Beyond single sleep measures: A composite measure of sleep health and its associations with psychological and physical well-being in adulthood

Abstract

Rationale: Sleep is important for many functions including body and mind restoration. Studies report the association of sleep with stress and physical deterioration, often focusing only on sleep duration; yet, sleep health needs to be understood by multiple dimensions to comprehensively capture its impact on well-being.

Objective: This study examined cross-sectional and longitudinal associations of multidimensional sleep health with perceived stress and chronic physical conditions.

Methods: We used a sample of 441 adults (M age = 57 years) who participated in the biomarker project of the Midlife in the United States Study. Participants provided self-report and actigraphy sleep data in 2004-2009 (T1). We created a composite score of sleep health (Range = 0-6; higher indicating more sleep problems) encompassing: actigraphy-measured regularity, timing, efficiency, duration, and self-reported satisfaction and alertness. Participants responded to the perceived stress scale and chronic physical conditions checklist at T1; chronic physical conditions were reassessed in 2013-2015 (T2).

Results: Cross-sectionally, a composite score of sleep health problems was uniquely associated with higher perceived stress and more chronic conditions, explaining additional variance that each individual sleep variable did not explain. Sleep duration - one of the most commonly researched dimensions of sleep - was not associated with either perceived stress or chronic conditions. Longitudinally, for individuals who had fewer chronic conditions at T1, having more sleep health problems was associated with an increase in chronic conditions at T2. Among the multiple dimensions, sleep satisfaction was most consistently and strongly associated with the outcomes.

Conclusion: Findings suggest the importance of considering multiple sleep dimensions concerning psychological and physical well-being in adulthood.

Keywords: Chronic conditions; Physical health; Psychological well-being; Sleep duration; Sleep health; Stress.