This article is more than 5 years old. Information may no longer be current.

Insomnia risk increased with certain stress coping behaviors

Certain coping behaviors for stress can lead to an increased risk for insomnia, according to study findings recently published in Sleep.

“Untreated or poorly managed stress can lead to insomnia,” Vivek Pillai, PhD, research fellow at the Sleep Disorders & Research Center at Henry Ford Hospital in Detroit, told Healio.com. “It is important that clinicians triage patients who report acute sleep disturbance to a sleep psychologist or physician. Behavior therapies such as ‘Cognitive Behavior Therapy for Insomnia’ can be the difference between a few bad nights and chronic insomnia.”

Vivek Pillai

Pillai and colleagues evaluated 2,892 people without a history of insomnia to determine the association between stress, coping behaviors and the sleep disorder. At baseline, participants reported on stressful events they had experienced within the last year, perceived severity and duration of stressful event, cognitive intrusion (recurrent thoughts about the stressor) and coping behaviors used within 7 days following the event. Follow-up was conducted 1 year after baseline to identify participants with insomnia.

Overall, 262 participants developed insomnia, and researchers reported a 2% decrease in insomnia risk for every 1 year increase in age. They also found women were more likely to develop insomnia compared with men (OR=1.39; 95% CI, 1.01-1.83).

Each additional stressor among participants led to a 19% increase in risk for developing insomnia. Severity of the stressor was also a predictor (OR=1.19; 95% CI, 1.13-1.26).

Substance use (OR=1.05; 95% CI, 1.01-1.10), self-distraction (OR=1.04; 95% CI, 1.00-1.08) and behavioral-disengagement (OR=1.09; 95% CI, 1.03-1.15) used as coping strategies were also significant predictors of insomnia.

“Turning to alcohol to help fall asleep is extremely common in the United States,” Pillai said. “It is critical that clinicians examine the drinking habits of their sleep patients, and educate them about the sleep-disruptive effects of alcohol, such as sleep fragmentation. Similarly, it is also important to discuss issues such as tolerance to the hypnotic effects of alcohol and, as such, its abuse potential.”

After controlling for age, sex and stress exposure, cognitive intrusion was also a predictor of insomnia (OR=1.01; 95% CI, 1.00-1.01).

 “In addition to assessing levels of stress patients are currently experiencing, it is very important to prove for the specific behaviors in which patients engage to cope with stress,” Pillai said. “Though commonly endorsed strategies like self-distraction (ie, taking your mind off the situation by doing something positive can be helpful in the short-run, they increase the risk for insomnia in the long term. On the other hand, less avoidant behaviors such as mindfulness-based meditation have been shown to improve adaptation to cognitive intrusion/rumination and improve sleep.” — by Amber Cox

Vivek Pillai, PhD, can be reached at vvenugo1@hfhs.org.

Disclosure: See the full study for a complete list of relevant financial disclosures.