Date of Award

4-3-2024

Publication Type

Dissertation

Degree Name

Ph.D.

Department

Psychology

Keywords

Affect;Concussion;Emotion;Sleep;Symptoms

Supervisor

Christopher Abeare

Abstract

Background & Purpose: There are known bi-directional associations between sleep and symptom experience, as well as sleep and social functioning. However, little is known about the mechanism of this effect. The purpose of the present study was to examine the role of emotional functioning in the relation between sleep and symptom reporting and sleep and social functioning with the intent to apply findings to sport-related concussion and more generally. Methods: The first study used retrospective data. Participants for study 1 were 266 undergraduate students (Mage= 21.85, SDage= 4.86, range = 18 to 52, Medu= 14.26, SDedu= 1.93; 35% male, 65% female). This study used free-living sleep duration the previous night and subjective sleep disturbance as the independent variables. The second study was a case-control experimental sleep restriction (ESR) study. Participants’ sleep was tracked with Fitbit devices for one week, and on the sixth night, the experimental group was permitted to sleep for only three hours. The control group slept normally. Both groups completed questionnaires at four time points: at the beginning of participation, the morning before ESR, the morning after ESR, and the morning after a night of normal sleep. Participants were 44 undergraduate students (Mage= 24.53, SDage= 5.16, range = 19 to 49, Medu= 25.89, SDedu= 1.90; 57% male, 43% female). Outcome variables for both studies were concussion-like symptoms and physical symptoms more generally. Study 2 also used loneliness, social isolation, and emotional support as outcome variables. Results: Results of study 1 indicated that those with more severe depression, anxiety, and stress generally reported more concussion-like and physical symptoms. Similarly, those who had shorter duration sleep the night previous and those with sleep disturbance reported more symptoms than those with longer sleep and no sleep disturbance respectively. Although females reported more symptoms than males, there was no interaction between either sleep duration or subjective sleep disturbance and sex. Lastly, emotional functioning mediated the relation between SSD and symptom reporting, but not the relation between free-living sleep duration and symptom reporting treated either continuously or categorically. Results of study 2 showed that there were within-and between-subjects differences for the symptom and emotional variables based on sleep restriction. The social variables showed no differences. Although there was no statistically significant interaction between sleep and sex, graphical representation of the data suggests that, with a larger sample size, there may have been. Lastly, emotional distress, anxiety, stress, and negative affect mediated the relation between sleep group (experimentally restricted vs. control) and concussion-like and physical symptom reporting. Depression and positive affect did not. There was an indirect effect, but not mediation when social variables were the outcome variables. Conclusions: Sleep restriction causes increases in emotional distress and concussion-like and physical symptom reporting. The relation between extreme sleep restriction and these symptoms is mediated by several aspects of emotional functioning. This is not true for free-living sleep duration. The relation between subjective sleep disturbance and symptom experience is also mediated by emotional functioning. Finally, the relation between subjective sleep disturbance, but not sleep duration, and social functioning is mediated by emotional functioning. There is an indirect effect of emotional functioning between extreme sleep restriction and social functioning. The implications for clinical practice are discussed.

Download

Included in

Psychology Commons

Share

COinS