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Low social support and disturbed sleep: epidemiological and psychological perspectives
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The Swedish work force underwent dramatic changes during an economic crisis in the 1990s. In the aftermath, sick leave increased at an unprecedented rate and stress-related disorders, such as burnout, depression, and sleep disturbances replaced earlier work-related diagnoses. Sleep disturbances have been demonstrated to both precede and succeed mental and physical illnesses, including burnout, depression, anxiety, and cardiovascular disease. Disturbed sleep is also a common complaint in Sweden as well as in the rest of the Western world. Sleep has been shown to easily be disturbed by cognitive, emotional, and physiological arousal (stress). However, several studies have demonstrated that social support has a protective effect against the adverse effects of stress as well as a generally beneficial effect on health. Other studies, though, suggest that lack of social support may increase the risk for mental and physical ill-health. The purpose of this thesis was therefore to investigate the association between social support and disturbed sleep; foremost in working populations.

Epidemiological methods were applied to investigate the association between social support and disturbed sleep. Three studies were used; a cross-sectional (MONICA, n = 1,179), a longitudinal (WOLF, n = 2,479), and a case-referent (SHEEP and VHEEP in conjunction, n = 6,231) study. The data was obtained by questionnaires, and social support was operationalized as network and emotional support. Disturbed sleep was defined as difficulties falling asleep, difficulties maintaining sleep, repeated awakenings, and disturbed sleep. Gender was taken into consideration throughout the studies.

Foremost, low network support was found to increase the risk for contracting disturbed sleep. Which source the network support was derived from did not alter the association between low network support and disturbed sleep—low network support at work increased the risk for disturbed sleep as did low network outside work. Prolonged low network support and impaired emotional support did also increase the risk for sleep disturbances in men who were under strain at work. Furthermore, open coping buffered against low network support in the association with disturbed sleep five years later in women, whereas low network support increased the risk for developing disturbed sleep at a later date when interacting with covert coping both in women and in men. Moreover, disturbed sleep was shown to mediate low network support in myocardial infarction in women.

In conclusion, the association between social support and disturbed sleep is complex and includes both interactions with other personality variables and mediating associations. Previous research on negative effects of low social support was confirmed as was previously observed gender differences in social support.

Place, publisher, year, edition, pages
Umeå: Folkhälsa och klinisk medicin , 2006. , 73 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1063
Keyword [en]
social support, sleep initiation and maintenance disorder, psychological adaptation, myocardial infarction, social psychology, public health, mental health, occupational health, epidemiology, cohort studies
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-906ISBN: 91-7264-196-7 (print)OAI: oai:DiVA.org:umu-906DiVA: diva2:144992
Public defence
2006-11-23, 260, 3A, Norrlands Universitetssjukhus, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2006-11-01 Created: 2006-11-01 Last updated: 2009-10-26Bibliographically approved
List of papers
1. Psychosocial factors, gender, and sleep.
Open this publication in new window or tab >>Psychosocial factors, gender, and sleep.
2005 (English)In: Journal of Occupational Health Psychology, ISSN 1076-8998, Vol. 10, no 1, 54-63 p.Article in journal (Refereed) Published
Keyword
Adult, Employment/*psychology, Epidemiologic Methods, Female, Humans, Male, Sex Factors, Sleep Disorders/*etiology, Social Support, Stress; Psychological/*complications
Identifiers
urn:nbn:se:umu:diva-18116 (URN)10.1037/1076-8998.10.1.54 (DOI)15656721 (PubMedID)
Available from: 2007-12-06 Created: 2007-12-06 Last updated: 2009-12-30Bibliographically approved
2. Low social support and vulnerability in the association with disturbed sleep: longitudinal results from the WOLF study
Open this publication in new window or tab >>Low social support and vulnerability in the association with disturbed sleep: longitudinal results from the WOLF study
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(English)Manuscript (preprint) (Other academic)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-5466 (URN)
Available from: 2006-11-01 Created: 2006-11-01 Last updated: 2017-10-19
3. Low social support and coping strategies in the prediction of disturbed sleep: main and interactive effects from the longitudinal WOLF study
Open this publication in new window or tab >>Low social support and coping strategies in the prediction of disturbed sleep: main and interactive effects from the longitudinal WOLF study
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In: Personality and individual differencesArticle in journal (Refereed) Submitted
Identifiers
urn:nbn:se:umu:diva-5467 (URN)
Available from: 2006-11-01 Created: 2006-11-01Bibliographically approved
4. Is disturbed sleep a mediator in the association between social support and myocardial infarction?
Open this publication in new window or tab >>Is disturbed sleep a mediator in the association between social support and myocardial infarction?
2008 (English)In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 13, no 1, 55-64 p.Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to investigate a mediating relationship between social support and disturbed sleep in cases surviving myocardial infarction. The case-referent studies, Stockholm Heart Epidemiological Program (SHEEP) and Västernorrland Heart Epidemiological Program (VHEEP) were used comprising 6231 participants (2046 women). Referents were randomly selected. Disturbed sleep was operationalized by the Karolinska Sleep Questionnaire, network support by the Availability of Social Integration Index and emotional support by the Availability of Attachment Index. Mediating associations were tested with logistic regression. The results show that disturbed sleep may act as a mediator between low network support and myocardial infarction in women.

Identifiers
urn:nbn:se:umu:diva-24865 (URN)10.1177/1359105307084312 (DOI)18086718 (PubMedID)
Available from: 2009-07-21 Created: 2009-07-21 Last updated: 2011-03-16

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