm intradaily variability (IV) and interdaily stability (IS). Dependent variables were metabolic syndrome prevalence and its five individual components. RESULTS: More regular behavioral-social rhythms were associated with lower odds of prevalent metabolic syndrome (SRM: odds ratio [OR] = 0.57, 95% confidence interval [CI] = 0.35-0.88; IV: OR = 4.00, 95% CI = 1.86-8.58; IS: OR = 0.42, 95% CI = 0.24-0.73) and two of its individual components: body mass index (SRM: OR = 0.56, 95% CI = 0.37-0.85; IV: OR = 2.84, 95% CI = 1.59-5.07; IS: OR = 0.42, 95% CI = 0.26-0.68) and high-density lipoprotein cholesterol (SRM: OR = 0.49, 95% CI = 0.30-0.80; IV: OR = 2.49, 95% CI = 1.25-4.96; IS: OR = 0.35, 95% CI = 0.19-0.66). Past shift work history did not moderate the association between behavioral-social rhythms and metabolic syndrome. CONCLUSIONS: Behavioral-social rhythms were related to CVD risk factors in retired adults regardless of prior night shift work exposure. Older retired workers may benefit from education and interventions aiming to increase behavioral-social rhythm regularity.

Same sleep disorder but different sleep patterns: individual differences in sleep health and depressive symptomatology in veterans with obstructive sleep apnea.

PURPOSE: Poor sleep health, a composite measure of key sleep characteristics, may relate to increased depressive symptoms among individuals treated for obstructive sleep apnea. The current investigation examined the association between sleep health and depressive symptomatology. METHODS: In a pilot sample of 13 symptomatic OSA military Veterans with adequate CPAP adherence (mean age = 54.8, 76.9% male, 100% White), empirically validated cutoffs were applied to actigraphy-derived sleep variables: duration, efficiency, timing, and regularity. RESULTS: Participants with zero optimal sleep scores had significantly higher depressive scores (M = 19.0, SD = 3.0) than participants with 1 or 2 (M = 9.8. SD = 4.3, p = .016) and 3 or more optimal sleep scores (M = 11.3, SD = 4.9, p = .038). CONCLUSIONS: These preliminary findings suggest that better sleep health was associated with lower depressive symptomatology. Future work should replicate these preliminary findings in a larger sample.

Does light physical activity reduce blood pressure responses to laboratory stressors?

Individuals exhibiting exaggerated blood pressure responses to stress are at increased risk for later cardiovascular disease. Engagement in brief bouts of moderate-to-vigorous physical activity may reduce instances of these exaggerated blood pressure responses. While observational work has shown that periods of light physical activity may also be associated with reduced blood pressure responses to stress in daily life, the few experimental studies involving light physical activity have methodological limitations that temper conclusions. The current investigation sought to understand the effects of brief bouts of light physical activity on blood pressure responses to psychological stress. In a between-person, single-session experimental design, 179 healthy, young adults were randomized to 15 min of light physical activity, moderate physical activity, or sitting before engaging in a 10-min computerized Stroop Color-Word Interference Task. Blood pressure readings were collected throughout the study session. Surprisingly, the light physical activity participants showed higher systolic blood pressure responses to stress than control participants by 2.9 mmHg (F (2, 174) = 3.49, ηp 2  = 0.038, p = .03), whereas no significant differences were shown between moderate physical activity and control groups (F (2, 174) = 2.59, ηp 2  = 0.028, p = .078). These findings show that light physical activity may not be related to reduced blood pressure responses to stress in an experimental session involving healthy, college-aged adults and question the extent to which brief bouts of physical activity may reduce acute blood pressure responses to stress.

Conscientiousness and Cardiometabolic Risk: A Test of the Health Behavior Model of Personality Using Structural Equation Modeling.

BACKGROUND: High trait conscientiousness is associated with lower cardiometabolic risk, and health behaviors are a putative but relatively untested pathway that may explain this association. PURPOSE: To explore the role of key health behaviors (diet, physical activity, substance use, and sleep) as links between conscientiousness and cardiometabolic risk. METHODS: In a cross-sectional analysis of 494 healthy, middle-aged working adults (mean age = 42.7 years, 52.6% women, 81.0% White), participants provided self-reports of conscientiousness, physical activity, substance use, diet, and sleep, and wore monitors over a 7-day monitoring period to assess sleep (Actiwatch-16) and physical activity (SenseWear Pro3). Cardiometabolic risk was expressed as a second-order latent variable from a confirmatory factor analysis involving insulin resistance, dyslipidemia, obesity, and blood pressure. Direct, indirect, and specific indirect effect pathways linking conscientiousness to health behaviors and cardiometabolic risk were examined. Unstandardized indirect effects for each health behavior class were computed separately using bootstrapped samples. RESULTS: After controlling for demographics (sex, age, race, and education), conscientiousness showed the predicted, inverse association with cardiometabolic risk. Among the examined health behaviors, objectively-assessed sleep midpoint variability (b = -0.003, p = .04), subjective sleep quality (b = -0.003, p = .025), and objectively-assessed physical activity (b = -0.11, p = .04) linked conscientiousness to cardiometabolic risk. CONCLUSIONS: Physical activity and sleep partially accounted for the relationship between conscientiousness and cardiometabolic risk.

Social Integration and Diurnal Cortisol Decline: The Role of Psychosocial and Behavioral Pathways.

OBJECTIVE: A growing number of studies have associated various measures of social integration, the diversity of social roles in which one participates, with alterations in hypothalamic-pituitary-adrenocortical (HPA) functioning. The pathways through which social integration may be linked to HPA functioning, however, are as yet unknown. The present study examined whether daily social interactions, affective responses, health behaviors, and personality help explain the association between social integration and diurnal cortisol slope. METHODS: A sample of 456 healthy, employed adults (53.9% female, 82.0% white, 72.2% bachelor's degree or greater, mean age of 42.86 years) completed a 4-day ecological momentary assessment protocol that measured cortisol, social interactions, affect, sleep, and physical activity at frequent intervals throughout the day. Social integration was measured at baseline. RESULTS: Regression results controlling for age, sex, race, and education indicated that more socially integrated individuals showed steeper cortisol slopes (B = -0.00253, p = .006). Exploratory analyses suggested that the consistency (i.e., reduced variability) in nightly sleep midpoint partially explained this association (B = -0.00042, 95% confidence interval = -0.00095 to -0.00001). Personality, mood, social interaction patterns, and nonsleep health behavior differences did not account for the association between social integration and HPA activity. CONCLUSION: This study replicates previous findings linking social integration and HPA functioning, and it examines patterns of nightly sleep as possible pathways through which the association may operate. Results have implications for understanding mechanisms for health risk and for development of future interventions.

Hostility Dimensions and Metabolic Syndrome in a Healthy, Midlife Sample.

OBJECTIVE: Evidence links trait hostility with components of the metabolic syndrome (MetS), a clustering of cardiometabolic risk factors, but which hostility dimensions (e.g., expressive or cognitive hostility) relate to MetS are not well known. Further, there may be age and sex differences in the extent to which hostility dimensions relate to MetS. The present study evaluated associations between dimensions of hostility and the metabolic syndrome and its individual components as well as the moderating effects of sex and age. METHODS: In a cross-sectional sample of 478 employed adults, a principal component analysis from common trait hostility questionnaires yielded a two-factor solution: expressive hostility (anger and aggression) and cognitive hostility (cynicism). Each of these two components of hostility was examined as predictors of each of two aggregated MetS outcomes: a dichotomous measure of MetS, based upon the NCEP-ATP III definition, and a continuous measure based upon the average of standardized scores for each component; and they were examined as predictors of individual MetS components as well. RESULTS: Expressive hostility was associated with MetS severity (b = 0.110, p = 0.04) and waist circumference (b = 2.75, p = 0.01). Moderation analyses revealed that elevated expressive hostility was associated with elevated waist circumference in women but not men. Cognitive hostility was not related to any metabolic syndrome component or aggregated outcome, and no moderation was observed. CONCLUSIONS: Among multiple individual components and two aggregated scores, only trait dispositions to expressed hostile affect and behavior were associated with MetS severity and waist circumference. The effects were small but statistically significant. The association between cognitive hostility and metabolic syndrome measures may not be robust in a large sample of healthy, midlife adults.

Physical activity moderates the effects of daily psychosocial stressors on ambulatory blood pressure.

OBJECTIVE: Previous literature has shown an inconsistent relationship between physical activity and stressor-evoked blood pressure reactivity. Use of ecological momentary assessment (EMA) may facilitate detecting such a relationship. In this study, the moderating effects of regular physical activity on the magnitude of ambulatory blood pressure (ABP) responses to psychosocial stressors experienced in daily life were examined. METHOD: Four hundred seventy-seven healthy working adults (ages 30-54) provided ABP readings and recorded their daily experiences, using electronic diaries (ED), over 4 monitoring days. Measures of momentary Task Strain (high demand, low control) and Social Conflict (rating of recent social interaction quality) were used as indices of stressor exposure, and an accelerometry device was used to create 2 indices of physical activity: weekly average and recent (30 min prior to each ED interview). Multilevel models were used to examine the moderating between- and within-person effects of physical activity on ABP fluctuations corresponding with the momentary psychosocial stressors. RESULTS: Weekly physical activity moderated the effects of ABP responses to Task Strain (systolic blood pressure [SBP]: p = .033; diastolic blood pressure [DBP]: p = .028) and Social Conflict (DBP: p = .020), with significant increases in SBP and DBP shown for less physically active individuals but not for more physically active individuals. Similarly, recent physical activity moderated within-person DBP responses to Task Strain (p = .025), with greater DBP increases following less active periods. CONCLUSION: Our results demonstrate that weekly and recent physical activity may moderate the effects of ABP responses to daily psychosocial stress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Beginning the Work of Integration: An Investigation of Primary Care Physicians' Attitudes Toward Psychiatry.

OBJECTIVE: The authors sought to better understand the attitudes of primary care physicians toward psychiatrists in order to assess their receptivity for further psychiatric education. METHODS: A survey about attitudes toward psychiatrists in comparison to other specialties was distributed among four family medicine residency programs at Southern Illinois University. RESULTS: Respondents rated psychiatry lower than other specialties in the areas measured. However, family medicine physicians expressed a desire to work with psychiatrists and receive further education in psychiatry. CONCLUSION: Favorable attitudes toward psychiatrists and education in psychiatry suggest the potential for additional family medicine training in psychiatry.