1006 Investigating Pre-sleep Processes And How They Influence Sleep And Nightmares

Abstract

Introduction: The current study examined the relationship between stress, pre-sleep processes and sleep in the context of real-world stress exposure in medical students during an internship. Medical students are often exposed to a variety of stressors and potentially traumatic events and have been shown to be at risk to develop psychopathology, such as anxiety and depression. Previous research has shown an association between stress, psychological distress and sleep disturbances. In this context, studies have investigated possible predictors for sleep disturbances. Recently, the period just prior to sleep onset has received increased interest. At the moment, little is known, however, about the influence of such pre-sleep processes. In this study, we investigated the influence of pre-sleep rumination, intrusion, and mindfulness on sleep disturbances (e.g. longer sleep onset latency, reduced sleep efficiency, alleviated heart rate during sleep) and nightmares. We aimed at identifying risk and potential protective factors for sleep quality and nightmare development. Methods: In a prospective study, we examined a sample of 50 medical students from the University of Zurich. All participants completed their first medical internship over 9 months as part of medical school. Predictors were assessed prior to starting the internship and pre-sleep processes and nightmares were indexed mid-internship using sleep diaries over seven consecutive days. Participants also provided descriptions of their nightmares. Additionally, a Fitbit tracking device was used to measure objective sleep quality. Correlational analyses and multilevel linear models were conducted Results: Results show associations between pre-sleep processes and sleep disturbances in this stress-exposed at risk population. For example, pre-sleep mindfulness predicted less nightmare distress and could function as a protective factor. Conclusion: Together, our data suggest pre-sleep processes and sleep quality as potential targets for stress-prevention programs that could help reduce the negative influence of stress in at risk populations.