How stress affects sleep and mental health: nocturnal heart rate increases during prolonged stress and interacts with childhood trauma exposure to predict anxiety

Impact of nocturnal road traffic noise and annoyance on self-reported insomnia symptoms: policy intervention in noise-polluted environments

Chronic exposure to traffic noise is associated with increased stress and sleep disruptions. Research on the health consequences of environmental noise, specifically traffic noise, has primarily been conducted in high-income countries (HICs), which have guided the development of noise regulations. The relevance of these findings to policy frameworks in low- and middle-income countries (LMICs) remains uncertain. To investigate the relationship between road traffic noise exposure and annoyance on insomnia symptoms, a questionnaire survey was administered to 5408 randomly selected participants residing in Srinagar, India. Sleep quality was assessed using a standardized sleep disturbance score, along with self-reported annoyance levels related to road traffic noise at the participants' residences. Nighttime road traffic noise was modeled using Sound PLAN 8.2 software to generate noise contour maps, enabling the spatial evaluation of noise levels along roadways near residential areas. A total of 79.3% of the 5408 respondents were exposed to noise levels exceeding 45 Lnight dB(A). Statistically significant associations were observed between traffic noise exposure and all insomnia symptoms, with difficulty falling asleep showing the strongest association (OR = 1.53; 95% CI = 1.12-2.09) within the study sample. Compared to males, females exhibited higher insomnia symptoms (OR = 1.68; 95% CI = 1.35-2.08). The results indicated that insomnia was strongly correlated with an increased odds of traffic noise annoyance (OR = 2.39; 95% CI = 1.73-3.76) (p = 0.029). Finally, this study advocates for a robust regulatory framework to incorporate noise pollution mitigation strategies into the public health action plans of developing nations.

Stress-induced increase in heart-rate during sleep as an indicator of PTSD risk among combat soldiers

STUDY OBJECTIVES

Discerning the differential contribution of sleep behavior and sleep physiology to the subsequent development of posttraumatic-stress-disorder (PTSD) symptoms following military operational service among combat soldiers.

METHODS

Longitudinal design with three measurement time points: during basic training week (T1), during intensive stressed training week (T2), and following military operational service (T3). Participating soldiers were all from the same unit, ensuring equivalent training schedules and stress exposures. During measurement weeks soldiers completed the Depression Anxiety and Stress Scale (DASS) and the PTSD Checklist for DSM-5 (PCL-5). Sleep physiology (sleep heart-rate) and sleep behavior (duration, efficiency) were monitored continuously in natural settings during T1 and T2 weeks using wearable sensors.

RESULTS

Repeated measures ANOVA revealed a progressive increase in PCL-5 scores from T1 and T2 to T3, suggesting an escalation in PTSD symptom severity following operational service. Hierarchical linear regression analysis uncovered a significant relation between the change in DASS stress scores from T1 to T2 and subsequent PCL-5 scores at T3. Incorporating participants' sleep heart-rate markedly enhanced the predictive accuracy of the model, with increased sleep heart-rate from T1 to T2 emerging as a significant predictor of elevated PTSD symptoms at T3, above and beyond the contribution of DASS stress scores. Sleep behavior did not add to the accuracy of the model.

CONCLUSION

Findings underscore the critical role of sleep physiology, specifically elevated sleep heart-rate following stressful military training, in indicating subsequent PTSD risk following operational service among combat soldiers. These findings may contribute to PTSD prediction and prevention efforts.

Individual-level noise exposure and its association with sleep quality and duration: A cross-sectional study using real-time data

As urban populations grow, the problem of noise pollution becomes more significant. The limited number of epidemiological studies linking individual-level dynamic noise exposure to sleep highlights a gap in our understanding of how individual-level noise exposure impact sleep quality and duration. A cross-sectional survey was conducted in Hong Kong, and portable noise sensors were used to record participants' real-time noise exposure. The Pittsburgh Sleep Quality Index was used to assess their sleep quality. Logistic regression was used to examine the relationship of individual-level noise exposure with sleep quality and sleep duration. Among a total of 763 subjects included in the analysis, and a-weighted decibels [dB(A)] 24-h average exposure (L24) was 63.21 (58.85-67.85) dB(A) for workday and 63.52 (59.03-67.86) dB(A) for non-workday. A significant decrease in individual noise level was observed closer to bedtime (P < 0.05). Compared with the lowest noise exposure, exposure to the highest noise level was positively associated with the presence of poor sleep quality for L24, Ld and Ln, with an odds ratio (OR) and 95 % confidential interval (CI) of 1.53 (1.04-2.24), 1.65 (1.12-2.43), and 1.51 (1.03-2.21), respectively. Exposure to elevated noise level was associated with increased risk of shorter nocturnal sleep duration (< 7 h), the OR and 95 % CI was 1.87 (1.29-2.73) for L24, 1.58 (1.09-2.30) for Ld, 1.50 (1.03-2.18) for Le, and 1.60 (1.10-2.32) for Ln in the highest noise exposure group. Similar findings were observed both on workdays and non-workdays, respectively. Furthermore, the results showed that each 10 dB(A) increment in L24 and Ln was associated with a probable 29 % and 27 % increase in poor sleep quality and a 24 % and 24 % reduction in sleep duration. This study demonstrates that environmental noise exposure was associated with poor sleep quality and shorter sleep duration, posing a significant public health issue in Hong Kong.

An exploration into the sleep of workers on block-calving, pasture-based dairy farms

The benefits of sufficient and high-quality sleep for people are well documented. Insufficient sleep increases the risk of accidents, injuries, and negative health implications for people. This is especially relevant for farmers because they work with large animals and machinery. Dairy farming often requires early start times and long days, particularly over the high-workload calving period in block-calving, pasture-based systems. However, there is little published data quantifying the sleep quantity and quality of farmers over this period. In this study, the sleep patterns of workers (n = 33) on 10 New Zealand dairy farms were measured for 90 d over the spring calving period using a sleep measuring device (Oura ring, Oura Health Ltd., Oulu, Finland). Total sleep time (TST) averaged 6 h 15 min, lower than the required 7 to 9 h for optimal wellbeing and cognitive functioning. The TST decreased over the calving period and was significantly correlated with both sleep start and wake times. Factors such as work start time, farm location, and role on farm influenced sleep quantity and quality. Further research is required to better understand sleep and its effect on dairy farmers, over both the calving period and the remaining months of the year.

Childhood trauma and college student health: a review of the literature

The experience of childhood trauma is known to predict health-relevant outcomes across the lifespan. Previous reviews summarize existing knowledge of the implications of childhood trauma for health in young adults and adults more generally. The current theoretical review aims to integrate the existing literature on the relationship between childhood trauma and health-relevant outcomes specifically in college students, consolidating findings across specific health domains. Further, the following theoretical review highlights the need for more research in this area and discusses how college campuses may use the knowledge in this area of work to develop targeted interventions aimed at improving the health of college students who experienced trauma in childhood.

Nonrestorative sleep and its associated factors in Chinese adolescents and the moderation effects of coffee or tea consumption

BACKGROUND

Nonrestorative sleep (NRS) is related to numerous adverse outcomes. There is rare evidence of its associated factors, especially in Chinese adolescents. This study aimed to explore the factors associated with NRS in Chinese adolescents and the potential moderation effects of coffee or tea consumption.

METHODS

This cross-sectional study invited adolescents attending Grades 7-11 in Nanjing, China, to complete a self-administered questionnaire, including their NRS, stress, anxiety, physical symptoms, depression, sociodemographics, and lifestyles. Linear regressions were applied to investigate the associated factors of their NRS, with the moderation effects of coffee or tea consumption and other characteristics being tested by additionally including their interactions.

RESULTS

Totally 481 adolescents (49% male, age 15.5 ± 1.5 years) were enrolled, with the average global NRS score of 42.16 ± 7.57. Higher family income (β = 2.01, P = 0.007), longer sleep duration (β = 2.33, P = 0.011), and moderate after-class activity (β = 1.50, P = 0.044) contributed less NRS, while higher educational level (β = -2.60, P = 0.033), more coffee or tea consumption (β = -1.68, P = 0.013), physical symptoms (β = -3.85, P < 0.001), stress (β = -0.23, P = 0.005), anxiety (β = -1.54, P = 0.045), and depression (β = -0.13, P = 0.014) contributed more NRS. Females (β = 0.82, P = 0.005), older age (β = -0.46, P = 0.029), and higher education level (β = -1.68, P < 0.001) contributed less refreshment from sleep, more physical/medical symptoms of NRS, and less daytime function, respectively. Coffee or tea consumption moderated the associations of somatic symptoms (β = 0.25, P = 0.021), stress (β = 0.29, P = 0.022), anxiety (β = 0.27, P = 0.005), and depression (β = 0.17, P = 0.021) with NRS.

CONCLUSIONS

Longer sleep duration, moderate after-class activity, reduced coffee or tea consumption, and promotion of physical and mental health may help reduce adolescents' NRS. Coffee or tea consumption may help buffer the negative associations of somatic symptoms, stress, anxiety, and depression with NRS.

Examining bi-directional links between loneliness, social connectedness and sleep from a trait and state perspective

Greater loneliness as well as a lack of social connectedness have often been associated with poorer sleep. However, the temporal dynamics and direction of these associations remain unclear. Aim of the current study was to examine bi-directional associations between loneliness/social connectedness and sleep in 48 stress-exposed medical students during their first medical internship, considered a period of heightened stress. We obtained trait-level questionnaire data on loneliness and global sleep completed before and during the internship as well as state-level diary- and wearable-based data on daily changes in social connectedness and sleep collected twice over the period of seven consecutive days, once before and once during the internship. Bi-directional associations among greater loneliness and higher daytime dysfunction on trait-level were identified. In addition, several uni-directional associations between loneliness/social connectedness and sleep were found on trait- and state-level. In sum, findings of this study point at a bi-directional relation among loneliness/social connectedness and sleep, in which variables seem to reciprocally influence each other across longer-term periods as well as on a day-to-day basis.

How acute stress affects sleep: large-scale observations from continuous smart ring measurements in free-living conditions

Stress management may be crucial to improving sleep quality due to the intertwined relationship between stress and sleep. Commercial wearables offer both acute stress tracking and sleep tracking, yet the effects of acute physiological stress on sleep have not been widely studied in uncontrolled, free-living conditions. This study employs stress and sleep data from over 45,000 individuals collected with the Oura Ring during daily life. A group of stressed individuals were compared with a group of individuals with high daytime recovery. Sleep related data were analyzed with respect to the number of accumulated stressful or restorative days, respective to the group in question, within a one-week period. The results highlight the destructive effect that the accumulation of stressful days may have on sleep biometrics, indicating significant decrease in sleep quality. Vice versa, the results also imply the opposite effect from restorative days, emphasizing the importance of balancing acute stress with rest and the potential benefits from data driven stress management.

Sleep, mental health and physical health in new shift workers transitioning to shift work: Systematic review and meta-analysis

This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers' sleep, mental health, and physical health during the transition to shift work and to consolidate information regarding predictors of shift work tolerance (SWT) during this transition period. Inclusion criteria included: new shift workers; sleep, mental health, or physical health outcomes; prospective study design with the first timepoint assessing workers within three months of starting shift work; and written in English. Searches from six databases returned 12,172 articles as of August 2023. The final sample included 48 papers. Publication quality and risk of bias was assessed using the critical appraisal skills program. Forty-five studies investigated longitudinal changes in sleep, mental health, or physical health outcomes and 29 studies investigated predictors of SWT (i.e., better sleep, mental and physical health). Sleep and mental health outcomes worsened following the onset of shift work, while physical health did not significantly change. Pre-shift work mental health, sleep, and work characteristics predicted SWT later in workers' careers. Shift work adversely impacts new workers' sleep and mental health early in their career, and interventions before beginning shift work are needed to promote better SWT.

Predicting stress in first-year college students using sleep data from wearable devices

Consumer wearables have been successful at measuring sleep and may be useful in predicting changes in mental health measures such as stress. A key challenge remains in quantifying the relationship between sleep measures associated with physiologic stress and a user's experience of stress. Students from a public university enrolled in the Lived Experiences Measured Using Rings Study (LEMURS) provided continuous biometric data and answered weekly surveys during their first semester of college between October-December 2022. We analyzed weekly associations between estimated sleep measures and perceived stress for participants (N = 525). Through mixed-effects regression models, we identified consistent associations between perceived stress scores and average nightly total sleep time (TST), resting heart rate (RHR), heart rate variability (HRV), and respiratory rate (ARR). These effects persisted after controlling for gender and week of the semester. Specifically, for every additional hour of TST, the odds of experiencing moderate-to-high stress decreased by 0.617 or by 38.3% (p<0.01). For each 1 beat per minute increase in RHR, the odds of experiencing moderate-to-high stress increased by 1.036 or by 3.6% (p<0.01). For each 1 millisecond increase in HRV, the odds of experiencing moderate-to-high stress decreased by 0.988 or by 1.2% (p<0.05). For each additional breath per minute increase in ARR, the odds of experiencing moderate-to-high stress increased by 1.230 or by 23.0% (p<0.01). Consistent with previous research, participants who did not identify as male (i.e., female, nonbinary, and transgender participants) had significantly higher self-reported stress throughout the study. The week of the semester was also a significant predictor of stress. Sleep data from wearable devices may help us understand and to better predict stress, a strong signal of the ongoing mental health epidemic among college students.

Mental health impacts of the COVID-19 pandemic on college students

The COVID-19 pandemic is having profound effects on college students, and those with mental health conditions are more vulnerable to the impact of this stress. Objective: To study the impact of the COVID-19 pandemic on college students' mental health. Participants: Participants (n=489) were mostly female, undergraduate, and aged 18-25. Methods: Participants completed an online survey assessing symptoms of mental health problems including hopelessness, loneliness, sadness, anxiety, sadness, and anger. Results: Approximately 81.6 % self-reported at least one negative mental health symptom. Students reported increased feelings of hopelessness (+7.8%), loneliness (+6.7%), sadness (+8.8%), depression (+2.6%), anxiety (+5.2%), and anger (+14.6%) during the pandemic than before. LGBTQ students and Black students had significantly more mental health symptoms during the pandemic than straight and White students. Conclusions: Results of this study highlight the negative impact of the pandemic and resultant changes on college students' mental health.

From childhood adversity to latent stress vulnerability in adulthood: the mediating roles of sleep disturbances and HPA axis dysfunction

Childhood adversity is a prominent predisposing risk factor for latent stress vulnerability, expressed as an elevated likelihood of developing stress-related psychopathology upon subsequent exposure to trauma in adulthood. Sleep disturbances have emerged as one of the most pronounced maladaptive behavioral outcomes of childhood adversity and are also a highly prevalent core feature of stress-related psychopathology, including post-traumatic stress disorder (PTSD). After reviewing the extensive literature supporting these claims, the current review addresses the notion that childhood adversity-induced sleep disturbances may play a causal role in elevating individuals' stress vulnerability in adulthood. Corroborating this, sleep disturbances that predate adult trauma exposure have been associated with an increased likelihood of developing stress-related psychopathology post-exposure. Furthermore, novel empirical evidence suggests that sleep disturbances, including irregularity of the sleep-wake cycle, mediate the link between childhood adversity and stress vulnerability in adulthood. We also discuss cognitive and behavioral mechanisms through which such a cascade may evolve, highlighting the putative role of impaired memory consolidation and fear extinction. Next, we present evidence to support the contribution of the hypothalamic-pituitary-adrenal (HPA) axis to these associations, stemming from its critical role in stress and sleep regulatory pathways. Childhood adversity may yield bi-directional effects within the HPA stress and sleep axes in which sleep disturbances and HPA axis dysfunction reinforce each other, leading to elevated stress vulnerability. To conclude, we postulate a conceptual path model from childhood adversity to latent stress vulnerability in adulthood and discuss the potential clinical implications of these notions, while highlighting directions for future research.

Multimodal assessment of effects of urban environments on psychological wellbeing

The built environment is a ubiquitous factor of modern human life, which fundamentally affects human wellbeing. Most existing research on the psychological effects of urban environments is predominantly based on subjective self-report measures, which provide valuable insights into subjective experiences, but are also affected by conscious and subconscious bias. In the current study, we evaluate a multimodal approach to capturing wellbeing by employing objective mobile physiological and neurophysiological measurement technologies alongside self-reports to capture the impact of two different urban environments. Moreover, we endeavoured to comprehensively measure and, when possible, control the physical aspects of the environment. Our study specifically aimed to discover differences between psychological wellbeing indicators in adults across low-density vs. moderate-density urban environments. Data collection took place in two urban outdoor locations in Australia. Statistical comparison of the two locations indicated that low urban density led to comparatively higher levels of psychological wellbeing compared to moderate urban density. Self-reports indicated that the low-density environment led to higher levels of subjective feelings of comfort and safety and reduced levels of negative mood. In line with the subjective reports, in the low-density environment compared to the moderate-density environment, individuals showed higher levels of EEG theta activity, while EEG beta and heart rate measures were lower. The research outcome provides insights into how urban density affects people's wellbeing and showcases the benefits of employing ecologically-valid multimodal psychological-environmental measurement approaches to effectively evaluate the psychological impacts of built environments.

Recent Progress in Long-Term Sleep Monitoring Technology

Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children's growth. Especially after the COVID-19 epidemic, sleep health issues have attracted more attention. In recent years, with the development of wearable electronic devices, there have been more and more studies, products, or solutions related to sleep monitoring. Many mature technologies, such as polysomnography, have been applied to clinical practice. However, it is urgent to develop wearable or non-contacting electronic devices suitable for household continuous sleep monitoring. This paper first introduces the basic knowledge of sleep and the significance of sleep monitoring. Then, according to the types of physiological signals monitored, this paper describes the research progress of bioelectrical signals, biomechanical signals, and biochemical signals used for sleep monitoring. However, it is not ideal to monitor the sleep quality for the whole night based on only one signal. Therefore, this paper reviews the research on multi-signal monitoring and introduces systematic sleep monitoring schemes. Finally, a conclusion and discussion of sleep monitoring are presented to propose potential future directions and prospects for sleep monitoring.

Life stress, insomnia, and anxiety/depressive symptoms in adolescents: A three-wave longitudinal study

PURPOSE

Life stress has negative impacts on sleep and mental health. Little empirical work has investigated the associations between life stress, insomnia, and anxiety/depressive symptoms (ADS) in multi-wave longitudinal studies. This longitudinal study examined these associations in a large sample of adolescents.

METHODS

A total of 6995 adolescents (mean age = 14.86 years, 51.4 % male) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess life stress, insomnia, and ADS in 2015 (T1), 1 year later (T2), and 2 years later (T3). Three-wave longitudinal panel models were conducted to examine the prospective relationships between life stress, insomnia, and ADS.

RESULTS

The prevalence and persistence rates of insomnia and ADS across T1-T3 significantly increased with elevated life stress score (p < .001). Cross-lagged panel analysis showed that life stress, insomnia, and ADS at a later time point were significantly predicted by the same variable at earlier time points (all p < .01). Life stress, insomnia, and ADS significantly predicted each other bidirectionally over time (all p < .01). The relationship between life stress and ADS was partially mediated by insomnia. The relationship between life stress and insomnia was partially mediated by ADS.

STUDY LIMITATION

Life stress, insomnia, and ADS were all self-reports.

CONCLUSIONS

Life stress, insomnia, and ADS are prospectively bidirectionally related to one another. Insomnia was a mediator of life stress and subsequent ADS and vice versa. These findings underscore the importance of sleep and mental health assessment and intervention in adolescents following life stress.

Functional Coupling of the Locus Coeruleus Is Linked to Successful Cognitive Control

The locus coeruleus (LC) is a brainstem structure that sends widespread efferent projections throughout the mammalian brain. The LC constitutes the major source of noradrenaline (NE), a modulatory neurotransmitter that is crucial for fundamental brain functions such as arousal, attention, and cognitive control. This role of the LC-NE is traditionally not believed to reflect functional influences on the frontoparietal network or the striatum, but recent advances in chemogenetic manipulations of the rodent brain have challenged this notion. However, demonstrations of LC-NE functional connectivity with these areas in the human brain are surprisingly sparse. Here, we close this gap. Using an established emotional stroop task, we directly compared trials requiring response conflict control with trials that did not require this, but were matched for visual stimulus properties, response modality, and controlled for pupil dilation differences across both trial types. We found that LC-NE functional coupling with the parietal cortex and regions of the striatum is substantially enhanced during trials requiring response conflict control. Crucially, the strength of this functional coupling was directly related to individual reaction time differences incurred by conflict resolution. Our data concur with recent rodent findings and highlight the importance of converging evidence between human and nonhuman neurophysiology to further understand the neural systems supporting adaptive and maladaptive behavior in health and disease.

The relationship between stress, trait emotional intelligence and mental health amongst Gaza’s basic-year medical students during the COVID-19 outbreak

Background

This study investigates the relationship between exposure to stress, trait emotional intelligence (trait EI) and mental health problems (anxiety and depression symptoms) amongst basic-year medical students during COVID-19. The sample consists of 379 basic-year medical students. Off them, 160 (42.4%) were male and 218 (57.5%) were female. The following measures were used in the study: The Medical Student Stressor Questionnaire (MSSQ), Trait Emotional Intelligence Questionnaire—Short Form (TEIQue-ASF), The anxiety symptoms scale and the depression scale.

Results

The majority of students reported high to severe level ARS and mild to moderate DRS. Female students showed higher levels of ARS, TLRS, SRS, GARS and anxiety symptoms compared to male ones. Moreover, students with higher levels of academic performance reported lower levels of ARS and DRS, higher levels of trait EI and lower levels of anxiety and depression symptoms. In addition, trait EI has a significant negative association with anxiety and depression symptoms and stress domains (ARS, IRS, TLRS, SRS, DRS, GARS) and total stress. Finally, stress domains are positively correlated with anxiety and depression symptoms.

Conclusion

Basic-year medical students in the Gaza Strip are exposed to stressful events which aggravate the effect of exposure and cause higher levels of anxiety and depression symptoms.

Pupil dilation predicts individual self-regulation success across domains

Multiple theories have proposed that increasing central arousal through the brain's locus coeruleus-norepinephrine system may facilitate cognitive control and memory. However, the role of the arousal system in emotion regulation is less well understood. Pupil diameter is a proxy to infer upon the central arousal state. We employed an emotion regulation paradigm with a combination of design features that allowed us to dissociate regulation from emotional arousal in the pupil diameter time course of 34 healthy adults. Pupil diameter increase during regulation predicted individual differences in emotion regulation success beyond task difficulty. Moreover, the extent of this individual regulatory arousal boost predicted performance in another self-control task, dietary health challenges. Participants who harnessed more regulation-associated arousal during emotion regulation were also more successful in choosing healthier foods. These results suggest that a common arousal-based facilitation mechanism may support an individual's self-control across domains.

Noise sensitivity associated with nonrestorative sleep in Chinese adults: a cross-sectional study

Background

Nonrestorative sleep is a common sleep disorder with a prevalence ranging from 1.4 to 35%, and is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to nonrestorative sleep. This study aimed to examine the relationships among noise, noise sensitivity, nonrestorative sleep, and physiological sleep parameters in Chinese adults.

Methods

A cross-sectional household survey was conducted with randomly selected Chinese adults based on a frame stratified by geographical districts and types of quarters in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale, the Weinstein Noise Sensitivity Scale, the ENRICHD Social Support Instrument, the Patient Health Questionnaire, and the Perceived Stress Scale to assess nonrestorative sleep, noise sensitivity, social support, somatic symptoms and stress, respectively. Anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale while sociodemographic and lifestyle characteristics were assessed with an investigator-developed sheet. Nocturnal noise level and physiological sleep parameters were measured during nighttime for a week by noise dosimetry and actigraphy, respectively. A structured multiphase linear regression was conducted to estimate associations.

Results

A total of 500 adults (66.4% female) with an average age of 39 years completed this study. Bivariate regressions showed that age, marital status, occupation, family income, season, exercise, cola and soda consumption, social support, somatic symptoms, stress, depression, noise sensitivity, total sleep time, and awakenings were associated with nonrestorative sleep. In the multivariable analysis, family income, season, exercise, social support, somatic symptoms, stress, and depression remained associated with nonrestorative sleep. Specifically, a one-unit increase of noise sensitivity was associated with 0.08 increase in nonrestorative sleep (95% confidence interval [CI]: 0.01, 0.15, p = 0.023). Nocturnal noise was negatively associated with time in bed (b = − 1.65, 95% CI: − 2.77, − 0.52, p = 0.004), total sleep time (b = − 1.61, 95% CI: − 2.59, − 0.62, p = 0.001), and awakenings (b = − 0.16, 95% CI: − 0.30, − 0.03, p = 0.018), but was not associated with nonrestorative sleep.

Conclusions

Nonrestorative sleep was predicted by noise sensitivity in addition to family income, season, exercise, social support, somatic symptoms, stress, and depression.

For the Greater Good? The Devastating Ripple Effects of the Covid-19 Crisis

As the crisis around Covid-19 evolves, it becomes clear that there are numerous negative side-effects of the lockdown strategies implemented by many countries. Currently, more evidence becomes available that the lockdowns may have more negative effects than positive effects. For instance, many measures taken in a lockdown aimed at protecting human life may compromise the immune system, and purpose in life, especially of vulnerable groups. This leads to the paradoxical situation of compromising the immune system and physical and mental health of many people, including the ones we aim to protect. Also, it is expected that hundreds of millions of people will die from hunger and postponed medical treatments. Other side effects include financial insecurity of billions of people, physical and mental health problems, and increased inequalities. The economic and health repercussions of the crisis will be falling disproportionately on young workers, low-income families and women, and thus exacerbate existing inequalities. As the virus outbreak and media coverage spread fear and anxiety, superstition, cognitive dissonance reduction and conspiracy theories are ways to find meaning and reduce anxiety. These behavioral aspects may play a role in the continuance of lockdown decisions. Based on theories regarding agnotology (i.e., the ways ignorance or doubt about certain topics is created by means of withholding or presenting information in a certain way), social influence, superstition and stress and coping, I seek to explain the social and behavioral aspects of human behavior in times of crises. Both the Covid-19 crisis itself as well as the resulting economic and (mental) health crisis are global problems that may require global solutions. I present a model of drivers and outcomes of lockdown behaviors and offer suggestions and a tool to counteract the negative psychological effects by means of online life crafting therapeutic writing interventions.