Jackowska, M; (2013) Sleep, health-related biological function and well-being. Doctoral thesis (PhD), UCL (University College London).

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Abstract

Sleep patterns are linked to cardiovascular outcomes and psychological well-being, but gaps in knowledge remain. This thesis tested four aspects of the relationships between sleep, cardiovascular risk and well-being using different methods of investigation; an analysis of a large population dataset (the English Longitudinal Study of Aging (Study 1), an investigation of affective and biological responses in everyday life of working women (Studies 2, 3), and a short-term well-being intervention (Study 4). Studies 1 and 2 tested whether direct biological dysregulation may be in part responsible for higher risk of cardiovascular outcomes in poor sleepers. Study 1 found that in older adults longer sleep was correlated with elevated inflammation, while short sleep was associated with low haemoglobin. Disturbed sleep was more prevalent among those with higher inflammation, lower dehydroepiandrosterone sulfate and haemoglobin as well as anaemia. These relationships were found mostly in men, but nonetheless they emphasise that self-reported sleep has important biological correlates in older adults. Study 2 extended data from experimental studies to real life settings, and found that disturbed sleep is related to lower heart rate variability (HRV). This suggests that lower HRV, a marker of dysfunctional autonomic activity, may be another pathway contributing towards higher risk of cardiovascular outcomes in poor sleepers. Study 3 compared objective and subjective measures of sleep efficiency and discovered that psychosocial characteristics including work stress and social support are related to underestimations of sleep efficiency, in comparison with objective measures. Thus associations between self-reported sleep and health-related factors may be overestimated in studies based on self-report. Study 4 aimed to induce positive well-being in a randomised controlled trial, to test whether this would lead to improvements in sleep. Well-being was increased post-intervention, but improvements in sleep were marginal. Importantly, changes in well-being were correlated with beneficial alternations in subjective sleep, tentatively suggesting that positive well-being may exert protective effects on (self-reported) sleep. In combination, these studies contribute to the research literature relating sleep problems with cardiovascular risk and poor psychological well-being

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