Association of hostility with sleep duration and sleep disturbances in an employee population

  • Niklas GranöEmail author
  • Jussi Vahtera
  • Marianna Virtanen
  • Liisa Keltikangas-Järvinen
  • Mika Kivimäki


Background: Sleep disturbances are common among the general population, and hostile persons have been proposed to be at greater risk of several serious health problems and diseases. Purpose: This study examined the relationships between hostility, sleep disturbances, and sleep duration in a large non-clinical sample of 5,433 employees working in 12 Finnish hospitals. Method: Data were collected by questionnaire surveys in 1998 and 2000. Results: Higher hostility was cross-sectionally associated with increased sleep disturbances but not with sleep duration after adjustment for gender, age, marital status, education, shift work, smoking, alcohol consumption, physical activity, body mass index, psychiatric morbidity, and somatic disease. A stratified analysis distinguishing individuals with stable hostility across the two measurements and those with transient hostility (>0.5 SD difference between measurements) replicated the association with increased sleep disturbance in both groups, but among those with transient hostility, there additionally was a cross-sectional association between higher hostility and shorter sleep duration. Conclusion: Our evidence suggests that hostility is an independent risk factor for sleep disturbances and that transient hostility may also predispose shorter sleep duration. However, the effect sizes for all these associations were small, suggesting limited clinical significance for our findings.

Key words

hostility sleep duration sleep disturbances 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Akerstedt, T. (2006). Psychosocial stress and impaired sleep. Scandinavian Journal of Work, Environment & Health, 32, 493–501.Google Scholar
  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed., p. 553). Washington, DC: American Psychiatric Publishing.Google Scholar
  3. Barefoot, J. C., Dahlström, W. G., & Williams, R. B. (1983). Hostility, CHD incidence, and total mortality: A 25-year follow-up study of 255 physicians. Psychosomatic Medicine, 45, 59–63.PubMedGoogle Scholar
  4. Bonnet, M. H., & Arand, D. L. (2003). Situational insomnia: Consistency predictors and outcomes. Sleep, 15 (8), 1029–1036.Google Scholar
  5. Drapeau, C., Hamel-Hebert, I., Robillard, R., Selmaoui, B., Filipini, D., & Carrier, J. (2006). Challenging sleep in aging: The effects of 200 mg of caffeine during the evening in young and middle- aged moderate caffeine consumers. Journal of Sleep Research, 15, 133–141.PubMedCrossRefGoogle Scholar
  6. Goldberg, D., & Williams, P. (1988). A users guide to the general health questionnaire. Berkshire, UK: NFER-Nelson Publishing.Google Scholar
  7. Hogan, B. E., & Linden, W. (2004). Anger response styles and blood pressure: At least don’t ruminate about it! Annals ofBehavioral Medicine, 27(1), 1–2.CrossRefGoogle Scholar
  8. Holi, M. M., Marttunen, M., & Aalberg, V. (2003). Comparison of the GHQ-36, the GHQ-12 and the SCL-90 as psychiatric screening instruments in the Finnish population. Nordic Journal of Psychiatry, 57, 233–238.PubMedCrossRefGoogle Scholar
  9. Jenkins, D. C., Stanton, B.-A., Niemcryk, S. J., & Rose, R. M. (1988). A scale for the estimation of sleep problems in clinical research. Journal of Clinical Epidemiology, 41, 313–321.PubMedCrossRefGoogle Scholar
  10. Johnson, E. O., Roth, T., & Breslau, N. (2006). The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk. Journal of Psychiatric Research, 40, 700–708.PubMedCrossRefGoogle Scholar
  11. Kales, A., Caldwell, A. B., Soldatos, C. R., Bixler, E. O., & Kales, J. D. (1983). Biopsychobehavioral correlates of insomnia. II. Pattern specificity and consistency with the Minnesota Multi- phasic Personality Inventory. Psychosomatic Medicine, 45(4), 341–356.PubMedGoogle Scholar
  12. Kaprio, J., Koskenvuo, M., Langinvainio, H., Romanov, K., Sarna, S., & Rose, R. J. (1987). Genetic influences on use and abuse of alcohol: A study of 5638 adult Finnish twin brothers. Alcoholism: Clinical and Experimental Research, 11, 349–356.CrossRefGoogle Scholar
  13. Kivimäki, M., Vahtera, J., Koskenvuo, M., Uutela, A., & Pentti, J. (1998). Response of hostile individuals to stressful changes in their working lives: Test of a psychosocial vulnerability model. Psychological Medicine, 28, 903–913.PubMedCrossRefGoogle Scholar
  14. Kivimäki, M., Elovainio, M., & Vahtera, J. (2000). Workplace bullying and sickness absence in hospital staff. Occupational and Environmental Medicine, 57, 656–660.PubMedCrossRefGoogle Scholar
  15. Kivimäki, M., Virtanen, M., Vartia, M., Elovainio, M., Vahtera, J., & Keltikangas-Järvinen, L. (2003). Workplace bullying and the risk of cardiovascular disease and depression. Journal of Occupational and Environmental Medicine, 60, 779–783.CrossRefGoogle Scholar
  16. Koskenvuo, M., Kaprio, J., Rose, R. J., Kesaniemi, A., Sarna, S., Heikkilä, K., & Langinvainio, H. (1988). Hostility as a risk factor for mortality and ischemic heart disease in men. Psychosomatic Medicine, 50, 330–340.Google Scholar
  17. Kujala, U. M., Kaprio, J., Sarna, S., & Koskenvuo, M. (1998). Relationship of leisure-time physical activity and mortality: The Finnish Twin Cohort. The Journal of American Medical Association, 279,440–444.CrossRefGoogle Scholar
  18. Landolt, H. P., Werth, E., Borbely, A. A., & Dijk, D. J. (1995). Caffeine intake (200 mg) in the morning affects human sleep and EEG power spectra at night. Brain Research, 675(1–2), 67–74.PubMedCrossRefGoogle Scholar
  19. Leiker, M., & Hailey, B. J. (1988). A link between hostility and disease: Poor health habits? Behavioural Medicine, 3,129–133.Google Scholar
  20. Madigan, Jr., M. F., Dale, J. A., & Cross, J. D. (1997). No respite during sleep: Heart rate hyperactivity to rapid eye movement sleep in angry men classified as type A. Perceptual and Motor Skills, 85(3, Pt 2), 1451–1454.PubMedGoogle Scholar
  21. Mahon, N. E., Yarchesci, A., Yarchesci, T. J., & Hanks, M. M. (2006). Correlates of low frustration tolerance in young adolescents. Psychological Reports, 99(1), 230.PubMedCrossRefGoogle Scholar
  22. Mellman, T. A. (2006). Sleep and anxiety disorders. The Psychiatric Clinics of North America, 29, 1047–1058.PubMedCrossRefGoogle Scholar
  23. Miller, T. Q., Smith, T. W., Turner, C. W., Quijarro, M. L., & Hallet, A. J. (1996). A meta-analytic review of research on hostility and physical health. Psychological Bulletin, 119, 322–348.PubMedCrossRefGoogle Scholar
  24. Montserrat, S.-O., Moore, N., Taillard, J., Valtat, C., Leger, D., Bioulac, B., & Philip. P. (2005). Sleep duration and caffeine consumption in a French middle-aged working population. Sleep Medicine, 6, 247–251.CrossRefGoogle Scholar
  25. Ohayon, M. M., Zulley, J., Guilleminault, C., Smirne, S., & Priest, R. G. (2001). How age and daytime activities are related to insomnia in the general population: Consequences for older people. Journal of American Geriatrical Society, 49, 360–366.CrossRefGoogle Scholar
  26. Ranchor, A., Sanderman, R., Bourna, J., Buunk, B., & Heuvel, W. (1997). An exploration of the relation between hostility and disease. Journal of Behavioural Medicine, 20, 223–240.CrossRefGoogle Scholar
  27. Romanov, K., Hatakka, M., Keskinen, E., Laaksonen, H., Kaprio, J., Rose, R. J., & Koskenvuo, M. (1994). Self-reported hostility and suicidal acts, accidents, and accidental deaths. A prospective study of 21,433 adults aged 25 to 59. Psychosomatic Medicine, 56, 328–336.PubMedGoogle Scholar
  28. Rosmalen, J. G. M., Neeleman, J., Gans, R. O. B., & Jonge, P. (2007). The association between neuroticism and self-reported common somatic symptoms in a population cohort. Journal of Psychosomatic Research, 62, 305–311.PubMedCrossRefGoogle Scholar
  29. Roth, T. (2001). New developments for treating sleep disorders. Journal of Clinical Psychiatry, 62(Suppl)10, 3–4.PubMedGoogle Scholar
  30. Sateia, M. J., Doghramji, K., Hauri, P. J., & Morin, C. M. (2000). Evaluation of chronic insomnia: An American Academy of Sleep Medicine review. Sleep, 23, 243–308.PubMedGoogle Scholar
  31. Scherwitz, L. W., Perkins, L. L., Chesney, M. A., Hughes, G. H., Sidney, S., & Manolio, T. A. (1992). Hostility and health behaviours in young adults: The Cardia study. American Journal of Epidemiology, 136, 136–145.PubMedGoogle Scholar
  32. Scott, J. P., McNaughton, L. R., & Polman, R. C. (2006). Effects of sleep deprivation and exercise on cognitive, motor performance and mood. Physiology & Behavior, 87(2), 396–408.CrossRefGoogle Scholar
  33. Shaver, J. L. F., Johnston, S. K., Lentz, M. J., & Landis, C. A. (2002). Stress exposure, psychological distress and physiological stress activation in midlife women with insomnia. Psychosomatic Medicine, 64, 793–802.PubMedCrossRefGoogle Scholar
  34. Shin, C., Kim, J., Yi, H., Lee, H., Lee, J., & Shin, K. (2005). Relationship between trait-anger and sleep disturbances in middle-aged men and women. Journal of Psychosomatic Research, 58,183–189.PubMedCrossRefGoogle Scholar
  35. Siegler, I. C., Costa, P. T., Brummett, B. H., Helms, M. J., Barefoot, J. C., Williams, R. B., Dahlstrom, W. G., Kaplan, B. H., Vitaliano, P. P., Nichman, M. Z., Day, R. S., & Rimer, B.K. (2003). Patterns of change in hostility from college to midlife in the UNC Alumni Heart Study predict high-risk status. Psychosomatic Medicine, 65,738–745.PubMedCrossRefGoogle Scholar
  36. Smith, T. W. (1992). Hostility and health: Current status of a psychosomatic hypothesis. Health Psychology, 11, 139–150.PubMedCrossRefGoogle Scholar
  37. Spielberger, C. D., Johnson, E. H., Russel, S. F., Crane, R. J., Jacobs, G. A., & Worden, T. J. (1985). The experience and expression of anger: construction and validation of an anger expression scale. In M. A. Chesney & R. H. Rosenman (Eds.), Anger and hostility in cardiovascular and behavioral disorders (pp. 5–30). New York: Hemisphere.Google Scholar
  38. Stakes. Terveydenhuollon ammattihenkilot. (2004). [The National Research and Development Centre for Welfare and Health, 2004. Health care professionals]. /pdf/tilastotiedotteet/Tt1004.pdf (Searched Nov. 31, 2005).Google Scholar
  39. Strandberg, T. E., Raikkönen, K., Partinen, M., Phil, S., Vanhanen, H., & Miettinen, T. A. (1994). Associations of cholesterol lowering by statins with anger and hostility in hypercholesterolemic men. Biological Psychiatry, 35, 375–377.CrossRefGoogle Scholar
  40. Suinn, R. M. (2001). The terrible twosflAnger and anxiety— American Psychologist, 56, 27–36.PubMedCrossRefGoogle Scholar
  41. Tanasescu, M., Leitzmann, M. F., Rimm, E. B., Willett, W.C., Stampfer, M. J., & Hu, F. B. (2002). Exercise type and intensity in relation to coronary heart disease in men. The Journal of American Medical Association, 288, 1994–2000.CrossRefGoogle Scholar
  42. Taub, J. M. (1977). Behavioral and psychological correlates of a difference in chronic sleep duration. Biological Psychology, 5(1), 28–45.CrossRefGoogle Scholar
  43. Vahtera, J., Kivimaki, M., Koskenvuo, M., & Pentti, J. (1997). Hostility and registered sickness absences: A prospective study of municipal employees. Psychological Medicine, 27, 693–701.PubMedCrossRefGoogle Scholar
  44. Vgontzas, A. N., & Chrousos, G. P. (2002). Sleep, the hypothalamic- pituitary-adrenal axis, and cytokines: Multiple interactions and disturbances in sleep disorders. Endocrinology and Metabolism Clinics of North America, 31(1), 15–36.PubMedCrossRefGoogle Scholar
  45. Waters, W F., Adams, S. G., Binks, P., & Varnado, P. (1993). Attention, stress and negative emotion in persistent sleep-onset and sleep-maintenance insomnia. Sleep, 16 (2), 128–136.PubMedGoogle Scholar
  46. Weitzman, E. D. (1976). Circadian rhythms and episodic hormone secretion in man. Annual Review of Medicine, 27, 225–243.PubMedCrossRefGoogle Scholar
  47. Whiteman, M. C., Fowkes, F. G., Deary, I. J., & Lee, A.J. (1997). Hostility, cigarette smoking and alcohol consumption in the general population. Social Sciences and Medicine, 44, 1089–1096.CrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2008

Authors and Affiliations

  • Niklas Granö
    • 1
    Email author
  • Jussi Vahtera
    • 1
  • Marianna Virtanen
    • 1
  • Liisa Keltikangas-Järvinen
    • 2
  • Mika Kivimäki
    • 1
    • 3
  1. 1.Finnish Institute of Occupational HealthFinland
  2. 2.Department of PsychologyUniversity of HelsinkiFinland
  3. 3.Department of Epidemiology and Public HealthUniversity College LondonUnited Kingdom

Personalised recommendations