Stress and sleep quality: the role of cognitive emotion regulation and pre-sleep arousal

Uzajamni odnos stresa i loše kvalitete spavanja utvrđen je kao globalni čimbenik rizika za razvoj mentalnih i fizičkih poteškoća (American Academy of Sleep Medicine, 2014). Stres uzrokuje povećanu fiziološku i psihološku aktivaciju kao odgovor na povećane zahtjeve okoline, a ta aktivacija oprečna je deaktivaciji koja je glavna karakteristika spavanja. Često se navodi mogućnost produljene aktivacije stresa kada osoba koristi maladaptivne strategije suočavanja, koja se može pojaviti i tijekom razdoblja prije početka spavanja. Naime, viša razina pobuđenosti prije spavanja, utvrđena je kao snažan posrednik putem kojeg se može održati maladaptivan odnos stresa, odnosno načina suočavanja sa stresom i spavanja (Winzeler i sur., 2014). S druge strane, istraživanja su pokazala da loša kvaliteta spavanja ostavlja manje samoregulacijske energije za suočavanje sa stresom te može doprinijeti višoj procjeni stresa (Barber i Munz, 2010). S obzirom na navedeno, cilj je ovog istraživanja bio ispitati ulogu strategija kognitivne emocionalne regulacije te pobuđenosti prije spavanja u odnosu stresa i kvalitete spavanja kod studenata. Uzorak se sastojao od ukupno 276 studenata. Sudionici su popunjavali online obrazac koji se redom sastojao od upitnika općih podataka, Pittsburgh indeksa kvalitete spavanja (eng. Pittsburgh Sleep Quality Indeks, Buysse i sur., 1989, hrvatska verzija Brajević-Gizdić i sur., 2010), Upitnika kognitivne emocionalne regulacije (eng. Cognitive Emotion Regulation Questionnaire, Garnefski i sur., 2001, hrvatska adaptacija Soldo i Vulić-Prtorić, 2018), Skale pobuđenosti prije spavanja (Pre-sleep Arousal Scale, Nicassio i sur., 1985) koja se u svrhu ovog istraživanja prevela na hrvatski jezik te Ljestvice percipiranog stresa (eng. Perceived Stress Scale, Cohen i sur., 1983, hrvatska verzija Hudek-Knežević i sur., 1999). Potvrđeno je postojanje dvaju faktora (kognitivna i somatska pobuđenost), kao i visoka pouzdanost i faktorska zasićenja čestica Skale pobuđenosti prije spavanja. Utvrđeno je da čestina korištenja strategija samookrivljavanja, ruminacije, katastrofiziranja, pozitivnog refokusiranja, pozitivne reprocjene i stavljanja u perspektivu doprinosi kvaliteti spavanja isključivo posredno preko kognitivne i somatske pobuđenosti prije spavanja, a korištenje strategije okrivljavanja drugih doprinosi kvaliteti spavanja isključivo preko kognitivne pobuđenosti. Nadalje, utvrđeno je da kvaliteta spavanja izravno doprinosi percipiranom stresu, ali i posredno preko čestine korištenja strategija ruminacije, katastrofiziranja te pozitivnog refokusiranja i pozitivne reprocjene.The mutual relationship between stress and poor sleep quality has been established as a global risk factor for the development of mental and physical difficulties (American Academy of Sleep Medicine, 2014). Stress causes increased physiological and psychological activation in response to increased environmental demands, and this activation is contrary to the deactivation that is the main characteristic of sleep. It is often mentioned that when a person uses maladaptive coping strategies, prolonged activation of stress can also occur during the period before the onset of sleep. Namely, a higher level of pre-sleep arousal has been determined as a strong mediator through which the maladaptive relationship between stress and sleep can be maintained (Winzeler et al., 2014). On the other hand, research has shown that poor sleep quality leaves less self-regulatory energy for dealing with stress and can contribute to a higher perceived stress (Barber and Munz, 2010). Considering the above, the goal of this research was to examine the role of cognitive emotion regulation strategies and pre-sleep arousal in the relationship between stress and sleep quality in students. The sample consisted of 276 students in total. The participants filled out an online form that consisted of a general data questionnaire, the Pittsburgh Sleep Quality Index (Buysse et al., 1989, Croatian version, Brajević-Gizdić i sur., 2010), the Cognitive Emotion Regulation Questionnaire (Garnefski i sur., 2001, Croatian adaptation, Soldo and Vulić-Prtorić, 2018), the Pre-sleep Arousal Scale (Nicassio et al., 1985) which was translated into Croatian for the purpose of this research, and the Perceived Stress Scale (Cohen i sur., 1983, Croatian version, Hudek-Knežević et al., 1999). The existence of two factors (cognitive and somatic arousal) was confirmed, as well as high reliability and factor saturation of the items of the Pre-sleep Arousal Scale. It was found that the frequent use of strategies of self-blame, rumination, catastrophizing, positive refocusing, positive reappraisal and putting into perspective contributes to sleep quality only indirectly through cognitive and somatic pre-sleep arousal, and the use of the strategy of blaming others contributes to sleep quality only indirectly through cognitive arousal. Furthermore, it was determined that sleep quality contributes directly to perceived stress, but also indirectly through the frequent use of strategies of rumination, catastrophizing and positive refocusing and positive reappraisal