Stress Management Based on Trait-Anxiety Levels and Sleep Quality in Middle-Aged Employees Confronted with Psychosocial Chronic Stress

Abstract

A stress management program using cardiac coherence was implemented after an organizational downsizing. The study was conducted in nine voluntary workers in order to evaluate the efficiency of the program. A baseline evaluation was conducted on psychological variables (anxiety, perceived-stress, wellbeing and sleep), endocrine assessments (urinary cortisol excretion, alpha-amylase and salivary concentrations) and physiological recordings (sleep and heart rate variability). The low number of participants was due to the intrusive approach in collecting physiological and endocrine variables. The program consisted of ten sessions of cardiac coherence training during a 3-month follow-up period. At the end of the training sequence, subjects were once again exposed to the same evaluation battery. A decrease in perceived stress and a subsequent increase in well-being were observed. Sleep quality improved as suggested by the results of the subjective and objective measurements. For the entirety of the results, improvements were higher in subjects with high vs. low trait-anxiety scoring. The pattern of results for subjects prone to a high level of trait-anxiety suggested that stress and sleep are related to each other in a bidirectional way: increased anxiety is associated to poor sleep and stress reduction improves both anxiety and sleep. On the basis of these results, we suggest that trait-anxiety can be used as an indicator of which employees should be given priority for stress management intervention. We will also highlight the interest of operationally physiological recordings, used outside the laboratory, for measuring objective improvements due to this stress management intervention, as quality of sleep.

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Trousselard, M. , Steiler, D. , Lebreton, A. , Beers, P. , Drogout, C. , Denis, J. , Chennaoui, M. & Canini, F. (2014). Stress Management Based on Trait-Anxiety Levels and Sleep Quality in Middle-Aged Employees Confronted with Psychosocial Chronic Stress. Psychology, 5, 78-89. doi: 10.4236/psych.2014.51013.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Akerstedt, T., Knutsson, A., Westerholm, P., Theorell, T., Alfredsson, L., & Kecklund, G. (2002). Sleep disturbances, work stress and work hours. Journal of Psychosomatic Research, 53, 741-748.
http://dx.doi.org/10.1016/S0022-3999(02)00333-1
[2] Baylor, G. W., & Cavallero, C. (2001). Memory sources associated with REM and NREM dream reports throughout the night: A new look at the data. Sleep, 24, 165.
[3] Bergdahl, J., & Bergdahl, M. (2002). Perceived stress in adults: Prevalence and association of depression, anxiety, and medication in Swedish population. Stress and Health, 18, 235-241.
http://dx.doi.org/10.1002/smi.946
[4] Bourbonnais, R., Brisson, C., Vezina, M., Masse, B., & Blanchette, C. (2005). Psychosocial work environment and certified leave among nurses during organisational changes and downsizing. Rel Ind—Ind Rel, 60, 483-509.
[5] Biondi, M., & Picardi, A. (1999). Psychological stress and neuroendocrine function in humans: The last two decades of research. Psychotherapy and Psychosomatics, 68, 114-150.
http://dx.doi.org/10.1159/000012323
[6] Bolmont, B., & Abraini, J. H. (2001). State-anxiety and low moods: Evidence for a single concept. Physiology & Behavior, 74, 421-424.
http://dx.doi.org/10.1016/S0031-9384(01)00575-3
[7] Boyce, T., & Ellis, B. (2005). Biological sensitivity to context: I. An evolutionary-developmental theory of the origins and functions of stress reactivity. Development and Psychopathology, 17, 271-301.
http://dx.doi.org/10.1017/S0954579405050145
[8] Brandberger, G. (1992). Endocrine ultradian rythms during sleep and wakefulness. In D. Lloyd, & E. L. Rossi (Eds.), Ultradian rythms in life process (pp. 123-138). London: Springer Verlag.
[9] Bruchon-Schweitzer, M. (2002). Psychologie de la santé: Modèles, concepts, et méthodes. Paris: Dunod.
[10] Bruchon-Schweitzer, M., & Paulhan, I. (1993). Inventaire d'Anxiété Trait-état. Forme Y. STAI-Y. Paris: Les éditions du Centre de Psychologie Appliquée.
[11] Buguet, A., Raphel, C., Bugat, R., & Fourcade, J. (1981). Etats de vigilance en opération continue. International Review of the Army Navy Air Force Medicine Services, 54, 101-102.
[12] Burr, R. L. (2007). Interpretation of normalized spectral heart rate variability indices in sleep research: A critical review. Sleep, 30.
[13] Carlson, L. E., & Garland, S. N. (2005). Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients. International Journal of Behavioral Medicine, 12, 278-285.
http://dx.doi.org/10.1207/s15327558ijbm1204_9
[14] Cartwright, R. D., & Wood, E. (1991. Adjustment disorder of sleep: The sleep effects of a major stressful event and its resolution. Psychiatry Research, 39, 199-209.
http://dx.doi.org/10.1016/0165-1781(91)90088-7
[15] Cerclé, A., Gadea, C., Hartmann, A., & Lourel, M. (2008). Typological and factor analysis of the perceived stress measure by using the PSS scale. Revue Européenne de Psychologie Appliquée, 58, 227-239.
http://dx.doi.org/10.1016/j.erap.2008.09.006
[16] Chida, Y., & Hamer, M. (2008). Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: A quantitative review of 30 years of investigations. Psychological Bulletin, 134, 829-885.
http://dx.doi.org/10.1037/a0013342
[17] Chida, Y., & Steptoe, A. (2009). Cortisol awakening response and psychosocial factors: A systematic review and meta-analysis. Biological Psychology, 80, 265-278.
http://dx.doi.org/10.1016/j.biopsycho.2008.10.004
[18] Childre, D., & Cryer, B. (2000). From Chaos to Coherence: The Power to Change Performance. Boulder Creek, CA: Planetary.
[19] Childre, D., & Martin, H. (1999). The HeartMath Solution. San Francisco: HarperSanFrancisco.
[20] Childre, D., & Rozman, D. (2005). Transforming stress: The HeartMath solution for relieving worry, fatigue, and tension. Oakland: New Harbinger Publications.
[21] Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5, 374-381.
http://dx.doi.org/10.1038/nrendo.2009.106
[22] Cohen, S., Karmak, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396.
http://dx.doi.org/10.2307/2136404
[23] DeMoja, C. A., & DeMoja, G. (1986). State-trait anxiety and motocross performance. Perceptual & Motor Skills, 62, 107-110.
http://dx.doi.org/10.2466/pms.1986.62.1.107
[24] Den, R., Toda, M., Nagasawa S, Kitamura, K., & Morimoto, K. (2007). Circadian rhythm of human salivary Chromogranin A. BioMed Research International, 28, 57-60.
http://dx.doi.org/10.2220/biomedres.28.57
[25] Elbaz, A., Metlaine, A., & Leger, D. (2008). Actiwave, nouvelle technologie d’enregistrement du sommeil. Nouvelles Technologies, 5, 30-32.
[26] Fales, C. L., Barch, D., M., Burgess, G. C., Schaefer, A., Mennin, D. S., Gray, J. R., et al. (2008). Anxiety and cognitive efficiency: Differential modulation of transient and sustained neural activity during a working memory task. Cognitive, Affective, & Behavioral Neuroscience, 8, 239-253. http://dx.doi.org/10.3758/CABN.8.3.239
[27] Friedman, B. H., & Thayer, J. F. (1998). Anxiety and autonomic flexibility: A cardiovascular approach. Biological Psychology, 47, 243-263. http://dx.doi.org/10.1016/S0301-0511(97)00027-6
[28] Gais, S., & Born, J. (2004). Declarative memory consolidation, mechanisms acting during human sleep. Learning & Memory, 11, 679-685.
http://dx.doi.org/10.1101/lm.80504
[29] Grillon, C., Ameli, R., Foot, M., & Davis, M. (1993). Fear-potentiated startle: Relationship to the level of state/trait anxiety in healthy subjects. Biological Psychiatry, 33, 566-574.
http://dx.doi.org/10.1016/0006-3223(93)90094-T
[30] Haftgoli, N., Favrat, B., Verdon, F., Vaucher, P., Bischoff, T., Burnand, B., & Herzig, L. (2010). Patients presenting with somatic complaints in general practice: Depression, anxiety and somatoform disorders are frequent and associated with psychosocial stressors. BMC Family Practice, 11, 67. http://dx.doi.org/10.1186/1471-2296-11-67
[31] Hanson, M. D., & Chen, E. (2010). Daily stress, cortisol, and sleep: The Moderating role of childhood psychosocial environments. Health Psychology, 29, 394-402. http://dx.doi.org/10.1037/a0019879
[32] Head, K. A., & Kelly, G. S. (2009). Nutrients and botanicals for treatment of stress: Adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Alternative Medicine Review, 14, 114-140.
[33] Hobson, J. A., McCarley, R. W., & Wyzinski, P. W. (1975). Sleep cycle oscillation: Reciprocal discharge by two brainstem neuronal groups. Science, 189, 55-58.
http://dx.doi.org/10.1126/science.1094539
[34] Hobson, J. A., Stickgold, R., & Pace-Schott, E. F. (1998). The neuropsychology of REM sleep dreaming. NeuroReport, 9, R1-R14.
http://dx.doi.org/10.1097/00001756-199802160-00033
[35] Horsten, M., Ericson, M., Perski A., Wamala S. P., Schenck-Gustafsson, K., & Orth-Gomér, K. (1999). Psychosocial factors and heart rate variability in healthy women. Psychosomatic Medicine, 61, 49-57.
[36] Jacquinet-Salord, M. C., Lang, T., Fouriaud, C., Nicoulet, I., & Bingham, A. (1993). Sleeping tablet consumption, self reported quality of sleep, and working conditions. Journal of Epidemiology & Community Health, 47, 64-68. http://dx.doi.org/10.1136/jech.47.1.64
[37] Kalimo, R., Taris, T., & Schaufeli, W. (2003). The effects of past and anticipated future downsizing on survivor wellbeing: An equity perspective. Journal of Occupational Health Psychology, 8, 91-109.
http://dx.doi.org/10.1037/1076-8998.8.2.91
[38] Kalimo, R., Tenkanen, L., Harma, M., Poppius, E., & Heinsalmi, P. (2000). Job stress and sleep disorders: Findings from the Helsinki heart study. Stress Medicine, 16, 65-75.
http://dx.doi.org/10.1002/(SICI)1099-1700(200003)16:2<65::AID-SMI834>3.0.CO;2-8
[39] Kang, M. G., Koh, S. B., Cha, B. S., Park, J. K., Baik, S. K., & Chang, S. J. (2004). Job stress and cardiovascular risk factors in male workers. Preventive Medicine, 40, 583-588.
http://dx.doi.org/10.1016/j.ypmed.2004.07.018
[40] Lazarus, R. S. (1993). From psychological stress to the emotions: A history of changing outlooks. Annual Review of Psychology, 44, 1-21.
http://dx.doi.org/10.1146/annurev.ps.44.020193.000245
[41] Lehrer, P. M., Vaschillo, E., Vaschillo, B., Lu, S. E., Eckberg, D. L., Edelberg, R., Shih, W. J., Lin, Y., Kuusela, T. A., Tahvanainen, K. U. O., & Hamer, R. M. (2003). Heart rate variability biofeedback increases baroreflex gain and peak expiratory flow. Psychosomatic Medicine, 65, 796-805. http://dx.doi.org/10.1097/01.PSY.0000089200.81962.19
[42] Linton, S. J. (2004). Does work stress predict insomnia? A prospective study. British Journal of Health Psychology, 9, 127-136.
http://dx.doi.org/10.1348/135910704773891005
[43] Lucassen, P. J., Meerlo, P., Naylor, A. S., van Dam, A. M., Dayer, A. G., Fuchs, E., Omen, C. A., & Czeh, B. (2010). Regulation of adult neurogenesis by stress, sleep disruption, exercise and inflammation: Implications for depression and antidepressant action. European Neuropsychopharmacology, 20, 1-17.
http://dx.doi.org/10.1016/j.euroneuro.2009.08.003
[44] Lucini, D., Norbiato, G., Clerici, M., & Pagani, M. (2002). Hemodynamics and autonomic adjustments to real life conditions in humans. Hypertension, 39, 184-188. http://dx.doi.org/10.1161/hy0102.100784
[45] Marquie, J. C., Foret, J., & Queinnec, Y. (1999). Effects of age, working hours, and job content on sleep: A pilot study. Experimental Aging Research, 25, 421-427. http://dx.doi.org/10.1080/036107399243896
[46] Malik, et al. (1996). Task force of the European society of cardiology and the North American society of pacing and electrophysiology. Heart rate variability. Standards of measurements, physiological interpretation and clinical use. Circulation, 93, 1043-1065.
http://dx.doi.org/10.1161/01.CIR.93.5.1043
[47] McCraty, R., Atkinson, M., Lipsenthal, L., & Arguelles, L. (2003). Boulder Creek, CA: HeartMath Research Center, Institute of HeartMath, Report No. 03-014.
[48] McCraty, R., Atkinson, M., Tiller, W. A., Rein, G., & Watkins, A. D. (1995). The effects of emotions on short term heart rate variability using power spectrum analysis. American Journal of Cardiology, 76, 1089-1093. http://dx.doi.org/10.1016/S0002-9149(99)80309-9
[49] McCraty, R., Atkinson, M., & Tomasino, D. (2003). Impact of a Workplace Stress Reduction Program on Blood Pressure and Emotional Health in Hypertensive Employees. Journal of Alternative and Complementary Medicine, 9, 355-369.
http://dx.doi.org/10.1089/107555303765551589
[50] McCraty, R., Barrios-Choplin, B., Rozman, D., Atkinson, M., & Watkins, A. D. (1998). The impact of a new emotional self-management program on stress, emotions, heart rate variability, DHEA and cortisol. Integrative Physiological and Behavioral Science, 33, 151-170.
http://dx.doi.org/10.1007/BF02688660
[51] McCraty, R., & Tomasino, D. (2004). Heart rhythm coherence feedback: A new tool for stress reduction, rehabilitation, and performance enhancement. Proceedings of the First Baltic Forum on Neuronal Regulation and Biofeedback, Riga, Latvia, 2-5 November 2004.
[52] Meerlo, P., Mistlberger, R. E., Jacobs, B. L., Heller, H. C., & McGinty, D. (2009). New neurons in the adult brain: The role of sleep and consequences of sleep loss. Sleep Medicine Reviews, 13, 187-194.
http://dx.doi.org/10.1016/j.smrv.2008.07.004
[53] Mellman, T. A., & Uhde, T. W. (1989). Electroencephalographic sleep in panic disorder: A focus on sleep-related panic attacks. JAMA Psychiatry, 46, 176-184.
http://dx.doi.org/10.1001/archpsyc.1989.01810020080013
[54] Nakane, H., Asami, O., Yamada, Y., Harada, T., Matsui, N., Kanno T., & Yanaihara, N. (1998). Salivary chromogranin A as an index of psychosomatic stress response. Biomedical Research, 19, 401-406.
[55] Nakata, A., Haratani, T., Takahashi, M., Kawakami, N., Arito, H., Kobayashi, F., & Araki, S. (2004). Job stress, social support, and prevalence of insomnia in a population of Japanese daytime workers. Social Science & Medicine, 59, 1719-1730.
http://dx.doi.org/10.1016/j.socscimed.2004.02.002
[56] Nater, U. M., Rohleder, N., Gaab, J., Berger, S., Jud, A., Kirschbaum, C., & Ehlert, U. (2005). Human salivary alpha-amylase reactivity in a psychosocial stress paradigm. International Journal of Psychophysiology, 55, 333-342.
http://dx.doi.org/10.1016/j.ijpsycho.2004.09.009
[57] Nater, U. M., La Marca, R., Florin, L., Moses, A., Langhans, W., Koller, M. M., & Ehlert, U. (2006). Stress-induced changes in human salivary alpha-amylase activity—associations with adrenergic activity. Psychoneuroendocrinology, 31, 49-58.
http://dx.doi.org/10.1016/j.psyneuen.2005.05.010
[58] Niskanen, J. P., Tarveinen, M. P., Ranta-aho, P. O., & Karjalainen, P. A. (2004). Software for advanced HRV analysis. Computer Methods and Programs in Biomedicine, 76, 73-81.
http://dx.doi.org/10.1016/j.cmpb.2004.03.004
[59] Nishida, M., Pearsall, J., Buckner, R. L., & Walker, M. P. (2009). REM sleep, prefrontal theta, and the consolidation of human emotional memory. Cerebral Cortex, 19, 1158-1166.
http://dx.doi.org/10.1093/cercor/bhn155
[60] Ohira, T., Diez Roux, A. V., Prineas, R. J., Kizilbash, M. A., Carnethon, M. R., & Folsom, A. R. (2008). Associations of psychosocial factors with heart rate and its short-term variability: Multi-ethnic study of atherosclerosis. Psychosomatic Medicine, 70, 141-146.
[61] Parati, G., Mancia, G., Di Rienzo, M., & Castiglioni, P. (2006). Point: Cardiovascular variability is/is not an index of autonomic control of circulation. Journal of Applied Physiology, 101, 676-678.
http://dx.doi.org/10.1152/japplphysiol.00446.2006
[62] Payne, J. D., & Nadel, L. (2004). Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol. Learning Memory, 11, 671-678. http://dx.doi.org/10.1101/lm.77104
[63] Plihal, W., & Born, J. (1999). Memory consolidation in human sleep depends on inhibition of glucocorticoid release. Neuroreport, 10, 2741-2747. http://dx.doi.org/10.1097/00001756-199909090-00009
[64] Poleshuck, E. L., Bair, M. J., Kroenke, K., Damush, T. M., Tu, W. Z., Wu, J. W., Krebs, E. E., & Giles, D. E. (2009). Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression. General Hospital Psychiatry, 31, 116-122.
http://dx.doi.org/10.1016/j.genhosppsych.2008.10.003
[65] Porges, S. W. (1995). Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A polyvagal theory. Psychophysiology, 32, 301-318.
http://dx.doi.org/10.1111/j.1469-8986.1995.tb01213.x
[66] Reynolds, C. F., Shaw, D. H., Newton, T. F., Coble, P. A., & Kupfer, D. J. (1983). EEG sleep in outpatients with generalized anxiety, a preliminary comparison with depressed outpatients. Psychiatry Research, 8, 81-89. http://dx.doi.org/10.1016/0165-1781(83)90094-X
[67] Riemann, D., Berger, M., & Voderholzer, U. (2001). Sleep deprivation—results from psychobiological studies: An overview. Biological Psychology, 57, 67-103.
http://dx.doi.org/10.1016/S0301-0511(01)00090-4
[68] Sade, S., Bar-Eli, M., Bresler, S., & Tenenbaum, G. (1990). Anxiety, self-control and shooting performance. Perceptual and Motor Skills, 71, 3-6.
[69] Sollers, J. J. 3rd, Buchanan, T. W., Mowrer, S. M., Hill, L. K., & Thayer, J. F. (2007). Comparison of the ratio of the standard deviation of the R-R interval and the root mean squared successive differences (SD/rMSSD) to the low frequency-to-high frequency (LF/HF) ratio in a patient population and normal healthy controls. Biomedical Sciences Instrumentation, 43, 158-163.
[70] Spielberger, C. D. (1966). Theory and research on anxiety. Anxiety and behavior. New York: Academic press.
[71] Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). State-trait anxiety inventory manual. Palo Alto, CA: Consulting Psychologists Press.
[72] Spielberger, C. D. (1975). Anxiety: State-trait-process. In C. D. Spielberger, & I. G. Sarason (Eds.), Stress and anxiety (pp. 115-143). New York: Wiley.
[73] Spoormaker, V. I., & van den Bout, J. (2005). Depression and anxiety complaints; relations with sleep disturbances. European Psychiatry, 20, 243-245. http://dx.doi.org/10.1016/j.eurpsy.2004.11.006
[74] Sterling, P., & Eyer, J. (1988). Allostasis: A new paradigm to explain arousal pathology. In S. Fisher, & J. reason (Eds.), Handbook of life stress, cognition and health (pp. 631-651). John Wiley and Sons Ltd.
[75] Sushecki, D., Machado, R. B., & Tiba, P. A. (2009). Stress-induced sleep rebound: Adaptative behaviour and possible mechanisms. Sleep Science, 2, 151-160.
[76] Thayer, R. E. (1967). Measurement of activation through self-report. Psychological Reports, 20, 663-678.
[77] Thayer, R. E. (1978). Factor analytic and reliability studies on the Activation-Deactivation Adjective Check List. Psychological Reports, 42, 747-756. http://dx.doi.org/10.2466/pr0.1978.42.3.747
[78] Thayer, R. E. (1986). Activation-Deactivation Adjective Check List (AD ACL): Current overview and structural analysis. Psychological Reports, 58, 607-614. http://dx.doi.org/10.2466/pr0.1986.58.2.607
[79] Thayer, R. E. (1987). Energy, tiredness, and tension effects of a sugar snack versus moderate exercise. Journal of Personality and Social Psychology, 52, 119-125.
http://dx.doi.org/10.1037/0022-3514.52.1.119
[80] Thayer, R. E. (1989). The biopsychology of mood and arousal. Oxford: Oxford University Press.
[81] Thayer, R. E., Newman R., & McClain, T. M. (1994). Self-regulation of mood: Strategies for changing a bad mood, raising energy, and reducing tension. Journal of Personality and Social Psychology, 76, 910-925. http://dx.doi.org/10.1037/0022-3514.67.5.910
[82] Trousselard, M., Cian, C., Barraud, P. A., Ferhani, O., Roux, A., Claverie, D., Canini, F., & Baert, P. (2009). Physiological and psychological effects of escape from a sunken submarine on shore and at sea. Aviation, Space, and Environmental Medicine, 80, 850-856.
http://dx.doi.org/10.3357/ASEM.2503.2009
[83] Vahtera, J., Kivimaki, M., Pentti, J., Linna, A., Virtanen, M., Virtanen, P., & Ferrie, J. (2004). Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study. British Medical Journal, 328, 555. online version.
[84] Vgontzas, A. N., Bixler, E. O., & Kales, A. (2000). Sleep, sleep disorders, and stress (pp. 449-457). San Diego: Academic Press.
[85] Watson, D., & Clark, L. A. (1994). Introduction to the special issue on personality and psychopathology. Journal of Abnormal Psychology, 103, 3-5. http://dx.doi.org/10.1037/h0092429
[86] Wessel, N., Voss, A., Malberg, H., Ziehmann, C., Voss, H. U., Schirdewan, A., Meyerfeldt, U., & Kurths, J. (1990). Nonlinear analysis of complex phenomena in cardiological data. Herzschrittmachertherapie und Elektrophysiologie, 11, 159-173.
http://dx.doi.org/10.1007/s003990070035

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