Background: Relationship quality and sleep quality influenced physiological and psychological health. Therefore, the aim of the present study was to determine a possible connection between relationship satisfaction and sleep quality and to test a theoretical model of sleep quality as related to relationship and psychological well-being. Methods: Fifty-one heterosexual, cohabitating couples between 24 and 70 years old participated. The relationship quality was measured by the German short version of relationship questionnaire. To determine the sleep quality, the Pittsburgh Sleep Quality Index and a two-week sleep diary were implemented. To gather information about psychological well-being, especially depression and anxiety, the German Symptom Checklist was used. Results: Sleep quality was measured by the Pittsburgh Sleep Quality Index and relationship quality correlated significantly negative. In addition, the study found a positive correlation between sleep duration and relationship quality. In a multiple regression model, fighting and mental strain explained 38% of variance of sleep quality. Depression, anxiety and relationship quality showed no further improvement of the model. These findings suggested that relationship quality, constructive partnership behavior and mental strain played an essential role in sleep quality.
Both relationships and sleep have a high impact on quality of life and well-being [
A large Korean longitudinal study showed a bidirectional association between sleep and relationship quality. Low marriage quality led to a higher risk of a clinically relevant sleep disorder. Vice versa, a low sleep quality in the early stages predicted lower marriage satisfaction four years later [
Various mechanisms might explain the association between relationship quality and sleep. For example, attachment styles impacted sleep in married couples [
Mental illnesses could influence the partner’s sleep as well. For example, partners reported shorter sleep duration if their spouses suffered from anxiety. But depressive husbands led to longer sleep durations in women [
Intimate partner violence also influenced sleep quality [
Investigating long term influences on relationships Orbuch and colleagues found only ethnicity and educational status to be significant predictors on divorces over a duration of 14 years [
Beyond that, the regularity of sexual intercourse influences relationship satisfaction as reported in a multiple regression. Results suggest younger women are more satisfied with sexual intercourse than older women. Youn- ger women tend to be slightly more satisfied with their relationships in general [
Taylor and colleagues found a connection between sleep, depression and anxiety [
Stress negatively influences sleep as Vahtera and colleagues [
In addition age and gender influence sleep. Higher age seems to be associated with sleep disorders as more women over 60 suffered from disturbed sleep (31.4%) about twice as many as women between 18 and 39 (17.9%). For men the rate was even three times higher. Between the age of 18 and 39 years about 9.5% reported sleep disturbances, where as nearly one third of men above 60 years showed sleep disorder symptoms (29.0%) [
As relationships and sleep seem to influence quality of life and health, the present study’s aim is to determine the link between sleep quality and relationship quality. Firstly, it is assumed that (1) women report subjectively poorer sleep quality than men. Women tend to suffer from more difficulties falling asleep and maintaining sleep. Secondly, (2) psychological well-being is associated with sleep quality in both sexes, since previous studies reported overall mental health, depression and anxiety to be associated with sleep disturbances. Thirdly, (3) sleep quality and relationship quality is correlated. Low relationship quality is associated with low sleep quality. Fourthly, (4) fighting in intimate relationships seems impact sleep negatively. Finally, (5) a theoretical model including relevant factors will be tested. The influence of partnership quality, fighting and mental health on sleep quality will be investigated.
Participants were recruited in public presentations and hearings at Landau University. All participants were informed prior to their participation about the content and duration of the study and gave their written consent. Furthermore, the Ethics Committee University of Landau permitted the study. Participants took part voluntarily. The participants filled out three questionnaires and recorded on their sleep for one week. After filling out the questionnaire, participants mailed them back via postal sending. Inclusion criteria were that couples cohabitated and both partners filled out the questionnaires.
The Pittsburgh Sleep Quality Index (PSQI) was implemented to assess sleep problems. 18 items (ranging from 0 to 3) measure self-rated sleeping habits within the last four weeks. The items are divided into seven scales, sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication and daytime dysfunction. A total sum score is built with a cut-off score above five indicating bad sleepers and a score above 10 suggesting severe sleep problems [
In addition, a standardized sleep-diary was used for diagnostics for 14 days. Every day, participants answered questions about the time they went to bed, when they got up and their latency to fall asleep. There were open questions about the amount of exercise, intake of medicine (type, dose and time), as well as consumption of alcohol, nicotine and caffeine. Subjective measures of mood, sleepiness and performance were rated in a scale from one (very good) to six (very bad). The diary compromised a morning and an evening component. The morning section should be completed immediately after getting up and consists of 12 items. The nine items of the evening component should be done just before turning off the light. Additionally dichotome items (yes or no) about sexuality, tenderness and fights were generated.
To evaluate partnership quality, a short version of a relationship questionnaire was used [
For mental health the symptom-checklist (SCL-90-R) [
The statistical analysis was calculated with IBM SPSS 21 for Windows. Pearson correlations were calculated to determine associations and t-tests were performed to test differences between genders. To investigate the influence of age, well-being and relationships on sleep parameters, a linear regression was performed. A multifactorial variance analysis was performed to identify different factors explaining sleep quality.
Seventy-one couples received questionnaires with 68% mailing them back. Data analysis included a total of 102 participants (n = 102), or 51 heterosexual couples. The couples’ age ranged between 24 and 70 years (M = 42.37, SD = 14.18). For further information see
All couples cohabited between 6 months and 44 years. Twenty-five (24.5%) participants had children living with them, whereas 35 (34.3%) had children, who were not living with the many more. Most of the participants had a fulltime job (54.9%). For further information see
Male M (SD) | Female M (SD) | Couples M (SD) | |
---|---|---|---|
age | 43.76 (14.52) | 40.98 (13.82) | 42.37 (14.18) |
Time as a couple | 16.02 (14.19) |
Note: M = mean; SD = standard deviation.
Frequencies | Percent | ||
---|---|---|---|
Children | None Living at home Not living at home | 42 25 35 | 41.2 24.5 34.3 |
Medication | Yes No | 35 67 | 34.3 65.7 |
Profession | None Retirement Full-time Part-time University student | 7 9 56 19 11 | 6.9 8.8 54.9 18.6 10.8 |
According to the PSQI, in mean the sample reported marginally poor sleep (M = 5.21; SD = 2.70). Overall, the participants (76.5%) needed up to 30 minutes to fall asleep (sleep latency PSQI-score; range 0 - 3: M = 0.98, SD = 0.89) and slept for more than seven hours in mean (sleep duration PSQI-score; range 0 - 3: M = 0.46, SD = 0.76).
In the morning participants rated their mood in the sleep diary and in mean their mood was fairly good (range 1 - 6, M = 2.55; SD = 0.64). Furthermore, participants felt fairly fresh in the mornings (range 1 - 6, M = 2.93; SD = 0.77). In mean, participants fell asleep after 14 minutes (M = 13.96; SD = 12.52). But sleep latency ranged between zero and 95 minutes. Only 4.9% needed more than 30 minutes to fall asleep and would therefore lie above clinical cut-off according to the DSM-5. Participants reported in mean 7.12 hours sleep with nightly awakenings occurring for 1.16 minutes on average. No participants experienced awakenings at night lasting longer than 30 minutes. Overall, participants were physically active for 67.73 minutes (SD = 73.53) per day. Couples reported close to no fights (M = 0.085; SD = 0.14). Zero to 10 (9.8%) reported a fight with the partner on any morning/evening protocol. Eight (7.8%) to 21 (20.6%) participants reported sexual intercourse per day. Forty (39.25%) to 82 (80.4%) reported tenderness.
Overall, the sample was mentally sane, as measured by the SCL-90-R (GSI t-transformed M = 50.51; SD = 9.44).
In mean the participants reported happy relationships above the cut-off (sum score > 17) for a satisfying relationship (M = 18.52; SD = 4.70). 26.5% of all participants showed a sum score of 16 or lower and seemed unhappy in their relationship. The mean for fighting behavior is M = 6.98 (SD = 1.95), for tenderness M = 5.76 (SD = 2.24) and for communality M = 5.80 (SD = 1.65). All above cut-off (<5.66), suggesting good relationships in all areas. Most couples considered sexual intercourse important in their relationship (range 0 - 3; M = 1.91; SD = 0.72), with higher scores indicating higher subjective importance. Furthermore, satisfaction with their inter course seemed common (range 0-3; M = 1.87; SD = 0.67).
Age and sleep duration correlated significantly (r = −0.402, p = 0.000) as older people slept less and age explains 16% of the variance. In a regression of daytime sleepiness and age, 5% of daytime sleepiness variance was explained by higher age. No other variables of the PSQI showed an association with age.
Gender had a significant influence on sleep latency (p = 0.037) and sleep duration (p = 0.049) with woman needing more time to fall asleep (M = 16.55; SD = 15.76) than men (M = 11.38; SD = 7.47). Furthermore, women slept longer (M = 7.28; SD = 0.81) than men (M = 6.96; SD = 0.80).
A significant relationship between sleep and mental health was found. The PSQI and SCL-90-R correlated significantly (r = 0.592; p < 0.001). In a linear regression 35% of variance was detected. The scales PSDI (Positive Symptom Distress Index), depression and anxiety correlated significantly with the PSQI sum score, but not with all subscales as seen in
But no significant correlations have been found between the SCL-90-Rs subscales and the sleep diary (all p > 0.05).
A significant negative relationship between PSQI and PFB-K (Relationship satisfaction Questionnaire) was found (r = −0.198; p = 0.047). This indicates low relationship quality is connected with low sleep quality. Higher scores on PFB-K resulted in lower PSQI scores, but only 4% of the variance was accounted for. A significant negative correlation between sleep medication and PFB-K (r = −0.219; p = 0.027) was found, but none for other PSQI subscales. For further details, see
GSI | Positive Symptom Distress Index (PSDI) | Depression | Anxiety | |||||
---|---|---|---|---|---|---|---|---|
r | p | r | p | r | p | r | p | |
PSQI total score | 0.592 | 0.000 | 0.514 | 0.000 | 0.469 | 0.000 | 0.432 | 0.000 |
PSQI.1 sleep quality | 0.504 | 0.000 | 0.468 | 0.000 | 0.353 | 0.000 | 0.306 | 0.002 |
PSQI.2 sleep latency | 0.336 | 0.001 | 0.306 | 0.002 | 0.242 | 0.014 | 0.257 | 0.009 |
PSQI.3 sleep duration | 0.208 | 0.036 | 0.140 | 0.163 | 0.142 | 0.157 | 0.167 | 0.094 |
PSQI.4 sleep efficiency | 0.248 | 0.013 | 0.202 | 0.043 | 0.170 | 0.090 | 0.154 | 0.125 |
PSQI.5 sleep disturbances | 0.515 | 0.000 | 0.517 | 0.000 | 0.418 | 0.000 | 0.393 | 0.000 |
PSQI.6 sleep medication | 0.225 | 0.023 | 0.135 | 0.176 | 0.213 | 0.032 | 0.223 | 0.024 |
PSQI.7 daytime sleepiness | 0.556 | 0.000 | 0.521 | 0.000 | 0.532 | 0.000 | 0.394 | 0.000 |
Marked results are based on p < 0.05.
PFB-K | Fighting | Tenderness | Comunality | Hapiness Item | Sex Importance | Sex Satisfaction | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
r | p | r | p | r | p | r | p | r | p | r | p | r | p | ||
PSQI sum score | 0.198 | 0.047 | 0.321 | 0.001 | 0.072 | 0.471 | 0.095 | 0.344 | 0.118 | 0.238 | 0.030 | 0.762 | 0.176 | 0.074 | |
PSQI.1 sleep quality | 0.102 | 0.310 | 0.128 | 0.203 | 0.028 | 0.783 | 0.101 | 0.317 | 0.057 | 0.569 | 0.029 | 0.777 | 0.164 | 0.100 | |
PSQI.2 sleep latency | 0.015 | 0.884 | 0.190 | 0.056 | 0.111 | 0.267 | 0.011 | 0.911 | 0.026 | 0.794 | 0.051 | 0.610 | 0.056 | 0.575 | |
PSQI.3 sleep duration | 0.155 | 0.120 | 0.178 | 0.075 | 0.117 | 0.244 | 0.083 | 0.407 | 0.148 | 0.139 | 0.066 | 0.513 | 0.052 | 0.603 | |
PSQI.4 sleep efficiency | 0.128 | 0.203 | 0.189 | 0.058 | 0.059 | 0.556 | 0.049 | 0.628 | 0.028 | 0.784 | 0.014 | 0.888 | 0.081 | 0.419 | |
PSQI.5 sleep disturbances | 0.172 | 0.084 | 0.144 | 0.148 | 0.139 | 0.162 | 0.135 | 0.176 | 0.078 | 0.438 | 0.102 | 0.305 | 0.275 | 0.005 | |
PSQI.6 sleep medication | 0.219 | 0.027 | 0.312 | 0.001 | 0.140 | 0.160 | 0.067 | 0.504 | 0.184 | 0.064 | 0.006 | 0.952 | 0.090 | 0.369 | |
PSQI.7 daytime sleepiness | 0.083 | 0.405 | 0.237 | 0.016 | 0.030 | 0.764 | 0.000 | 0.997 | 0.072 | 0.475 | 0.024 | 0.810 | 0.086 | 0.388 | |
Marked results are based on p < 0.05.
Sleep duration based on the sleep diary correlated significantly with the PFB-K score (r = 0.289; p = 0.003). The PBF-K score explains 8% of the sleep durations variance, calculated by linear regression (F(1, 99) = 9.020, p = .003). No other sleep diary parameters correlated with the PBF-K. The effect of PFB-K score on sleep duration is mediated by the participant’s age (see
The PFB-K subscale, fighting behavior, correlated significantly with the PSQI sum score (r = =0.321; p = 0.001), suggesting couples who were fighting more often slept worse. In a linear regression 10% of PSQIs variance was explained by fighting behavior.
Furthermore, fighting measured on basis of the sleep diary showed a negative correlation with sleep latency (r = −0.286, p = 0.004). Fighting during the night led to shorter sleep durations (r = 0.202; p = 0.043), whereas fighting during the day did not influence sleep duration (r = 0.152; p = 0.129).
No significant correlation was found between satisfaction with sexual intercourse and the PSQI sum score (r = −0.176; p = 0.074) but the PSQI subscale sleep disturbances correlated significantly with inter course satisfaction (r = −0.275; p = 0.005). The more satisfied the participants were with sex the less sleep disturbances they reported, in a linear regression with 8% of variance explained.
To prove the theoretical Partnership-Emotional wellbeing-Sleep model (PES), contained influences on sleep disturbances by relationship quality, fighting and well-being (as seen in
In the present study a significant correlation of PSQI and PFB-K supports the association of sleep quality and relationship satisfaction. Previous studies showed that relationship quality predicted clinically relevant sleep disturbances. Women in a satisfying marriage experienced significantly fewer sleep problems than women in non-satisfying marriages [
Sleep duration measured by the sleep diary correlated with relationship satisfaction. Age explains this link, as older people show shorter sleep durations and less relationship satisfaction [
Variable | Standardized Coefficients Beta | t | Sig. | ||||
---|---|---|---|---|---|---|---|
Age | −0.342 | −3.432 | 0.001 | ||||
Total sleep duration (sleep diary) | 0.151 | 1.516 | 0.133 | ||||
Regression coefficient B, standard deviation and β for variables in the model *p < 0.05. **p < 0.001.
Variable | B | SE B | β |
---|---|---|---|
GSI | 0.156 | 1.602 | 0.545** |
PFB-K constructive fighting behavior | −0.248 | 0.114 | −0.179* |
Regression coefficient B, standard deviation and β for variables in the model *p < 0.05. **p< 0.001
In addition, we found an association between destructive fighting behaviour and sleep quality. This result is in line with earlier studies [
In our sample, satisfaction with sexual life correlated negatively with sleep disturbances. This suggests that couples who were satisfied with their sexual intercourse suffered from less sleep disturbances. Furthermore, participants reported a better mood when they had sex during the night. Supported is this finding by Ditzen and colleagues who stated intimacy alleviates stress [
In a multiple regression model fighting and mental strain explained 38% of sleep quality variance. Depression, anxiety and relationship quality showed no further improvement of the model. Other factors―like attachment style―which were not considered in this study might improve the model, as Carmichael and Reisfound a higher fear of attachment to be associated with poor sleep quality in couples [
Consistent with findings by Schlack and colleagues we found a decrease in sleep duration with higher age [
In the present sample gender differences in sleep were only partly found. Women showed an equal number of sleep disturbances compared to men, contrary to earlier findings of more sleep disturbances in women [
In addition, mental strain (measured by GSI) and sleep quality (measured by PSQI) correlated significantly positively, supporting earlier findings. Therefore, mental strains are associated with sleep disturbances and a lower sleep quality, like Taylor and colleagues stated [
However, some limitations should be named. Intimate topics like sexuality and fighting in relationships might methodologically limit this study. Further anonymity?possibly through online questionnaires―might improve following studies about this topic. In addition, this sample did not show a continuous distribution of age. Longitudinal studies could determine causalities for underlying mechanisms. Additionally, intervention-studies concerning destructive fighting behaviour can give further information. Following studies should implement more couples which might help detect more underlying mechanisms.
In this study, subjective sleep quality and relationship satisfaction significantly correlated. In the theoretical Partnership-Emotional wellbeing-Sleep model (PES) higher relationship quality, better mental health and fewer conflicts in a relationship were associated with better sleep quality.
Conflicts often led to longer sleep latency and less sleep duration. Nevertheless the association of overall relationship quality and sleep quality was moderated by age, as older participants slept worse and were less satisfied with their relationships.
Sexual intercourses were another important factor influencing sleep quality. Intercourse at night led to a better mood in the morning.
These findings underlined that intimate relationships were important for sleep quality and vice versa. Therefore, relationship quality should always be taken into account and be asked for in adults suffering from sleep problems.
Angelika AnitaSchlarb,MerleClaßen,E.-S.Schuster,FrankNeuner,MartinHautzinger, (2015) Did You Sleep Well, Darling?—Link between Sleep Quality and Relationship Quality. Health,07,1747-1756. doi: 10.4236/health.2015.712190