1. Test Battery Time Points
Self-Reported Stress During Sleep Extension and Sleep Deprivation
Prindle NE, Trach SK, Mahfouz SH, Moore LT, Ratcliffe R, Yarnell A, Capaldi V, Balkin TJ, Simonelli G, Doty TJ
Walter Reed Army Institute of Research, Silver Spring, MD, USA
INTRODUCTION
RESULTS
Self-reported stress can negatively impact health and performance (Ohlin et al, 2004; Lieberman et al, 2001).
A few studies have shown that lack of sleep can increase subjective stress (Htaik et al, 2012; Frey et al, 2007). However, it is not clear whether sleeping more than usual has the opposite effect - i.e., reduces subjective stress.
In the present study self-reported stress, sleepiness/fatigue, and anxiety were assessed under three sleep conditions: normal sleep, sleep extension, and sleep deprivation.  
STATISTICAL ANALYSIS:
The data were analyzed with a 3 (Sleep Condition) x  8 (Time of Day)  mixed linear model within measures. SVAS and FVAS scores were correlated across baseline, extension, and sleep deprivation days.
The main effect of Sleep Condition was significant for all measures (shown below).
SVAS
KSS
STAI
SVAS main effect of sleep condition: [F( 2, ) = 81.51, p = < .001]
FVAS main effect of sleep condition: [F( 2, ) = , p = < .001]
KSS main effect of sleep condition: [F( 2, ) = , p = < .001]
STAI main effect of sleep condition: [F( 2, ) = 63.58, p = < .001]
FVAS
R2 = 0.315
METHODS
N = 27 healthy participants
Stress assessed using the Stress Visual Analogue Scale (SVAS)
Fatigue assessed with Karolinska Sleepiness Scale (KSS) & Fatigue Visual Analog Scale (FVAS)
Anxiety assessed with the Spielberger State Trait Anxiety Inventory (STAI)
Table 1: Appearance of the SVAS (top) and FVAS (bottom)
R2 = 0.112
DISCUSSION
SVAS, FVAS, KSS, & STAI were administered every 2 hours from 0700 to 2100 under 3 conditions:
BASELINE SLEEP (BL): 2 weeks of normal/baseline sleep
SLEEP EXTENSION (SE): 7 consecutive nights of extended sleep (10 h TIB overnights only)
SLEEP DEPRIVATION: 40 hours of continuous wakefulness
On average, subjects increased nightly sleep duration by 1.5 hours during the sleep extension phase.
Relative to baseline, self-reported stress, sleepiness/fatigue, and anxiety increased during sleep deprivation, but were not reduced during sleep extension.
CONCLUSION: Sleep extension does not reduce stress levels relative to baseline. However, self-reported stress levels and sleepiness/fatigue both increase during sleep deprivation.
Mean/Frequency
[N = 27]
Age (SD)
in years
24.37 (5.41)
Gender (%)
Female
Male
11 (40.7%)
16 (59.3%)
SLEEP DEPRIVATION
(40h wake)
DAY 2
DAY 1
DAY 3
DAY 9
DAY 8
DAY 7
DAY 6
DAY 5
DAY 4
DAY 10
DAY 11
SCHEDULE OF EVENTS:
SLEEP EXTENSION
(7 nights of 10h TIB)
BASELINE
(TIB 8h TIB)
Table 1: Demographics for study participants (N=27)
TESTING BL SE
Difference
P-value
Mean
Sleep Duration [min (SD)]
481.3
(49.6)
(8 hrs)
564.8
(35.3)
(~9.5 hrs)
83.5
(42.2)
0.001
REFERENCES
Test Battery Time Points
Frey, D. J., Fleshner, M., & Wright, K. P. (2007). The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults. Brain, behavior, and immunity, 21(8),
Lieberman, H. R., Tharion, W. J., Shukitt-Hale, B., Speckman, K. L., & Tulley, R. (2002). Effects of caffeine, sleep loss, and stress on cognitive performance and mood during US Navy SEAL training. Psychopharmacology, 164(3),
Minkel, J. D., Banks, S., Htaik, O., Moreta, M. C., Jones, C. W., McGlinchey, E. L., ... & Dinges, D. F. (2012). Sleep deprivation and stressors: evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion, 12(5), 1015.
Öhlin, B., Nilsson, P. M., Nilsson, J. Å., & Berglund, G. (2004). Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men. European heart journal, 25(10),
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Table 2: Average sleep duration on BL and SE nights
DISCLAIMER: The views of the authors are their own and do not purport to reflect the position of the Department of the Army or the Department of Defense (para 4-3, AR 360-5).