Heart Rate Variability, Sleep Quality, and Depression in the Context of Chronic Stress
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Background: Disrupted sleep quality is one of the proposed mechanisms through which chronic stress may lead to depression. However, there exist significant individual differences in sleep reactivity, which is the extent to which one experiences sleep disturbances in response to stress. Purpose: The aim of the current study was to investigate whether low high-frequency heart rate variability (HRV), as a psychophysiological marker of poor emotional and physiological arousal regulation, predicts stress-related sleep disturbances associated with greater risk of depression symptoms. Methods: Using a chronic caregiving stress model, 125 mothers of adolescents with developmental disorders and 97 mothers of typically developing adolescents had their resting HRV and HRV reactivity recorded and completed a measure of depressive symptoms, as well as a 7 day sleep diary to assess their sleep quality. A moderated mediation model tested whether sleep quality mediated the association between chronic stress exposure and depressive symptoms and whether HRV moderated this mediation. Results: After controlling for participant age, body mass index, ethnicity, socioeconomic status, and employment status, poor sleep quality mediated the association between chronic stress and depressive symptoms. Resting HRV moderated this indirect effect such that individuals with lower HRV were more likely to report poorer sleep quality in the context of chronic stressor exposure, which, in turn, was related to greater depressive symptoms. Conclusions: Lower HRV, a potential biomarker of increased sleep reactivity to stress, is associated with greater vulnerability to stress-related sleep disturbances, which, in turn, increases the risk for elevated depressive symptoms in response to chronic stress.
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Heightened sympathetic activity delays the parasympathetic dominance required for sleep initiation, contributing to restlessness and delayed sleep onset.
“Heightened sympathetic activity delays the parasympathetic dominance required for sleep initiation, contributing to restlessness and delayed sleep onset [20,21].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [21]
The Discussion (page unavailable) says stress-induced hyperarousal may interfere with sleep onset and maintenance, and the Conclusions (page unavailable) identify HRV as a marker of parasympathetic activity. The paper does not say that heightened sympathetic activity delays a parasympathetic shift required for sleep initiation or specifically causes restlessness; the claim presents that mechanism more definitively than the source does. (LLM, conf=0.84)
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Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Heart rate variability: origins, methods, and interpretive caveats
BERNTSON, G. G., THOMAS BIGGER, J., ECKBERG, D. L., GROSSMAN, P., KAUFMANN, P. G., MALIK, M., NAGARAJA, H. N., PORGES, S. W., SAUL, J. P., STONE, P. H., et al. (1997) · Psychophysiology · doi:10.1111/j.1469-8986.1997.tb02140.x · Cited by 3,962 · see citing works
Hammen, C. (2005) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.1.102803.143938 · Cited by 2,979 · see citing works
Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., Lombardo, C., & Riemann, D. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.01.011 · Cited by 2,779 · see citing works
Sleep Health: Can We Define It? Does It Matter?
Buysse, D. J. (2014) · SLEEP · doi:10.5665/sleep.3298 · Cited by 2,607 · see citing works
The consensus sleep diary: standardizing prospective sleep self-monitoring
Carney, C. E., Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Krystal, A. D., Lichstein, K. L., & Morin, C. M. (2012) · Sleep · doi:10.5665/sleep.1642 · Cited by 2,172 · see citing works
Thayer, J. F., & Lane, R. D. (2009) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2008.08.004 · Cited by 2,040 · see citing works
Hayes, S. A., & Watson, S. L. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1604-y · Cited by 1,847 · see citing works
The hyperarousal model of insomnia: A review of the concept and its evidence
Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., & Nissen, C. (2010) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2009.04.002 · Cited by 1,789 · cited 2× · see citing works
“In particular, individual differences in physiological and emotional arousal have been proposed to underlie vulnerability to stress-related sleep disturbances [28, 29].”
BackgroundIs caregiving hazardous to one’s physical health? A meta-analysis
Vitaliano, P. P., Zhang, J., & Scanlan, J. M. (2003) · Psychological Bulletin · doi:10.1037/0033-2909.129.6.946 · Cited by 1,734 · see citing works
Gender differences in depression
Nolen-Hoeksema, S. (2001) · Current Directions in Psychological Science · doi:10.1111/1467-8721.00142 · Cited by 1,474 · see citing works
Sex Differences in Insomnia: A Meta-Analysis
Zhang, B., & Wing, Y.-K. (2006) · Sleep · doi:10.1093/sleep/29.1.85 · Cited by 1,286 · see citing works
Recommendations for a standard research assessment of insomnia
Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Lichstein, K. L., & Morin, C. M. (2006) · Sleep · doi:10.1093/sleep/29.9.1155 · Cited by 1,206 · see citing works
Karst, J. S., & Van Hecke, A. V. (2012) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-012-0119-6 · Cited by 977 · see citing works
Heart rate variability as a transdiagnostic biomarker of psychopathology
Beauchaine, T. P., & Thayer, J. F. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.08.004 · Cited by 870 · see citing works
Sleep, insomnia, and depression
Riemann, D. W., Krone, L. B., Wulff, K., & Nissen, C. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0411-y · Cited by 863 · see citing works
Sex differences in healthy human heart rate variability: A meta-analysis
Koenig, J., & Thayer, J. F. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.03.007 · Cited by 860 · see citing works
Depression in mothers and fathers of children with intellectual disability
Olsson, M. B., & Hwang, C. P. (2001) · Journal of Intellectual Disability Research · doi:10.1046/j.1365-2788.2001.00372.x · Cited by 771 · see citing works
Morin, C., Vallières, A., Guay, B., Ivers, H., Savard, J., Mérette, C., Bastien, C., & Baillargeon, L. (2009) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.2009.682 · Cited by 766 · see citing works
Jansson-Fröjmark, M., & Lindblom, K. (2008) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.10.016 · Cited by 646 · see citing works
Kalmbach, D. A., Anderson, J. R., & Drake, C. L. (2018) · Journal of Sleep Research · doi:10.1111/jsr.12710 · Cited by 620 · see citing works
Psychosocial stress and impaired sleep
Åkerstedt, T. (2006) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.1054 · Cited by 585 · see citing works
Who gets the best sleep? Ethnic and socioeconomic factors related to sleep complaints
Grandner, M. A., Patel, N. P., Gehrman, P. R., Xie, D., Sha, D., Weaver, T., & Gooneratne, N. (2010) · Sleep Medicine · doi:10.1016/j.sleep.2009.10.006 · Cited by 562 · see citing works
Circadian Profile of Cardiac Autonomic Nervous Modulation in Healthy Subjects:
Bonnemeier, H., WIEGAND, U. K. H., Brandes, A., Kluge, N., Katus, H. A., Richardt, G., & Potratz, J. (2003) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2003.03078.x · Cited by 532 · see citing works
A meta-analysis of heart rate variability in major depression
Koch, C., Wilhelm, M., Salzmann, S., Rief, W., & Euteneuer, F. (2019) · Psychological Medicine · doi:10.1017/s0033291719001351 · Cited by 489 · see citing works
Zohar, D., Tzischinsky, O., Epstein, R., & Lavie, P. (2005) · Sleep · doi:10.1093/sleep/28.1.47 · Cited by 478 · see citing works
Vulnerability to Stress-related Sleep Disturbance and Hyperarousal
Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004) · Sleep · doi:10.1093/sleep/27.2.285 · Cited by 469 · see citing works
The Subjective Meaning of Sleep Quality: A Comparison of Individuals with and without Insomnia
Harvey, A. G., Stinson, K., Whitaker, K. L., Moskovitz, D. J., & Virk, H. S. (2008) · SLEEP · doi:10.1093/sleep/31.3.383 · Cited by 459 · see citing works
The Effect of Psychosocial Stress on Sleep: A Review of Polysomnographic Evidence
Kim, E.-J., & Dimsdale, J. E. (2007) · Behavioral Sleep Medicine · doi:10.1080/15402000701557383 · Cited by 448 · see citing works
Minkel, J. D., Banks, S., Htaik, O., Moreta, M. C., Jones, C. W., McGlinchey, E. L., Simpson, N. S., & Dinges, D. F. (2012) · Emotion · doi:10.1037/a0026871 · Cited by 379 · see citing works
Chronic parenting stress: Moderating versus mediating effects of social support.
Quittner, A. L., Glueckauf, R. L., & Jackson, D. N. (1990) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.59.6.1266 · Cited by 365 · see citing works
Taylor, D. J., & Pruiksma, K. E. (2014) · International Review of Psychiatry · doi:10.3109/09540261.2014.902808 · Cited by 359 · see citing works
Stress and Sleep Reactivity: A Prospective Investigation of the Stress-Diathesis Model of Insomnia
Drake, C. L., Pillai, V., & Roth, T. G. (2014) · SLEEP · doi:10.5665/sleep.3916 · Cited by 347 · see citing works
Carney, R. M., Freedland, K. E., Stein, P. K., Skala, J. A., Hoffman, P., & Jaffe, A. S. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200009000-00007 · Cited by 319 · see citing works
Insomnia causes, consequences, and therapeutics: An overview
Drake, C. L., Roehrs, T., & Roth, T. G. (2003) · Depression and Anxiety · doi:10.1002/da.10151 · Cited by 307 · see citing works
Schiweck, C., Piette, D., Berckmans, D., Claes, S. J., & Vrieze, E. (2018) · Psychological Medicine · doi:10.1017/s0033291718001988 · Cited by 293 · see citing works
Weber, C. S., Thayer, J. F., Rudat, M., Wirtz, P. H., Zimmermann-Viehoff, F., Thomas, A., Perschel, F. H., Arck, P. C., & Deter, H. C. (2010) · European Journal of Applied Physiology · doi:10.1007/s00421-009-1341-x · Cited by 286 · see citing works
Effects of sleep deprivation and exercise on cognitive, motor performance and mood
Scott, J. P. R., McNaughton, L. R., & Polman, R. C. J. (2006) · Physiology & Behavior · doi:10.1016/j.physbeh.2005.11.009 · Cited by 279 · see citing works
Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: a systematic review
Cunningham, J. E. A., & Shapiro, C. M. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.12.012 · Cited by 278 · see citing works
Sleep and circadian functioning: critical mechanisms in the mood disorders?
Harvey, A. G. (2011) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032210-104550 · Cited by 237 · see citing works
Does work stress predict insomnia? A prospective study
LINTON, S. J. (2004) · British Journal of Health Psychology · doi:10.1348/135910704773891005 · Cited by 236 · see citing works
de Lange, A., Kompier, M. A. J., Taris, T. W., Geurts, S. A. E., Beckers, D. G. J., Houtman, I. L. D., & Bongers, P. M. (2009) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2009.00735.x · Cited by 209 · see citing works
Åkerstedt, T., Orsini, N., Petersen, H., Axelsson, J., Lekander, M., & Kecklund, G. (2012) · Sleep Medicine · doi:10.1016/j.sleep.2011.12.013 · Cited by 193 · see citing works
Babson, K. A., Trainor, C. D., Feldner, M. T., & Blumenthal, H. (2010) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2010.02.008 · Cited by 192 · see citing works
Castro‐Diehl, C., Roux, A. V. D., Redline, S. S., Seeman, T. E., McKinley, P. S., Sloan, R. P., & Shea, S. A. (2016) · SLEEP · doi:10.5665/sleep.6218 · Cited by 188 · see citing works
The alteration of human sleep and circadian rhythms during spaceflight
GUNDEL, A., POLYAKOV, V. V., & ZULLEY, J. (1997) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1997.00028.x · Cited by 170 · see citing works
Sleep Reactivity and Insomnia: Genetic and Environmental Influences
Drake, C. L., Friedman, N. P., Wright, K. P., & Roth, T. (2011) · Sleep · doi:10.5665/sleep.1234 · Cited by 166 · see citing works
Tsui-Caldwell, Y. H. W., & Steffen, P. R. (2018) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2018.01.001 · Cited by 160 · see citing works
Wohlgemuth, W. K., Edinger, J. D., Fins, A. I., & Sullivan, R. J. (1999) · Psychophysiology · doi:10.1111/1469-8986.3620233 · Cited by 158 · see citing works
Porges, S. W., Bohrer, R., Cheung, M. N., Drasgow, F., McCabe, P. M., & Keren, G. B. (1980) · Psychological Bulletin · doi:10.1037/0033-2909.88.3.580 · Cited by 155 · see citing works
Hall, M. H., Thayer, J. F., Germain, A., Moul, D. E., Vasko, R., Puhl, M. D., Miewald, J. M., & Buysse, D. J. (2007) · Behavioral Sleep Medicine · doi:10.1080/15402000701263221 · Cited by 151 · see citing works
Beauchaine, T. P., Bell, Z., Knapton, E., McDonough‐Caplan, H., Shader, T., & Zisner, A. (2019) · Psychophysiology · doi:10.1111/psyp.13329 · Cited by 144 · see citing works
Financial strain is a significant correlate of sleep continuity disturbances in late-life
Hall, M. H., Buysse, D. J., Nofzinger, E. A., Reynolds, C. F., Thompson, W. K., Mazumdar, S., & Monk, T. H. (2007) · Biological Psychology · doi:10.1016/j.biopsycho.2007.10.012 · Cited by 141 · see citing works
Situational insomnia: consistency, predictors, and outcomes
Bonnet, M. H., & Arand, D. L. (2003) · SLEEP · doi:10.1093/sleep/26.8.1029 · Cited by 135 · see citing works
Chronic Stress is Prospectively Associated with Sleep in Midlife Women: The SWAN Sleep Study
Hall, M. H., Casement, M. D., Troxel, W., Matthews, K. A., Bromberger, J. T., Kravitz, H. M., Krafty, R. T., & Buysse, D. J. (2015) · SLEEP · doi:10.5665/sleep.5066 · Cited by 135 · see citing works
Heart rate variability in insomnia patients: A critical review of the literature
Dodds, K. L., Miller, C. B., Kyle, S. D., Marshall, N. S., & Gordon, C. J. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.06.004 · Cited by 134 · see citing works
Prevalence, Correlates, and Predictors of Insomnia in the US Army prior to Deployment
Taylor, D. J., Pruiksma, K. E., Hale, W. J., Kelly, K., Maurer, D., Peterson, A. L., Mintz, J., Litz, B. T., & Williamson, D. E. (2016) · SLEEP · doi:10.5665/sleep.6156 · Cited by 132 · see citing works
Sleep Problems of Parents of Typically Developing Children and Parents of Children With Autism
Lopez-Wagner, M. C., Hoffman, C. D., Sweeney, D. P., Hodge, D., & Gilliam, J. E. (2008) · The Journal of Genetic Psychology · doi:10.3200/gntp.169.3.245-260 · Cited by 131 · see citing works
Cerezuela, G. P., Andrés, M. I. F., Mínguez, R. T., & Navarro-Peña, J. M. (2015) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/1088357615583471 · Cited by 131 · see citing works
Pillai, V., Roth, T. G., Mullins, H. M., & Drake, C. L. (2014) · SLEEP · doi:10.5665/sleep.3838 · Cited by 130 · see citing works
Bhattacharyya, M. R., Whitehead, D. L., Rakhit, R. D., & Steptoe, A. (2008) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318189afcc · Cited by 102 · see citing works
An Open Pilot of Cognitive-Behavioral Therapy for Insomnia in Women with Postpartum Depression
Swanson, L. M., Flynn, H., Adams-Mundy, J. D., Armitage, R., & Arnedt, J. T. (2013) · Behavioral Sleep Medicine · doi:10.1080/15402002.2012.683902 · Cited by 98 · see citing works
High cardiac vagal control is related to better subjective and objective sleep quality
Werner, G. G., Ford, B. Q., Mauss, I. B., Schabus, M., Blechert, J., & Wilhelm, F. H. (2015) · Biological Psychology · doi:10.1016/j.biopsycho.2015.02.004 · Cited by 92 · see citing works
Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder
Bylsma, L. M., Salomon, K., Taylor-Clift, A., Morris, B. H., & Rottenberg, J. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000019 · Cited by 89 · see citing works
Assessment and treatment of sleep disturbances in older adults
Martin, J. L., Shochat, T., & Ancoli‐Israel, S. (2000) · Clinical Psychology Review · doi:10.1016/s0272-7358(99)00063-x · Cited by 88 · see citing works
Winzeler, K., Voellmin, A., Schäfer, V., Meyer, A. H., Cajochen, C., Wilhelm, F. H., & Bader, K. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.09.027 · Cited by 76 · see citing works
Cardiac autonomic control and the effects of age, race, and sex: The CARDIA study
Sloan, R. P., Huang, M.-H., McCreath, H., Sidney, S., Liu, K., Dale Williams, O., & Seeman, T. (2008) · Autonomic Neuroscience · doi:10.1016/j.autneu.2008.01.006 · Cited by 65 · see citing works
Stress and Sleep Patterns of College Students
VERLANDER, L. A., Benedict, J. O., & Hanson, D. P. (1999) · Perceptual and Motor Skills · doi:10.2466/pms.1999.88.3.893 · Cited by 61 · see citing works
VI. MARITAL CONFLICT, VAGAL REGULATION, AND CHILDREN’S SLEEP: A LONGITUDINAL INVESTIGATION
El‐Sheikh, M., Hinnant, J. B., & Erath, S. A. (2015) · Monographs of the Society for Research in Child Development · doi:10.1111/mono.12146 · Cited by 60 · see citing works
Parasympathetic nervous system activity and children's sleep
El‐Sheikh, M., Erath, S. A., & Bagley, E. J. (2012) · Journal of Sleep Research · doi:10.1111/jsr.12019 · Cited by 50 · see citing works
Psychophysiological correlates of generalized anxiety disorder with or without comorbid depression
Hofmann, S. G., Schulz, S. M., Heering, S., Muench, F. J., & Bufka, L. F. (2010) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2009.12.016 · Cited by 49 · see citing works
Keller, P. S., Kouros, C. D., Erath, S. A., Dahl, R. E., & El‐Sheikh, M. (2013) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12151 · Cited by 47 · see citing works
Gouin, J., Deschênes, S. S., & Dugas, M. J. (2014) · Stress · doi:10.3109/10253890.2014.949666 · Cited by 45 · see citing works
Self-citationDoes improving mood in depressed patients alter factors that may affect cardiovascular disease risk?
Taylor, C. B., Conrad, A., Wilhelm, F. H., Strachowski, D., Khaylis, A., Neri, E., Giese‐Davis, J., Roth, W. T., Cooke, J. P., KRAEMER, H. C., et al. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.05.006 · Cited by 45 · see citing works
Gouin, J., Wenzel, K., Boucetta, S., O’Byrne, J., Salimi, A., & Dang‐Vu, T. T. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2015.02.001 · Cited by 39 · see citing works
Self-citationVargas, I., Friedman, N. P., & Drake, C. L. (2015) · Translational Issues in Psychological Science · doi:10.1037/tps0000015 · Cited by 37 · see citing works
Preschoolers' daytime respiratory sinus arrhythmia and nighttime sleep
Elmore‐Staton, L., El‐Sheikh, M., Vaughn, B. E., & Arsiwalla, D. D. (2012) · Physiology & Behavior · doi:10.1016/j.physbeh.2012.07.005 · Cited by 36 · see citing works
Chronic parenting stress and mood reactivity: The role of sleep quality
da Estrela, C., Barker, E. T., Lantagne, S., & Gouin, J. (2017) · Stress and Health · doi:10.1002/smi.2790 · Cited by 28 · see citing works
Self-citationHovland, A., Pallesen, S., Hammar, Å., Hansen, A. L., Thayer, J. F., Sivertsen, B., Tarvainen, M. P., & Nordhus, I. H. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.12.017 · Cited by 26 · see citing works
MacNeil, S., Deschênes, S. S., Caldwell, W., Brouillard, M., Dang-Vu, T.-T., & Gouin, J.-P. (2017) · Annals of Behavioral Medicine · doi:10.1007/s12160-017-9915-z · Cited by 24 · see citing works
Self-citationRelationship of subjective helplessness and pain perception after electric skin stimuli
Müller, M. J., & Netter, P. (2000) · Stress Medicine · doi:10.1002/(sici)1099-1700(200003)16:2 · Cited by 13 · see citing works
Sleep disturbance and physiological regulation among young adults with prior depression
Hamilton, J. L., Stange, J. P., Burke, T. A., Franzen, P. L., & Alloy, L. B. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.05.016 · Cited by 12 · see citing works
Cardiac Vagal Control and Depressive Symptoms: The Moderating Role of Sleep Quality
Werner, G. G., Ford, B. Q., Mauss, I. B., Schabus, M., Jens Blechert, A., & Wilhelm, F. H. (2016) · Behavioral Sleep Medicine · doi:10.1080/15402002.2016.1150280 · Cited by 11 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [17]17. Kalimo R, Tenkanen L, Härmä M, Poppius E, Heinsalmi P. Job stress and sleep disorders: Findings from the Helsinki Heart Study. Stress Med. 2000;16:65–75. [Google Scholar]
- [58]58. Hayes AF. Methodology in the Social Sciences. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, NY: Guilford Press; 2013. [Google Scholar]
- [78]78. Morin CM, Vallières A, Guay B, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: A randomized controlled trial. JAMA. 2009;301:2005–2015. [DOI] [PMC free article] [PubMed] [Google Scholar]
Cited by
Sorted by citations
Olivieri, F., Biscetti, L., Pimpini, L., Pelliccioni, G., Sabbatinelli, J., & Giunta, S. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102521 · Cited by 110 · see citing works
“For instance, studies showed that in the context of chronic stress, lower HRV is associated with lower sleep quality and depressive symptoms (da Estrela et al., 2021; Dauphinot et al., 2012).”
BackgroundNeurobiological Underpinnings of Hyperarousal in Depression: A Comprehensive Review
Xie, M., Huang, Y., Cai, W., Zhang, B., Huang, H. D., Li, Q., Qin, P., & Han, J. (2024) · Brain Sciences · doi:10.3390/brainsci14010050 · Cited by 33 · see citing works
“…sleep, performs limb movements, or speaks [11,33]; EDA reflects autonomic nervous system activity, which typically increases during states of high arousal [36]; HRV measures the natural variability in time intervals between heartbeats, and shows an inverse relationship with arousal levels [34].”
BackgroundZierer, C., Behrendt, C., & Lepach-Engelhardt, A. C. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.163 · Cited by 30 · see citing works
Sleep Neurophysiology in Depression
Rosenblum, Y., Nakagawa, J., van Hattem, T., Krugliakova, E., Sabhapondit, B., Bovy, L., Mikoteit, T., Steiger, A., Zeising, M., & Dresler, M. (2025) · Biological Psychiatry · doi:10.1016/j.biopsych.2025.07.023 · Cited by 28 · see citing works
Yang, F., Bi, Y., & Chen, H. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.635762 · Cited by 27 · see citing works
Reffi, A. N., Kalmbach, D. A., Cheng, P., & Drake, C. L. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13892 · Cited by 25 · see citing works
Baumann, H., Heuel, L., Bischoff, L. L., & Wollesen, B. (2023) · Sensors · doi:10.3390/s23042322 · Cited by 25 · see citing works
A mysterious sensation about sleep and health: the role of interoception
Arora, T., Barbato, M., Hemeiri, S. A., Omar, O., & AlJassmi, M. A. (2021) · BMC Public Health · doi:10.1186/s12889-021-11603-0 · Cited by 23 · see citing works
“the risk for depressive symptoms, as a response to chronic stress [40].”
BackgroundSocial jetlag and depressive symptoms among young people: a systematic review and meta-analysis
Sun, S., Yang, Y., Yu, F., He, Y., Luo, C., Zhang, M., Chen, H., & Tung, T. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07066-x · Cited by 27 · see citing works
Kocsel, N., Köteles, F. G., Galambos, A., & Kökönyei, G. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110676 · Cited by 24 · see citing works
Early adolescent development in the face of violence: A systematic review running
Jagasia, E., Bloom, I., Nelson, K. E., & Campbell, J. C. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106751 · Cited by 21 · see citing works
Mei, Z., Cai, C., Luo, S., Zhang, Y., Lam, C., & Luo, S. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1413694 · Cited by 21 · see citing works
Guo, X., Su, T., Xiao, H., Xiao, R., & Xiao, Z. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.781673 · Cited by 21 · see citing works
Kim, B., & Park, H. (2023) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvad005 · Cited by 18 · see citing works
Lutin, E., Schiweck, C., Cornelis, J. P., Raedt, W. D., Reif, A., Vrieze, E., Claes, S. J., & Hoof, C. A. V. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1022298 · Cited by 16 · see citing works
“(77) showed that lower resting HRV was linked to poorer sleep quality.”
BackgroundLatina, D., Goreis, A., Sajko, P., & Kothgassner, O. D. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12052056 · Cited by 17 · see citing works
Haghi, M., Asadov, A., Boiko, A., Ortega, J. A., Madrid, N. M., & Seepold, R. (2023) · Sensors · doi:10.3390/s23083973 · Cited by 18 · see citing works
Heart rate variability and overtraining in soccer players: A systematic review
Lipka, A., Luthardt, C., Tognaccioli, T., Cairo, B., & de Abreu, R. M. (2025) · Physiological Reports · doi:10.14814/phy2.70357 · Cited by 15 · see citing works
“Lower physiological and emotional arousal regulation is associated with an increased response to stress, resulting in a lower resting HRV (Da Estrela et al., 2021).”
da Estrela, C., MacNeil, S., & Gouin, J. (2021) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2021.02.001 · Cited by 16 · see citing works
Self-citationAssociation of intra‐shift nap duration with heart rate variability in medical night shift workers
Deng, S., Wang, Q., Fan, J., Lu, J., Liu, W., Wang, W., Yang, Y., Ding, F., Mei, J., & Ba, L. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13935 · Cited by 14 · see citing works
“Concur-rently, lower HRV was associated with greater vulnerability to stress-related sleep disturbances in the context of chronic stress (Da Estrela et al., 2021).”
BackgroundSkalski‐Bednarz, S. B., Toussaint, L. L., & Surżykiewicz, J. (2024) · Journal of Religion and Health · doi:10.1007/s10943-024-02084-7 · Cited by 14 · see citing works
“HRV measures the variation between heartbeats and reflects autonomic nervous system balance, inversely related to stress, anxiety, and depression, indicating stress regulation capacity (Cheng et al., 2022; da Estrela et al., 2021).”
BackgroundBaumann, H., Heuel, L., Bischoff, L. L., & Wollesen, B. (2023) · Trials · doi:10.1186/s13063-023-07182-7 · Cited by 16 · see citing works
“Studies show that for example in response to stress-inducing tasks, such as the Trier Social Stress Test, test participants show low parasympathetic activity, characterized by a decrease in High-Frequency Power (HF) and an increase in Low-Frequency Power (LF) HRV values [23–25].”
BackgroundInfluentialde Vries, H., Kamphuis, W., Oldenhuis, H. K. E., van der Schans, C. P., & Sanderman, R. (2021) · JMIR Cardio · doi:10.2196/28731 · Cited by 14 · see citing works
“Resting HRV has also been reported to buffer against the negative effects of chronic stress on sleep quality, which in turn is related to greater depressive symptoms [77].”
BackgroundAhmmed, P., Reynolds, J., Bozkurt, A. Y., & Regmi, P. (2022) · Poultry Science · doi:10.1016/j.psj.2022.102375 · Cited by 13 · see citing works
Boiko, A., Gaiduk, M., Scherz, W. D., Gentili, A., Conti, M., Orcioni, S., Madrid, N. M., & Seepold, R. (2023) · Sensors · doi:10.3390/s23115351 · Cited by 13 · see citing works
Ren, Z., Nie, L., Du, Y., & Liu, J. (2024) · General Psychiatry · doi:10.1136/gpsych-2023-101156 · Cited by 12 · see citing works
“Lastly, the apolipoprotein E allele was not adjusted in our analysis to retain a larger sample size.”
MethodWalschots, Q., Zarchev, M. G., Unkel, M., & Kamperman, A. M. (2024) · Algorithms · doi:10.3390/a17090408 · Cited by 10 · see citing works
Silva, G., Estima, F., Silva, A. C., Mota, J. A. P. S., Martins, C., & Aires, L. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22020241 · Cited by 12 · see citing works
Wiltgen, A., Rufino, K. A., Nadorff, M. R., & Patriquin, M. A. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.08.011 · Cited by 10 · see citing works
Resting-state EEG as a potential indicator to predict sleep quality in depressive patients
Lin, S., Du, Y., Xia, Y., Xiao, L., & Wang, G. (2023) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2023.06.007 · Cited by 9 · see citing works
Chaudhary, R., Azam, M. A., Dowand, B., Singh, A., Rehman, M., Agarwal, V., Kumar, A., Kaushik, A. S., Srivastava, S., Srivastava, S., et al. (2024) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-024-03529-2 · Cited by 9 · see citing works
RetractedWu, Q., Xu, J., Xu, X., & Yang, J. (2025) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2025.03.011 · Cited by 8 · see citing works
HADD: High-Accuracy Detection of Depressed Mood
Liu, Y., Kang, K., & Doe, M. J. (2022) · Technologies · doi:10.3390/technologies10060123 · Cited by 8 · see citing works
Yu, K., Xia, L., Chen, H.-H., Zou, T.-T., Zhang, Y., Zhang, P., Yang, Y., Wei, R.-M., Su, Z.-F., & Chen, G.-H. (2024) · Nature and Science of Sleep · doi:10.2147/nss.s491040 · Cited by 7 · see citing works
Ladisa, E., Abbatantuono, C., Ammendola, E., Tancredi, G., Delussi, M. D., Paparella, G., Clemente, L., Silvestri, A., Federici, A., & de Tommaso, M. (2025) · Sensors · doi:10.3390/s25082618 · Cited by 8 · see citing works
“Factors such as sleep and autonomic functions may play a key role in mediating stress exposure and improving quality of life in FM due to their involvement in self-regulation [42,43].”
Habits and vulnerability or resilience to stress – Impact on depressive disorders
Bertollo, A. G., Capitanio, M. Z., Schuh, L. A., Pradella, N., & Ignácio, Z. M. (2025) · Behavioural Brain Research · doi:10.1016/j.bbr.2025.115630 · Cited by 7 · see citing works
Ma, L., Lv, M., Li, Y., Yang, C., Li, W., Sun, J., Han, T., Guo, Z., Li, D., Yan, Z., et al. (2025) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2025.120460 · Cited by 8 · see citing works
Lv, W., Qiu, H., Lü, H., Ya-juan, Z., Yongjie, M., Xing, C., & Zhu, X. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1358097 · Cited by 6 · see citing works
Park, K., Lee, S. E., Lee, C., Hwang, H. D., Yoon, D. H., Choi, E. C., & Lee, E. M. (2024) · Annals of Medicine · doi:10.1080/07853890.2024.2405077 · Cited by 6 · see citing works
“…source, analysis method, or data length. hRV is used in sleep research because it reflects psychological arousal due to stress exposure. estrela and colleagues found that lower high-frequency hRV (hF-hRV), reflecting increased sleep reactivity to stress, is associated with poor sleep quality [10].”
MethodIadarola, S., Cai, P., Porto, M., & Mustian, K. M. (2025) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-130.4.280 · Cited by 6 · see citing works
Biomarkers of sleep disturbance in adults with chronic illness: A scoping review
Winders, S., Lyon, D., Stechmiller, J. K., & Kelly, D. L. (2022) · Chronic Illness · doi:10.1177/17423953211073697 · Cited by 6 · see citing works
“Resting HRV acted as a moderator between chronic stress and sleep quality.(14) Oxidative stress marker Oxidized LDL.”
BackgroundMethodDembo, R. S., Hong, J., DaWalt, L. S., Berry‐Kravis, E., & Seltzer, M. M. (2023) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-128.3.254 · Cited by 6 · see citing works
Stress and Molecular Drivers for Cancer Progression: A Longstanding Hypothesis
Tripathi, M. K. (2021) · Biomedical Journal of Scientific & Technical Research · doi:10.26717/bjstr.2021.37.005953 · Cited by 6 · see citing works
“Chronic stress has been shown to cause macroscopic changes in brain structure, dysregulation of the immune system, atherosclerosis, depression, poor sleep quality, and hypertension, among other disorders and chronic illnesses [7-10].”
BackgroundLi, X., Ono, C., Warita, N., Shoji, T., Nakagawa, T., Usukura, H., Yu, Z., Takahashi, Y., Ichiji, K., Sugita, N., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1104222 · Cited by 5 · see citing works
Payette, J., Vaussenat, F., & Cloutier, S. G. (2024) · Sensors · doi:10.3390/s24072238 · Cited by 5 · see citing works
Stress Detection using CNN Fusion
Radhika, K. R., & Murthy, O. V. R. (2021) · IEEE Region 10 Conference (TENCON) · doi:10.1109/tencon54134.2021.9707438 · Cited by 5 · see citing works
Klumpp, M., Mandolfo, M., Meiser, A., & Grauel, C. (2025) · International Journal of Physical Distribution & Logistics Management · doi:10.1108/ijpdlm-03-2025-0109 · Cited by 4 · see citing works
Condominas, E., Niubo, A. S., Domènech‐Abella, J., Haro, J. M., Bailón, R., Giné-Vázquez, I., Alacid, G. R., Matcham, F., Lamers, F., Kontaxis, S., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.02.010 · Cited by 5 · see citing works
“Previous studies have demonstrated that changes in HR across sleep may be a physiological marker of depression severity in a sample with MDD and sleep disturbance (da Estrela et al., 2021; Saad et al., 2019, 2020).”
Liu, Y., Zhang, D., Sui, L., Li, D., Wang, M., Wang, W., Xue, M., Hao, J., Zhang, L., & Wu, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-93681-3 · Cited by 6 · see citing works
“Some studies have indicated that exposure to chronic stress can lead to a decline in sleep quality, which in turn indirectly triggers depression 66 .”
Shen, Y., Fang, Z., Zhang, T., Yu, F., Xu, Y., & Yang, L. (2025) · Frontiers in Physiology · doi:10.3389/fphys.2025.1535331 · Cited by 6 · see citing works
Lawrence, D. W. (2022) · Journal of Psychedelic Studies · doi:10.1556/2054.2022.00178 · Cited by 4 · see citing works
Reffi, A. N., Jankowiak, L., Iqal, J., Jovanović, T., & Drake, C. L. (2024) · Current Sleep Medicine Reports · doi:10.1007/s40675-024-00279-8 · Cited by 4 · see citing works
Lee, J., Schwichtenberg, A. J., Bliwise, D. L., Ali, S. Z., Hayat, M. J., Clark, P. C., & Spratling, R. G. (2023) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-023-09896-7 · Cited by 4 · see citing works
“, 2018a) and mediated the association between heart rate variability (as a proxy of chronic stress) and depressive symptoms (Estrela et al., 2021) in mothers of children with DDs.”
Laufer, S., Bohn, J., Engel, S., Klusmann, H., Skoluda, N., Nater, U. M., Knaevelsrud, C., & Schumacher, S. (2025) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2025.100314 · Cited by 3 · see citing works
“Other studies in subclinical samples report moderating and mediating effects of sleep parameters on the association between HPA axis [22], or ANS [23] markers and depressive symptoms.”
InfluentialLambert, M., Sabiston, C. M., Wrosch, C., & Brunet, J. (2020) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2020.100180 · Cited by 3 · see citing works
Chia, P.-F., Lee, Y., Li, Y., Lee, D., & Chang, Y. (2024) · International Journal of Nursing Practice · doi:10.1111/ijn.13265 · Cited by 3 · see citing works
Respiratory sinus arrhythmia as a dyadic protective factor in the transition to parenthood
Bar‐Kalifa, E., Daleski, M. A., Pshedetzky‐Shochat, R., Gleason, M. E. J., & Rafaeli, E. (2020) · Psychophysiology · doi:10.1111/psyp.13736 · Cited by 3 · see citing works
Mood swings in cows : Cognitive and physiological assessments
Kremer, L. (2022) · doi:10.18174/562024 · Cited by 3 · see citing works
Morency, M. M., Donzella, B., Reid, B. M., Lee, R. M., Dengel, D. R., & Gunnar, M. R. (2024) · Development and Psychopathology · doi:10.1017/s0954579424000932 · Cited by 3 · see citing works
“Sleep is critical to neuroprotection (Eugene & Masiak, 2015) and is a major stress regulator, providing a buffer against depression (da Estrela et al., 2021).”
Adverse Childhood Experiences Influence Longitudinal Changes in Leptin But Not Adiponectin
Matovic, S., Rummel, C. D., Neumann, E., McGrath, J. J., & Gouin, J. (2025) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001366 · Cited by 2 · see citing works
Self-citationWang, Y., Zhang, Z., Ye, Y., Xu, J., & Zhou, J. (2025) · BMC Psychology · doi:10.1186/s40359-025-02722-z · Cited by 2 · see citing works
Li, J.-B., Ye, X.-B., & Tu, X. M. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i11.110699 · Cited by 2 · see citing works
Sun, J., Gao, D., Zhang, J., Liu, H., Zhou, Y., Ma, C., Zhang, X., Liu, S., Zhao, J., Hao, C., et al. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1788611 · Cited by 2 · see citing works
“As such, HRV has emerged as an essential objective biomarker for evaluating autonomic nervous function and psychological stress levels (67).”
Conflict at Work Impairs Physiological Recovery during Sleep: A Daily Diary Study
Kerman, K., Prem, R., Kubicek, B., Meyer, E., Tement, S., & Korunka, C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811457 · Cited by 2 · see citing works
Heart Rate Variability Subsequent to Auriculotherapy Among Individuals Afflicted by Major Burn Scars
Chen, C.-C., Chen, S.-P., & Hsu, C.-H. (2025) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000004193 · Cited by 2 · see citing works
“12,13 We previously conducted a prospective, single-arm study with the aim to evaluate the potential of auriculotherapy to alleviate the symptoms of postburn hypertrophic scar pain, itchiness, and sleeping quality in individuals with major burn injuries (> 20% total burn scar area).”
Lee, D., Yamazaki, Y., Kuwamizu, R., Okamoto, M., & Soya, H. (2025) · NeuroImage · doi:10.1016/j.neuroimage.2025.121139 · Cited by 3 · see citing works
Lowe, A. C., Niclou, A. M., Varanoske, A. N., Harris, M. N., Hebert, C., Johannsen, N. M., Heymsfield, S. B., Greenway, F. L., Margolis, L. M., Lieberman, H. R., et al. (2025) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003743 · Cited by 3 · see citing works
“…personnel during times of high military training and combat strain are understood to decrease parasympathetic function and/or increase sympathetic function at rest, during acute stress, and around sleep, resulting in decreased time-domain HRV and a shift in frequency-domain HRV power (23 – 26).”
Association between heart rate variability and ECG changes in on-duty prehospital physicians
Maleczek, M., Schebesta, K., Hamp, T., Laussner, B., Pezawas, T., Krammel, M., & Roessler, B. (2025) · Frontiers in Physiology · doi:10.3389/fphys.2025.1617377 · Cited by 2 · see citing works
High Heart Rate Variability Buffers the Effect of Attachment Insecurity on Sleep Quality
Paoletti, J., Argueta, D. L., Wu‐Chung, E. L., Chen, M. A., Brown, R. L., LeRoy, A. S., Murdock, K. W., Thayer, J. F., & Fagundes, C. P. (2024) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001295 · Cited by 2 · see citing works
Park, J. I., Aqajari, S. A. H., Rahmani, A. M., & Lee, J. (2024) · CIN Computers Informatics Nursing · doi:10.1097/cin.0000000000001192 · Cited by 3 · see citing works
Fuentes-Barría, H., Aguilera-Eguía, R. A., Alarcón-Rivera, M., Angarita, L., Rojas-Gómez, D. M., Maureira-Sánchez, J., López-Soto, O. P., & Guzmán-Muñoz, E. (2025) · Retos · doi:10.47197/retos.v64.111922 · Cited by 3 · see citing works
Sleep in Juvenile Idiopathic Arthritis: An Exploratory Investigation of Heart Rate Variability
Lopes, M. C., Roizenblatt, S., Soster, L. A., & Spruyt, K. (2025) · Brain Sciences · doi:10.3390/brainsci15060648 · Cited by 1 · see citing works
Perseverative Thinking in Depression and Insomnia
Ballesio, A., Zagaria, A., & Goldschmied, J. (2025) · CBT: science into practice · doi:10.1007/978-3-031-92265-7_3 · Cited by 1 · see citing works
da Silva, V. O. S., Thirupathi, A., Macedo, R. A. D. S., Santos, M. F., Borba, A. C. D. O., Gu, Y., Gomes, K. M., Delevatti, R. S., Silveira, P. C. L., & da Silva, L. A. (2025) · Clinics · doi:10.1016/j.clinsp.2025.100803 · Cited by 1 · see citing works
“The physiological 33 – 36 However, anxiety disorders and depression are not rare in older people with multimorbidity.”
Courtney, R. E., Schadegg, M. J., Brice, P. J., Friedman, B. H., & Fanning, J. T. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1502890 · Cited by 1 · see citing works
Non-invasive physiological indicators of welfare in dairy cows
Kremer, L., van Reenen, K., Kok, A., Bokkers, E. A. M., Gort, G., Engel, J., van der Werf, J. T. N., & Webb, L. E. (2026) · Animal Welfare · doi:10.1017/awf.2026.10063 · Cited by 1 · see citing works
“…reflective of poor welfare (e.g. depression and chronic stress) have been associated with low resting HRV (Kovacs et al. 2015; Sgoifo et al. 2015; da Estrela et al. 2021), whereas positive states (e.g. cheerfulness and calmness) have been associated with higher resting HRV (Geisler et al. 2010;…”
Shu, Y., Qiang, L., Liu, Q., Xu, Y., Huang, C., & Yao, X. P. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-07942-0 · Cited by 1 · see citing works
“Previous studies have consistently demonstrated that patients with depression or anxiety exhibit significantly lower HRV, which reflect diminished ability to regulate emotions and physiological responses to stress [18, 19].”
Alnaser, A. R., Zitoun, O. A., Saquib, J., Rajab, T. M., Khojah, A. A. A., Almazrou, A., & Saquib, N. (2024) · Work · doi:10.3233/wor-220631 · Cited by 1 · see citing works
“Poor sleep may impair emotional regulation mechanisms; one study showed that poor sleep quality mediated the association between chronic stress and depressive symptoms [34].”
СУЧАСНІ ДОСЛІДЖЕННЯ ВІКОВИХ ОСОБЛИВОСТЕЙ ВАРІАБЕЛЬНОСТІ СЕРЦЕВОГО РИТМУ: ТЕОРЕТИЧНІ АСПЕКТИ
Ляшенко, В. П., & Дуванов, Д. С. (2024) · Слобожанський науковий вісник. Серія Природничі науки. · doi:10.32782/naturalspu/2024.1.3 · Cited by 1 · see citing works
Quiróz-González, S., López-Espinosa, E., Liu, Z., & Fossión, R. (2024) · Revista Internacional de Acupuntura · doi:10.1016/j.acu.2024.100288 · Cited by 1 · see citing works
Moebus, M., Hilty, M., Oldrati, P., Barrios, L., & Holz, C. (2024) · JMIR Neurotechnology · doi:10.2196/48148 · Cited by 1 · see citing works
“These effects are consistent with existing literature [26-28 , 61 ].”
Li, J., Matsunaga, M., Myowa, M., & Nagai, Y. (2025) · PLoS ONE · doi:10.1371/journal.pone.0320175 · Cited by 1 · see citing works
“Furthermore, the ANS is subject to the influence of a myriad of internal and external factors, such as stress and sleep, resulting in alterations in HRV recurrence patterns [42].”
Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice.
Song, S., Irfan, M., Tahir, Z., Garrison, K. A., & Ziskind, S. (2026) · Current Sleep Medicine Reports · doi:10.1007/s40675-026-00370-2
Change of Heart: Parenting Stress and Distress, and Associations with Heart Rate Variability
da Estrela, C. (2020) · Spectrum Research Repository (Concordia University)
Lee, J., Schwichtenberg, A. J., Bliwise, D. L., Ali, S. Z., Hayat, M., Clark, P. C., & Spratling, R. G. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4127819
Predictors of psychological and physiological measures of graduate student health during COVID-19
Marashi, M., & Heisz, J. J. (2022) · Frontiers in Education · doi:10.3389/feduc.2022.941871 · Cited by 1 · see citing works
Health and social relationships of mothers of children in special education schools
Yamaoka, Y., Doi, S. K., Isumi, A., & Fujiwara, T. (2022) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2022.104374
Hartner‐Tiefenthaler, M., Polic-Tögel, S., & Mayer, M. M. (2023) · Springer eBooks · doi:10.1007/978-3-662-63129-4_3
Qiu, H., Lü, H., Zhang, Y., Ma, Y., Xing, C., & Zhu, X. (2023) · Research Square · doi:10.21203/rs.3.rs-3187929/v1
Prediction of Stress Coping Capabilities from Nightly Heart Rate Patterns using Machine Learning
Vorberg, L., Pflueger, S., Richer, R., Jaeger, K. M., Küderle, A., Rohleder, N., & Eskofier, B. M. (2023) · IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI ...) · doi:10.1109/bhi58575.2023.10313401
“Associations between HRV and sleep quality were investigated by da Estrela et al. [6], which reported that lower HRV can be linked to a greater risk for stress-related sleep disturbances which can even increase the likelihood of developing depressive symptoms.”
BackgroundOsborne, J. C., Odlum, M. L., & Sedrak, A. (2024) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11004
“14,15 An exacerbation of sleep disturbance during the height of the coronavirus disease (COVID-19) pandemic was reported in a previous study by Blanc et al. 16 For parents of children with chronic diseases such as SCD, sleep disturbance during the COVID-19 pandemic can be assumed.”
Twilleger, T., Dallam, G. M., & McKinley, J. (2024) · Journal of Kinesiology & Wellness · doi:10.56980/jkw.v12i1.118
Billeci, L., Tonacci, A., Accorinti, I., Distefano, G., Guccione, F., Milone, A., Masi, G., & Sesso, G. (2024) · doi:10.22541/au.172447094.43924098/v1
The Relationship Between Age and Stress on Sleep Quality
Trisnowiyanto, B., Andriani, I., & Adriani, R. B. (2024) · Jurnal Kesehatan · doi:10.23917/jk.v17i3.5188
“People with this condition are more likely to have poor sleep quality and an increased risk of chronic stress-related depressive symptoms than people with high heart rate variability (Da Estrela et al., 2021).”
Working memory training improves general emotion regulation: Evidence from resting HF-HRV
Long, F., Chen, L., Zhou, W., Oei, T. P. S., & Zhou, R. (2025) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2025.2487430
“As resting HF-HRV can be defined as a psychophysiological index reflecting general emotion regulation (da Estrela et al., 2021), the results of this study suggest that WMT has the potential for sustained improvement in emotion regulation.”
Lee, H., Kang, S., & Lee, S. H. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5216287
Assessment of Heart Rate Variability Among Plant Nursery Workers
Thamsuwan, O., & Cherik, K. (2025) · Journal of Agromedicine · doi:10.1080/1059924x.2025.2517845
“17 Abnormal HRV patterns have been linked to neurological and psychological conditions, including mild cognitive impairment, dementia, mild traumatic brain injury, migraines, stroke, epilepsy, anxiety, stress, and schizophrenia.”
Anxiety and sleep quality in the undergraduate stress–depression link: A moderated mediation studyPreprint
Koebeli, C., Koebeli, M., Morgan, K., Edginton, T. L., & Boubert, L. (2025) · medRxiv · doi:10.1101/2025.08.01.25332606
A broken power-law model of heart rate variability spectra in sleep
Schneider, B., Dresler, M., Gombos, F., Kovács, I., & Bódizs, R. (2026) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2026.111853
Seki, T., Shimura, A., Nakajima, K., Kikkawa, M., Morishita, C., Tamada, Y., Honyashiki, M., Masuya, J., & Inoue, T. (2025) · European Journal of Sport Science · doi:10.1002/ejsc.70111
“A study using the chronic caregiving stress model showed that the association between chronic stress and depressive symptoms was mediated by poor sleep quality (da Estrela et al. 2021).”
- Authors
- da Estrela, C., McGrath, J., Booij, L., & Gouin, J.-P.
- Affiliations
- Department of Psychology, Concordia University, Montréal, Canada
- Concordia University (CA)
- Corresponding author
- Gouin, Jean-Philippe
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-06-11
- Volume
- 55
- Issue
- 2
- Pages
- 155-164
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC7962885
- OpenAlex
- W3033191763
- Cited by
- 118
- References
- 83
- Citations by year
- 2026: 21 · 2025: 33 · 2024: 26 · 2023: 16 · 2022: 11 · 2021: 8 · 2020: 3
- FWCI
- 5.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Social Sciences and Humanities Research Council of Canada
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- heart rate variability, sleep quality, depression, chronic stress, sleep reactivity, caregiving stress, depressive symptoms, sleep disorders, mediation, moderated mediation
- MeSH terms
- Mediation Analysis, Adult, Chronic Disease, Depression, Female, Heart Rate, Humans, Middle Aged, Mothers, Sleep, Stress, Psychological, Caregivers
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