The Relationship Between Subjective Sleep, Biological Sex, and Cardiovascular and Psychological Reactivity to Acute Psychological Stress

Poor sleep has been associated with cardiovascular disease (CVD). Research indicates a bidirectional relationship between stress and disrupted sleep. It is possible individual differences in cardiovascular and psychological responses to acute stress may be a pathway connecting sleep and CVD. Research has also separately found biological sex may impact sleep and CVD outcomes. While studies examining subjective sleep and cardiovascular reactivity to acute stress show mixed results, few have concurrently assessed psychological stress responses or considered the moderating role of biological sex. The current paper aimed to explore the associations between subjective sleep quality and cardiovascular and psychological responses to acute stress and the role of biological sex as a potential moderator in this relationship. In two independent studies (Study 1: N = 154, 50.6% female; Study 2: N = 212, 64.2% female), young adults completed a resting baseline period followed by standardized psychological stress tasks with cardiovascular activity measured throughout. Following the stress task, participants rated the intensity and interpretation of their stress during the task. Participants also completed a questionnaire regarding their sleep over the past month. Across both studies, subjective sleep quality was not statistically significantly associated with cardiovascular reactivity (all ps ≥ 0.286, all βs ≤ 0.08). However, worse sleep was significantly associated with increased levels of stress intensity (all ps ≤ 0.023, all βs ≤ 0.22) and more debilitative interpretations of stress during the acute psychological stress task (all ps ≤ 0.020, all βs ≥ -0.25). Biological sex did not moderate any of these relationships (all ps ≥ 0.073). Results indicate that poor subjective sleep quality is associated with psychological, not physiological, responses to stress. Perceptions of stress may be a mechanism linking poor sleep and CVD.