Biological Rhythms, Sleep & Stress: Psychological Impact - Martina Case Study

1. Introduction - Biological Rhythms, Sleep & Stress: Psychological Impact - Martina Case Study

Biological psychology studies the dynamic interplay of physiological processes and psychological functioning regarding bodily rhythms, sleep, and stress throughout life. Disruption to sleep and biological rhythms can have detrimental effects, as these systems are fundamental to regulating cognitive, emotional, and physical health (Coskun et al. 2023). It has been widely researched on how circadian rhythms are disturbed in shift workers with the possibility of sleep deprivation, mood disturbances and metabolic changes. Another major factor of psychological health is chronic stress, which interacts with the disruption of sleep patterns to exacerbate physical and emotional distress further.

This case study examines how Martina, a 52-year-old mental health support worker, works rotational shifts, that is nights and on-call. In the past year, the sleep problems have been persistent, with difficulty in sleeping, increased fatigue, appetite loss, and frequent disturbing dreams. Plus, she may also be coping with great stress occurring in her life as she puts together the pieces of her dysfunctional family after a divorce: her daughter moving back home with her infant grandchild.

2. Biological Rhythms and Their Disruptions

Creating stability and helping the body adapt to changes, biological rhythms, or physiologic circadian pathways, regulate many essential physiological and certain psychological functions (Reddy et al., 2023). These rhythms have three main categories: circadian, infradian, and ultradian. Research suggests that disrupted circadian rhythms in shift workers can lead to sleep disturbances, impaired memory, and increased vulnerability to health issues. (Reddy et al. 2023). It has also been observed that Martina’s shifting schedule, leading to both rotating on-call responsibilities and varying hours, also likely led to an imbalance in Martina’s biological rhythms that persist in ongoing sleep difficulties, chronic fatigue, and appetite loss. Martina’s case clearly illustrates this, as her irregular shift patterns interfere with her biological clock, preventing her from establishing a consistent sleep routine.

The body’s internal clock that controls the sleep-wake cycle, hormone production and body temperature all operate under a roughly 24-hour cycle, known as circadian rhythm. These rhythms depend greatly on exposure to light, as darkness leads to the release of the hormone that controls sleep, melatonin. This natural cycle is disrupted by shift work, which is particularly problematic if night shifts expose workers to artificial light that suppresses melatonin production and makes it hard to fall asleep. Sleeping inconsistent schedules make the body unable to identify a regular rhythm, resulting in chronic sleep deprivation, poor cognitive functioning, and elevated levels of fatigue (Caldwell et al., 2019). Martina often had fluctuating shift patterns and night shift patterns, which indicates her body is not able to maintain a stable sleep-wake cycle, which would then lead to her difficulties with sleep and overall exhaustion.

Infradian rhythms occur longer than 24 hours, such as changing emotions and energy levels over time and hormonal fluctuations (Coskun et al., 2023). The likelihood is that these rhythms were not personally responsible for Martina’s sleep problems. However, chronic stress in her life can affect the balance of hormones, thereby interfering with her capacity to sleep. Yet high amounts of stress cause cortisol, a hormone that regulates energy and alertness, to be produced at high levels. High cortisol levels, especially in the evening but also during the day, can interfere with the body entering deep sleep and cause frequent wakeups (Henry et al., 2021). Martina’s inability to get a good night’s sleep may be due to an inability to stay consistent in sleep patterns caused by heightened stress levels that would otherwise be enough to pull back the biological internal clock.

Ultradiand rhythms are repeated many times in 24 hours and can include the phase of sleep, phases of hunger, and feeding (Kim et al., 2020). Misalignment of the body’s internal clock can upset digestion and metabolism, and therefore, a reduced appetite at certain times of the day. Irregular hunger signals are common for shift workers and can lead to a loss of appetite or craving for unhealthy foods at unconventional hours (Azmi et al., 2020). Inadequate nutritional intake can lead to immune function weakening over time, as well as lowering mood stability, thereby reducing the body's physical resilience, which also helps increase the effects of chronic sleep deprivation and stress.

A key factor in Martina’s case is the occurrence of disturbing dreams and frequent light awakenings at night. Both physiological arousal and psychological stress are known to negatively influence sleep quality due to the difficulty of sleeping deeply (Zhang et al., 2024). Vivid or unsettling dreams are experienced in emotional distress, and these usually cause the person to awaken several times throughout the night, resulting in disrupted sleep (Whiting et al. 2023). Since Martina has known some very major personal changes, such as her daughter and grandchild moving back into the family home, a reason for the fragmented sleep could be stressors from this.

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3. Sleep Deprivation and Stress

Both cases involve sleep deprivation where a person fails to get sufficient or high quality amount of sleep that their body needs. The lack of sleep shows in a broad range of specific impairments, including slower reaction time, less attention span, poor memory consolidation and deficient decision-making (Colten and Altevogt, 2019; Henry et al., 2021). In addition, it is correlated with increased irritability and anxiety, as well as a greater risk of developing depressive symptoms, decreased immune function, and higher blood pressure (Whiting et al., 2023; Zhang et al., 2024). Furthermore, Martina’s continuous stress and her irregular shift work schedule have worsen the impact of chronic sleep deprivation. Therefore, she is physically fatigued as well as emotionally instable, has disturbing dreams and diminished ability to have a balanced diet, all of them resulting in further degradation of her overall well-being (Conte et al., 2020; Rogers et al., 2023).

However, as one of the most prominent effects of sleep deprivation, its effect on cognitive function is considered to be one of the most tragic manifestations associated with incomplete sleep. Consistent and restorative sleep is necessary for the brain to help consolidate memories, control attention, and maintain problem-solving abilities (Colten and Altevogt, 2019). Disrupted sleep causes cognitive efficiency to decrease and, therefore results in poor concentration, poor decision making and poor control of emotions. In light of Martina’s work as a mental health support worker, this job requires an abundance of mental and cognitive resilience and this may be limiting her ability to do the job as she should.

Sleep deprivation also affects emotional well-being. Insufficient sleep is also known to make people more prone to irritability, anxiety and susceptibility to stress since sleep helps regulate emotions (Whiting et al., 2023). Martina’s sleep disturbance, including disturbing dreams and frequent awakenings, suggests emotional distress occurring in sleep, causing a profound emotional impediment to achieving deep, restorative nights of sleep. However, her daughter’s subsequent return home.

Both chronic stress and sleep deprivation are known to be related to each other and form a cycle of negative reinforcement. When the body is stressed, it triggers the so-called hypothalamic-pituitary-adrenal (HPA) axis, which increases the production of cortisol (Lawrence and Scofield, 2024). While cortisol is needed for alertness and handling challenges, high cortisol levels (especially in the evening) can prevent us from sleeping. Martina is likely still stressed from her work and, even more importantly, from her other responsibilities, which is resulting in continuous cortisol levels in her, leaving her unable to go into the restful cycle of sleeping.

Martina’s loss of appetite may be a side effect of sleep deprivation, just like her feelings of ‘hungry and not hungry’ here. Sleep helps regulate two hormones that control hunger and satiety (leptin and ghrelin). Reduced levels of leptin and increased production of ghrelin, both due to disrupted sleep patterns, lead to loss of appetite or craving for unhealthy food (Lawrence and Scofield, 2024). The fact that Martina has difficulty eating breakfast means that her body’s natural hunger cues have been distorted by the irregular sleep and meals she eats due to her shift work. This further suggests that her emotional stress prevents her from obtaining restful sleep, as disturbing dreams indicate a lack of restful sleep. Dreams are an important aspect of emotional processing, so frequently, distressed dreams may point to unresolved stressors (Conte et al., 2020). Martina’s life begins to by a difficult cycle of sleep deprivation, chronic stress, and shift work.

4. Suggestions for Improvement

Given that Martina is currently experiencing sleep deprivation, a number of evidence-based strategies can be implemented to support her well-being. These strategies aim to manage the disruptions associated with shift work, enhance the quality of sleep, reduce stress, and restore a healthy routine (Boivin et al., 2021). This will help restore balance in her sleep-wake cycle to help heal her emotional well-being and support her overall health.

Maintaining a structured and consistent sleep schedule is the most effective method of addressing shift work related sleep disturbance. Most people experiencing difficulties falling or staying asleep likely have disrupted their circadian rhythm, which the body uses to regulate the sleep–wake cycle (Jha, 2023). Though the shift scheduling and work she can't control, she can enhance sleep quality through maintaining consistent sleep and wake times, even on days off. It also helps to maintain the body’s circadian stability and prepares the body to adapt to changing demands. While regular sleep schedule, even throughout shift transitions, was found to reduce sleep disruption and increase alertness (Boivin et al., 2021), findings were quite contradictory on whether total sleep time was a crucial aspect of alertness. She could ask as it is better to have more structured shift rotations, such as changes of morning, evening, and night shifts more slowly than abruptly, for more adaptation.

Managing light exposure is another key factor in improving sleep. The hormone-producing sleep, known as melatonin, is regulated by light. Certain kinds of exposure, such as bright light, specifically blue light from screens, and artificial light, suppress melatonin levels, causing it to be challenging to fall asleep (Falcón et al., 2020). If a dark sleep environment does not work, Martina should avoid staring at the screen before bed and cut down on screen use at least an hour before bed. On the other hand, exposure to bright light in the morning getting out or using a light therapy lamp, can help re-set her circadian rhythm and increase alertness.

The bedtime routine can be further relaxed to help improve sleep quality by signalling the body that it is time to rest. Reading, deep breathing, and listening to soft music are just some calming activities you can do before you go to bed that will help you relax and help you sleep easier. Besides, Matina can also avoid caffeine, nicotine and heavy food intake a few hours before bedtime to prevent the physiological stimulation that disrupts the sleep onset (Rogers, Banks and Jenkins, 2023). With Martina not very keen on eating breakfast, eating small, nutrient-rich meals at specific time intervals throughout the day can stabilise her metabolism and energy levels.

Another essential element to improving sleep involves optimising the sleep environment. A room that is cool, quiet, and comfortable dramatically affects one’s sleep quality (Falcón et al., 2020). White noise machines, earplugs, or simply listening to their broader household noise, such as that from her daughter and grandchild, can help serve as a shield against disruptive sounds that are bothering her sleep. Promoting restful sleep also involves investing in comfortable mattresses and pillows (Rogers, Banks and Jenkins, 2023). Aside from learning to improve their sleep habits, techniques to manage stress can also help Martina mentally overcome the emotional or psychological toll affecting her now. To unwind before bed, one can practice mindfulness meditation, yoga, or progressive muscle relaxation to reduce physiological stress response. It is also possible to create an emotional outlet for stress by practising gratitude, journaling or enjoying hobbies.

Another effective method for reducing stress and encouraging sleep is physical activity. Stress hormones are regulated and mood is stabilized by light to moderate physical exercise, such as walking, improving sleep quality (Lu et al., 2021). Although it is important not to exercise right before bedtime, since higher physiological arousal may slow down the process of falling asleep.

It is also important to deal with emotional side of the issue, such as Martina’s family situation. There may be a psychological burden due to caregiving to her daughter and infant grandchild, added onto Martina’s demands, which could make it more difficult to relax and get to restorative sleep. Interpersonal communication can be strengthened in the household as a form of supporting the household; to reduce emotional tension, discussions can be held on roles, setting boundaries and sharing responsibilities. Besides accessing support networks from friends, colleagues and getting professional counselling help, Martina can further develop effective coping mechanisms to mitigate stress and regulate emotions (Oladoye et al., 2022).

Martina can significantly enhance her sleep quality and general health by combining habitual sleep, stress minimisation, nutritional replenishment, and environmental outer works. The aim is to make a routine that is sustainable to her physiology and her emotions, enough to interrupt the vicious cycle of sleep deprivation and chronic stress (Oladoye et al., 2022). She can restore her sleep, energy levels, and life quality and regain control of her sleep patterns with the help of a slow and consistent change.

5. Conclusion

This is evident in Martina’s case where disrupted biological rhythms; lack of sleep and high stress levels negatively affects both the physical and mental health of the affected person. This could possibly cause her to be experiencing circadian misalignment and this simply means that her biological clock is not in harmony with the natural clock hence making it hard for her to have a normal sleep clock, diet clock or even the energy clock. This has also added an emotional burden in her daily life because of the family-related stress; she gets a lot of stress, disturbing dream, and excessive fatigue. Therefore, in order to determine what might be underlying her symptoms, it is possible to speak about biological rhythms, sleep problems, and stress.

This cycle leads to stress and exhaustion, and sleep deprivation disrupts both cognitive function and emotional regulation as well as metabolic balance. In turn, chronic stress disrupts hormonal regulation and makes it even harder to go back to sleep. However, this has to stop to prevent further health consequences and deterioration in the long term in Martina’s life. However, there are several strategies to see if shift work and stress will feel their effects on sleep. On the flipside you need to establish a nighttime sleep routine structured as much as possible, good light exposure management and sleep environment improvement are important for better sleep quality. Mindfulness, physical activity, and open communication stress reduction techniques can help Martina manage her emotional burden. In addition, the tiny modifications to her nutrition and hydration can help restore metabolic balance and energy levels. Professional intervention by a sleep specialist or therapist for sustained sleep disturbance despite the interventions mentioned above may be required.

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