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Key points
- The rising cost of living is being felt around the globe, with the cost of essentials soaring high.
- A recent survey of 15,000 adults throughout the UK reported a mere 5 percent slept well and woke up feeling refreshed.
- The best sleepers tend to be those who are financially comfortable, largely due to their environment.
The "cost of living crisis" can be defined as a fall in real disposable incomes, because the price of everyday essentials rises faster than average household incomes.1 Inflation, on the other hand, is the percentage increase in the price of goods and services over time. Unfortunately, inflation has gone up much faster than anticipated, which caused this financial crisis. This is because incomes have increased in monetary value, but they have not increased enough to compensate for the sharp rise in inflation. For this reason, money just does not go as far as it once did.2 It is why we are flailing over the price of fuel and the cost of food. It is why we are feeling the financial crunch toward the end of the month and are pinching pennies.
It's in the numbers
The Inequalities in Health Alliance (IHA), convened by the Royal College of Physicians (RCP), published results showing that more than half of British people feel their health has been negatively affected by the rising cost of living. Of those, 84 percent put it down to increased heating costs, 78 percent blamed the rising cost of food, and 46 percent reported rising transport costs.3 Meanwhile, a recent survey of 15,000 adults throughout the UK reported a mere 5 percent slept well and woke up feeling refreshed. Thirty-four percent could not sleep because of stress, 24 percent were anxious about the following day, and 23 percent said difficulties with sleep were explicitly because of money worries.4
Tossing and turning
It is said that “good sleepers are all alike, but poor sleepers have poor sleep for any number of reasons” (p. 694).5 But the best sleepers tend to be those who are financially comfortable. This is for many reasons. They tend not to lay in bed at night, tossing and turning, wondering whether they can keep the heat on, feed their children, or put fuel in their car to get to work. Their living conditions tend to be more conducive to sleep, with better bedding, quality housing, and fewer chances of interruptions to sleep such as neighbours, traffic, and other likely disruptions that come from highly populated areas. They tend not to need a second or even third job to survive. Shift work is rare, overtime is optional, and entrepreneurship is for passion, not a necessity. It is why the cost of living crisis and the subsequent "cost of sleep crisis" is really a social crisis.
Feel stressed, can’t sleep
Many people struggle to sleep when stressed. Stress is as antithetical to sleep as sleep is to stress. There is a dynamic and complex relationship between the two. They frequently occur together and reinforce each other. A thousand thoughts overwhelm our ability to fall asleep. Underlying anxieties interrupt our sleep. Longer work hours shorten our sleep. Even the anticipation of impending bills can cause stress and disrupt sleep. Yet understanding how this happens is less clear.
We are all hormonal
Stress has biological influences on sleep. It can activate the defense system of the central nervous system (CNS), with changes seen in the level of activity in the immune and neuroendocrine systems. More specifically, stress activates the sympatho-adreno-medullary (SAM) and hypothalamic-pituitary-adrenal (HPA) systems. Stress systems interact with the immune and endocrine systems. So, we see a positive-negative feedback between each system. The excessive secretion of cortisol, along with other hormones and proteins then negatively impact sleep.6
Snug as a bug in a rug
It should be noted that we each have different psychoneurobiological vulnerabilities to stress. Individuals with highly reactive sleep systems experience a drastic deterioration in sleep when stressed. It contributes to why some of us are more prone to sleep issues than others in the face of financial concerns.7 A final notice arrives and the money just is not there— and you're wide awake, counting sheep in an attempt to sleep. Meanwhile, your partner is drawing zzz's, snug as a bug in a rug.
A vicious cycle
As stress influences sleep, so can sleep influence our ability to cope with stress. Either can trigger a vicious descending cycle between them. Poor sleep over the short term can spark mild, temporary increases in the activity of the major immune and neuroendocrine stress systems, such as the autonomic sympatho-adrenal (SA) system and the HPA axis. The immediate signs of alterations to these systems are in the way that we manage (or don’t manage) problems such as financial stressors. By acting on stress systems over the long term, insufficient sleep can leave us entirely unable to cope and it can sensitize us to stress-related disorders. Further, not only does chronically restricted sleep impact our emotional perception, but it can also change the fundamental properties of these biological stress systems.8
Sweet dreams, composed emotions
Another perhaps more immediate pathway is through the disruption to rapid eye movement (REM) sleep. This is the phase of sleep where dreams are most intense—vivid and fantastical. Normally consuming 20-25 percent of our entire sleep, REM sleep consolidates our emotions. It has a protective effect and usually increases to process strong emotions. Stress recovery during sleep is essential to effectively cope with stressors the following day. (Just so you know: Alcohol dramatically reduces the amount of REM sleep we have, so it should be especially avoided when faced with stressors during the day. It only further hinders sleep’s ability to provide restoration.)9
A formidable pair
Ultimately, stress and sleep are a formidable pair. Much of their effects are unseen but they are certainly not unfelt. The cost of living crisis has caused a "cost of sleep" crisis, but neither are experienced equally. It is yet another discriminating social issue that exacerbates health inequalities. It adds to the case for a government-wide approach to reducing financial inequalities stronger and more urgent than ever. After all, an increased focus on the improvement of stress and sleep has the ability to improve health and well-being across the nation.3
References
1. Williams, S. N. & Dienes, K. The ‘Cost of Living Crisis’ and its effects on health: A qualitative study from the U. Preprint at https://doi.org/10.31234/osf.io/tr4xf (2022).
2. Glick, R. Will Workers Demand Cost-of-Living Adjustments. 6 (2022).
3. Goddard, A. The cost of living crisis is another reminder that our health is shaped by our environment. BMJ 377, o1343 (2022).
4. SMC. The 2022 UK Sleep Survey | Sleep Matters Club. https://www.dreams.co.uk/sleep-matters-club/sleep-survey-2022 (2022).
5. Barber, L. K. Ethical considerations for sleep intervention in organizational psychology research. Stress Health 33, 691–698 (2017).
6. Han, K. S., Kim, L. & Shim, I. Stress and Sleep Disorder. Exp. Neurobiol. 21, 141–150 (2012).
7. Kalmbach, D. A., Anderson, J. R. & Drake, C. L. The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. J. Sleep Res. 27, e12710 (2018).
8. Meerlo, P., Sgoifo, A. & Suchecki, D. Restricted and disrupted sleep: Effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Med. Rev. 12, 197–210 (2008).
9. Stipp, W. Assessment of psychological stress during sleep using digital devices and its clinical relevance to future occupational health practice. Digit. Med. 5, 102 (2019).
