A growing literature examines the correlates and sequelae of spiritual struggles, such as religious doubts. To date, however, this literature has focused primarily on a handful of mental health outcomes (e.g., symptoms of depression, anxiety, negative affect), while the possible links with other aspects of health and well-being, such as poor or disrupted sleep, have received much less attention. After reviewing relevant theory and previous studies, we analyze data from a nationwide sample of Presbyterian Church (USA) members to test the hypothesis that religious doubts will be inversely associated with overall self-rated sleep quality, and positively associated with the frequency of sleep problems and the use of sleep medications. We also hypothesize that part of this association will be explained by the link between religious doubts and psychological distress. Results offer moderate but consistent support for these predictions. We end with a discussion of the implications of these findings, a brief mention of study limitations, and some suggestions for future research.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
The panel includes a representative sample of another population, active ministers, but it is not included in the current analysis.
We recognize the possibility that the relationship between self-rated physical health and sleep quality may be bidirectional, i.e., that sleep quality may erode health just as poor health can undermine sleep quality. It is also conceivable that self-reported, subjective assessments of both sleep quality and overall health may be correlated due to common, unmeasured influences, including possible response biases. Nevertheless, we follow the lead of previous researchers (e.g., Moore et al. 2002) who incorporate adjustments for the potentially confounding effects of health status on indicators of sleep quality.
Asplund, Ragnar. 1999. Sleep disorders in the elderly. Drugs and Aging 14: 91–103.
Barton, J., E. Spelten, P. Totterdell, and L. Smith. 1995. Is there an optimum number of night shifts? Relationship between sleep, health, and well-being. Work and Stress 9: 109–123.
Berger, Peter L. 1969. The sacred canopy. Garden City, NY: Doubleday.
Bliwise, Nancy G. 1992. Factors related to sleep quality in healthy elderly women. Psychology and Aging 7: 83–88.
Breslau, Naomi, Thomas Roth, Leon Rosenthal, and Patricia Andreski. 1996. Sleep disturbance and psychiatric disorders: A longitudinal study of young adults. Biological Psychiatry 39: 411–418.
Burker, Eileen J., Donna M. Evon, Jan A. Sedway, and Thomas Egan. 2004. Religious coping, psychological distress, and disability among patients with end-stage pulmonary disease. Journal of Clinical Psychology in Medical Settings 11: 179–193.
Buysse, Daniel J., Charles F. Reynolds III, Timothy H. Monk, Susan R. Berman, and David J. Kupfer. 1989. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research 28: 193–213.
Ellis, Albert L. 1962. Reason and emotion in psychotherapy. Secaucus, NJ: Lyle Stuart.
Ellison, Christopher G. 1991. Religious involvement and subjective well-being. Journal of Health and Social Behavior 32: 80–99.
Ellison, Christopher G., Jason D. Boardman, David R. Williams, and James S. Jackson. 2001. Religious involvement, stress, and mental health: Findings from the 1995 Detroit area study. Social Forces 80: 215–249.
Ellison, Christopher G., and Jinwoo Lee. 2010. Spiritual struggles and psychological distress among US adults: Is there a dark side of religion? Social Indicators Research 98: 501–517.
Ellison, Christopher G., and Jeffrey S. Levin. 1998. The religion-health connection: Evidence, theory, and future directions. Health Education and Behavior 25: 700–720.
Espie, Colin A. 2002. Insomnia: Conceptual issues in the development, persistence, and treatment of sleep disorder in adults. Annual Review of Psychology 53: 215–243.
Exline, Julia J. 2002. Stumbling blocks on the religious road: Fractured relationships, nagging vices, and the inner struggle to believe. Psychological Inquiry 13: 182–189.
Exline, Julia J., and E. Rose. 2005. Religious and spiritual struggles. In Handbook of the psychology of religion, ed. F.Paloutzian Raymond, and L.Park Crystal. New York: Guilford.
Fabricatore, Anthony N., Paul J. Handal, Doris M. Rubio, and Frank H. Gilner. 2004. Stress, religion, and mental health: Religious coping in mediating and moderating roles. International Journal for the Psychology of Religion 14: 91–108.
Fitchett, George, Patricia E. Murphy, Jo Kim, James L. Gibbons, Jacqueline R. Cameron, and Judy A. Davis. 2004. Religious struggle: Prevalence, correlates, and mental health in diabetic, congestive heart failure, and oncology patients. International Journal for Psychiatry in Medicine 34: 179–196.
Galek, Kathleen C., Neal Krause, Christopher G. Ellison, Taryn Kudler, and Kevin J. Flannelly. 2007. Religious doubt and mental health across the lifespan. Journal of Adult Development 14: 16–25.
Gellis, Les A., Kenneth L. Lichstein, Isabel C. Scarinci, H. Health Durrance, Daniel J. Taylor, Andrew J. Bush, and Brant W. Riedel. 2005. Socioeconomic status and insomnia. Journal of Abnormal Psychology 114: 111–118.
Hall, Martica, Joyce Bromberger, and Karen Matthews. 1999. Socioeconomic status as a correlate of sleep in African American and Caucasian women. Annals of the New York Academy of Sciences 896: 427–430.
Hamilton, N., C. Nelson, N. Stevens, and Heather Kitzman. 2007. Sleep and psychological well-being. Social Indicators Research 82: 147–163.
Hecht, Jennifer M. 2003. Doubt: A history. San Francisco: Harper and Row.
Hill, Peter C., and Kenneth I. Pargament. 2003. Advances in the conceptualization and measurement of religion and spirituality. American Psychologist 58: 64–74.
Hill, Terrence D., Amy M. Burdette, Christopher G. Ellison, and Marc A. Musick. 2006. Religious attendance and the health behaviors of texas adults. Preventive Medicine 42: 309–312.
Hill, Terrence D., Amy M. Burdette, and Lauren Hale. 2009. Neighborhood disorder, sleep quality, and psychological distress: Testing a model of structural amplification. Health and Place 15: 1006–1013.
Hoch, Carolyn C., Mary Amanda Dew, Charles F. Reynolds III, Daniel J. Buysse, Peter D. Nowell, Timothy J. Monk, Sati Mazumdar, Michael D. Borland, Jean Miewald, and David J. Kupfer. 1997. Longitudinal changes in diary- and laboratory-based sleep measures in healthy “Old Old” and “Young Old” subjects: A three-year follow-up. Sleep 20: 192–202.
Hoch, Carolyn C., Charles F. Reynolds III, David J. Kupfer, Patricia R. Houck, Susan R. Berman, and Jacqueline A. Stack. 1987. The superior sleep of healthy elderly nuns. International Journal of Aging and Human Development 25: 1–9.
Hummer, Robert A., Christopher G. Ellison, Richard G. Rogers, Benjamin E. Moulton, and Ron R. Romero. 2004. Religious involvement and adult mortality: Review and perspective. Southern Medical Journal 97: 1223–1230.
Hunsberger, Bruce, B. McKenzie, S. Michael Pratt, and Mark Pancer. 1993. Religious doubt: A social psychological analysis. Research in the Scientific Study of Religion 5: 27–51.
Hunsberger, Bruce, S. Michael Pratt, and Mark Pancer. 2002. A longitudinal study of religious doubt in high school and beyond: Relationships, stability, and looking for answers. Journal for the Scientific Study of Religion 41: 255–266.
Idler, Ellen L., Marc A. Musick, Christopher G. Ellison, Linda K. George, Neal Krause, Marcia Ory, Kenneth Pargament, Lynda H. Powell, Lynn G. Underwood, and David R. Williams. 2003. Measuring multiple dimensions of religion and spirituality for health research: Conceptual background and findings from the 1998 general social survey. Research on Aging 25: 327–366.
Kessler, R.C., G. Andrews, L.J. Colpe, E. Hiripi, D.K. Mroczek, S.L.T. Normand, E.E. Waters, and A.M. Zaslavsky. 2002. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 32: 959–976.
Koenig, Harold G., Michael E. McCullough, and David B. Larson. 2001. Handbook of religion and health. New York: Oxford University Press.
Kojima, Masayo, Kenji Wakai, Takashi Kawamura, Akiko Tamakoshi, Rie Aoki, Yingsong Lin, Toshiko Nakayama, Hiroshi Horibe, Nobuo Aoki, and Yoshiyuki Ohno. 2000. Sleep patterns and mortality: A 12-year follow-up study in Japan. Journal of Epidemiology 10: 87–93.
Krause, Neal. 2003. Religious meaning and subjective well-being in late life. Journal of Gerontology: Social Sciences 58B: S160–S170.
Krause, Neal. 2006a. Religious doubt and psychological well-being: A longitudinal investigation. Review of Religious Research 47: 287–302.
Krause, Neal. 2006b. Gratitude toward God, stress, and health in late life. Research on Aging 28: 163–183.
Krause, Neal. 2008. Aging in the church: How social relationships affect health. West Conshohocken, PA: John Templeton Foundation Press.
Krause, Neal, and Christopher G. Ellison. 2009. The doubting process: A longitudinal study of the precipitants and consequences of religious doubt. Journal for the Scientific Study of Religion 48: 293–312.
Krause, Neal, and Keith M. Wulff. 2004. Religious doubt and health: Exploring the potential dark side of religion. Sociology of Religion 65: 35–56.
Krause, Neal, Berit Ingersoll-Dayton, Christopher G. Ellison, and Keith M. Wulff. 1999. Aging, religious doubt, and psychological well-being. The Gerontologist 39: 525–533.
McEwen, Bruce. 2006. Protective and damaging effects of stress mediators: Central role of the brain. Dialogues in Clinical Neuroscience 8: 367–381.
Mezick, Elizabeth J., Karen A. Matthews, Patrick J. Strollo Jr., Daniel J. Buysse, Thomas W. Kamarck, Jane F. Owens, and Steven E. Reis. 2008. Influence of race and socioeconomic status on sleep: The Pittsburgh SleepSCORE Project. Psychosomatic Medicine 70: 410–416.
Middlekoop, Huub, Dini A. Smilde-van den Doel, Arie Kniustingh Neven, Hilbert A.C. Kamphulsen, and Chiel P. Springer. 1996. Subjective Sleep characteristics of 1, 485 males and females aged 50–93: Effects of sex and age, and factors related to self-evaluated quality of sleep. Journal of Gerontology: Medical Sciences 51A: M108–M115.
Moore, Philip J., Nancy E. Adler, David R. Williams, and James S. Jackson. 2002. Socioeconomic status and health: The role of sleep. Psychosomatic Medicine 64: 337–344.
Musick, Marc A. 2000. Theodicy and life satisfaction among black and white Americans. Sociology of Religion 61: 267–287.
Naitoh, Paul, T.L. Kelly, and Carl E. Englund. 1990. Health effects of sleep deprivation. Occupational Medicine 5: 209–237.
National Sleep Foundation. 2008. The Importance of Sleep. http://www.sleepfoundation.org; retrieved 8/17/08.
Pargament, Kenneth I. 2002. The bitter and the sweet: An evaluation of the costs and benefits of religiousness. Psychological Inquiry 13: 168–181.
Pargament, Kenneth I., Harold G. Koenig, and Lisa M. Perez. 2000. The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology 56: 519–543.
Pargament, Kenneth I., Harold G. Koenig, Nalini Tarakeshwar, and June Hahn. 2001. Religious struggle as a predictor of mortality among medically ill elderly patients. Archives of Internal Medicine 161: 1881–1885.
Pargament, Kenneth I., Harold G. Koenig, Nalini Tarakeshwar, and June Hahn. 2004. Religious coping methods as predictors of psychological, physical, and spiritual outcomes among medically ill elderly patients: A two-year longitudinal study. Journal of Health Psychology 9: 713–730.
Pargament, Kenneth I., Nicole Murray-Swank, Gina M. Magyar, and Gene G. Ano. 2005. Spiritual struggle: A phenomenon of interest to psychology and religion. In Judeo-Christian perspectives on psychology: Human nature, motivation, change, ed. W.R. Miller, and H.D. Delaney, 245–268. Washington: American Psychological Association.
Pilcher, June J., and Allen I. Hunnicut. 1996. Effects of sleep deprivation on performance: A meta-analysis. Sleep 19: 318–326.
Pilcher, June J., and Amy S. Walters. 1997. How sleep deprivation affects psychological variables related to college students’ cognitive performance. Journal of American College Health 46: 121–126.
Pilcher, June J., Douglas R. Ginter, and Brigitte Sadowsky. 1997. Sleep quality versus sleep quantity: Relationships between sleep and measures of health, well-being, and sleepiness in college students. Journal of Psychosomatic Research 42: 583–596.
Powers, Daniel A., and Yu. Xie. 2000. Statistical methods for categorical data. San Diego: Academic Press.
Research Services, Presbyterian Church. (USA). 2006. Religious and demographic profile of presbyterians, 2005: Findings from the initial survey of the 2006–2008 presbyterian panel. Louisville: Research Services.
Rowatt, Wade C., and Lee A. Kirkpatrick. 2002. Dimensions of attachment to God and their relation to affect, religiosity, and personality constructs. Journal for the Scientific Study of Religion 41: 637–651.
Schwartz, Skai, W. McDowell Anderson, Stephen R. Cole, Joan Cornoni-Huntley, Judith C. Hays, and Daniel G. Blazer. 1999. Insomnia and heart disease; a review of epidemiologic studies. Journal of Psychosomatic Research 47: 313–333.
Shaver, Joan L.F., and Virginia M. Paulsen. 1993. Sleep, psychological distress, and somatic symptoms in perimenopausal women. Family Practice Research Journal 13: 373–384.
Sloan, Richard P. 2006. Blind faith: The unholy alliance of religion and medicine. New York: St. Martin’s Press.
Smith, Timothy P., Michael E. McCullough, and Justin Poll. 2003. Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events. Psychological Bulletin 129: 614–636.
Van Cauter, Eve, and Karine Spiegel. 1999. Sleep as a mediator of the relationship between socioeconomic status and health: A hypothesis. Annals of the New York Academy of Sciences 896: 254–261.
Van Reeth, O., L. Weibel, K. Spiegel, R. Leproult, C. Dugovic, and S. Maccari. 2000. Interactions between stress and sleep: From basic research to clinical situations. Sleep Medicine Reviews 4: 201–219.
About this article
Cite this article
Ellison, C.G., Bradshaw, M., Storch, J. et al. Religious Doubts and Sleep Quality: Findings from a Nationwide Study of Presbyterians #090709revised. Rev Relig Res 53, 119–136 (2011). https://doi.org/10.1007/s13644-011-0019-0
- Spiritual struggle