Results of the Heart Rate Variability and Recovery from Work Stress Study

Results of the Heart Rate Variability and Recovery from Work Stress Study JUNE 2015 Queensland, Australia Dr. Stacey Parker & Karly Head School of Psychology, The University of Queensland, St Lucia, QLD 4072 T: +61 (7) 3365 6423 F: +61 (7) 3365 4466 E: s.parker@psy.uq.edu.au

CONTENTS Executive Summary iii PART I: INTRODUCTION 1 1. INTRODUCTION 2 1.1 AIM OF THE RESEARCH 3 1.2 SAMPLE 3 1.3 STUDY METHOD 4 PART II: STUDY FINDINGS 5 2. RESULTS: AT WORK 6 2.1 WORK EVENTS 6 2.2 COPING STRATEGIES USED 8 2.3 HRV SCORES 10 2.4 DAILY HASSLES /UPLIFTS RELATED TO COPING AND HRV 11 3. RESULTS: AT HOME 12 3.1 RECOVERY ACTIVITIES AT HOME 12 3.2 SLEEP QUALITY 13 3.3 SLEEP QUALITY RELATED TO RECOVERY ACTIVITIES 14 PART III: CONCLUSIONS & RESOURCES 15 4. CONCLUSIONS 16 5. RESOURCES 17 5.1 TIPS FOR REDUCING STRESS 17 5.2 FURTHER READING 19 Acknowledgements and Contributions The authors thank Professors Nerina Jimmieson and Cameron Newton of the School of Management at Queensland University of Technology for their contribution to the design of this study. This research was funded by an Australian Research Council Linkage Grant (#LP110100616) and a UQ Social and Behavioural Sciences Small Grant. ii

Executive Summary Stable, happy employees are a key component of a stable and happy economy. Confirming this, a recent report by Workforce Magazine found that an increasing number of employees who feel stressed and pressed at work are leaving their jobs for positions with fewer demands and greater flexibility 1. Of those stressed workers who retain their jobs, some will seek workplace compensation for mental stress. The purpose of the present study was to investigate how work-related stress affects individuals at a psychological and physiological level, how people cope with daily hassles and uplifts during the working day, and how they recover when they get home. In addition, this study explored which types of coping strategies are most effective at helping people recover from daily work stressors. Seventy-two people from diverse backgrounds and occupations completed questionnaires assessing their experiences at work, common coping strategies used, and the type of activities they engaged in at home. Heart rate monitors were also worn for a period of one work week. Results revealed that: Daily uplifts (e.g., goal attainment, positive interactions) were more commonly reported than daily hassles (e.g., goal frustrations, negative interactions, technical problems, health issues, private life intrusions). Planning and emotion suppression coping strategies were more common than positive reappraisal, attention redeployment, and support seeking coping strategies. Heart rate variability scores seemed to indicate high pressure and stress overall, and the height of physiological stress occurred (for most people) in the middle of the working week. Planning and positive reappraisal coping strategies were related to experiencing more daily uplifts at work which, in turn, were associated with feeling more physiologically relaxed (i.e., higher HRV-HF scores). When experiencing daily hassles at work, using adaptive coping strategies (e.g., attention redeployment) was also related to feeling more physiologically relaxed. Participants experienced the poorest sleep quality on Friday nights (as indicated by HRV). Moreover, engaging in low effort activities (e.g., watching TV) after work was related to lower self-reported sleep quality, while physical activity was related to improved sleep quality, as indicated by HRV. 1 Nikravan, L. (2014). Two Years Later Still Stressed and Pressed. Workfoce Magazine. Retrieved from http://www.workforce.com.articles/20310-two-years-later-still-stressed-and-pressed. iii

Part I Introduction 1

1 Introduction While some people claim to work better under stress, it would appear they are part of the minority. A recent survey conducted by the Australian Psychological Society has found that one in four Australian workers have felt moderately to severely stressed in the past year, and that more than half of this stress stemmed from work 2. The survey also revealed that work demands were cited as a barrier to maintaining a healthy lifestyle by nearly half of the responders (48%). To make matters worse, work-related stress affects not only employees, but also the economy as a whole. A report published by Safe Work Australia in 2013 found that mental stress costs Australian businesses more than $10 billion per year in workplace compensation, sick leave, and wages for replacement staff 3. In addition, Medibank Private s report on The Cost of Workplace Stress in Australia found that these figures soar to over $14 billion per annum for the Australian Government 4. It is important to note that while stress-related claims A report published by Safe Work Australia in 2013 found that mental stress costs Australian businesses more than $10 billion per year. have a lower prevalence than other types of claims (i.e., physical injury or disorder), the average payouts are actually greater. This is a result of stress claims generally requiring longer periods of absence than other claim types. As shown in Figures 1 and 2, the median time off work and the median payment for mental stress related claims is significantly greater than for all other claim types. Figure 1. Median time off work (in weeks) for mental stress claims compared with all other claim types. 2 Australian Psychological Society. (2014). Stress and Wellbeing in Australia Survey 2014. 3 Safe Work Australia. (2010). Compendium of Workers Compensation Statistics Australia 2007-08. 4 Medibank Private. (2008). The Cost of Workplace Stress in Australia. 2

Figure 2. Median payments (in $AUD) for mental stress claims compared with all other claim types. This raises a very important question: How does work stress affect individuals, both psychologically and physiologically, and which types of coping strategies are most effective to help people recover from daily work stressors? 1.1 Aim of the Research Through this research, we aimed to investigate how people cope with daily hassles and uplifts during the working day, and how they recover when they get home. Beyond this, we wanted to see how coping strategies and recovery activities relate to physiology in particular, heart rate variability. Heart rate variability, or HRV, is the variation in time intervals between heartbeats. Previous research has demonstrated that it is an objective measure of emotional arousal and emotion regulation, and can be useful as a physiological indicator of lack of recovery, stress, and burnout (as indicated by lower scores on HRV-HF and higher scores on HRV-LF see Table 3). 1.2 Sample In mid-2013, participants were recruited via a press release about coping with work stress. Participants were invited to take part in the study if they: 1. Were at least 18 years of age; 2. Were employed full-time and working fairly standard work hours (i.e., roughly 9am- 5pm, 5 days a week); and 3. Were free from health or medication issues that would invalidate the heart rate recording, including: having a previously diagnosed cardiac or psychiatric disorder; current use of psychotropic or heart rate altering medications; or current use of stimulants or recreational drugs. 3

A total of 86 participants met suitability criteria, completed the initial surveys, and were sent a portable heart-rate monitor to wear for the duration of one work week. Of these, 72 participants provided enough usable data to be included in the study s final analyses. Participants were from a broad range of occupations and industries. Sixty-one percent of the sample was female, and their average age was 43.66 years (SD = 11.03). The average age for males was 42.49 years (SD = 10.23). As displayed in Figure 3, ages ranged from 25 to 77 years, with 46 being the most frequently reported age. Average job role tenure for participants was 5 years, and average organisation tenure was 9.5 years. As shown in Figure 4, education ranged from Year 10 level through to PhD, with the majority of participants reporting a Degree level education (36%). Figure 3. Age distribution of participants grouped in 10 year brackets. Figure 4. Participants completed level of education. 1.3 Study Method Participants completed initial questionnaires to assess their suitability for the study. Those that met inclusion criteria were sent a portable heart-rate monitor to wear full-time in a nominated working week. During the week they wore the heart-rate monitor, participants completed several diaries each day that recorded work hassles and uplifts, coping strategies, evening recovery activities, and sleep quality. 4

Part II Study Findings 5

2 Results: At Work 2.1 Work Events Participants completed two surveys at work- one just before lunch (AM), and one before going home (PM). At each time point, they were asked to rate how often they had experienced a number of work events (see Table 1). Responses were measured on a 7-point scale ranging from 1 (none of the time) to 7 (all of the time). Table 1. Work Event Descriptions Category Work Event Description Daily uplifts Daily hassles Goal attainment Positive interactions Goal frustrations Negative interactions Technical problems Health issues Private life intrusions Solve work-related problems, complete a work task, or succeed in a certain task Experience praise, appreciation, or positive feedback Experience time pressure, excessive demands, or recognise mistakes Experience difficulties, conflicts, or communication problems Technical problems, problems with PC or work tools Health issues (e.g., headache, stomach ache, back ache, or discomfort) Experience negative news or happenings in private environment As shown in Figure 5, there was little variation between AM and PM work events. Goal attainment was the most frequently experienced event across both time points, followed by goal frustrations, and then positive interactions. Participants reported experiencing private life intrusions the least. Figure 5. How often participants experienced events at work in the morning and afternoon. 6

Averaging across AM and PM time points, we looked at how often each of the work events were experienced over the five working days. As shown in Figure 6, work events were fairly steady across the week, but participants did report experiencing goal attainment more often on a Monday relative to the rest of the week, and negative interactions less often on a Friday relative to the rest of the week. The frequency of experiencing health issues also seemed to decline as the week progressed. Figure 6. How often participants experienced events at work across the five-day working week. 7

2.2 Coping Strategies Used In each of the two at work surveys (AM and PM), participants were asked to rate the extent to which they had engaged in a number of coping strategies (see Table 2). Responses were measured on a 5-point scale ranging from 0 (not at all) to 4 (almost all the time). Table 2. Coping Strategy Descriptions Coping Strategy Description Example Item Planning Targets cause of problem in logical way I made a plan and followed it Attempts to see the good (i.e., silver lining) in I looked for something good in what Positive reappraisal what is happening happened Emotion suppression Keeps feelings about problems/ stressors hidden I kept my emotions to myself Attention redeployment Support seeking Focuses on something other than the stressor Actively seeks help and advice for solving problems I daydreamed about things other than the problems I was facing I tried to get advice from someone about what to do Again, there was little variation between coping strategies used in the morning versus the afternoon. As shown in Figure 7, planning and emotion suppression were the most frequently used strategies, while support seeking was the coping strategy used least. Figure 7. Average frequency of coping strategies used in the morning and afternoon. 8

Averaging across AM and PM time points, we looked at how often each of the coping strategies were used over the five working days. As shown in Figure 8, planning was used a slightly more often on a Monday relative to the rest of the week, while it seemed positive reappraisal was used less as the week progressed. In general however, coping strategies were quite steady across the five-day week. Figure 8. Average frequency of coping strategies used across the five-day working week. 9

2.3 HRV Scores Participants HRV was measured continuously throughout the week, so we were able to select and compare specific time periods. We were particularly interested in HRV at work in the morning (AM) and afternoon (PM) across the five days of the working week. As outlined in Table 3, we focused on two main components of HRV low frequency HRV (HRV-LF) and high frequency HRV (HRV- HF). In general, lower HRV-LF and higher HRV-HF is observed during times of relaxation, while higher HRV-LF and lower HRV-HF is observed during emotional strain and pressure. By calculating a ratio score, we were able to evaluate scores using the rule of thumb that.30 indicates a healthy level,.70 indicates a stressed or near-burnout level, and 1.00 indicates a chronically stressed or burnout level. However, it should be noted that the average ratio score in our employee samples typically ranges between.55 and.65. Table 3. Heart Rate Variability Descriptions. Construct Low HRV-LF, High HRV-HF High HRV-LF, Low HRV-HF Log LF/HF Ratio Indicates Observed during times of relaxation or during recovery from (or adaptive coping with) stress Observed during times of pressure, emotional strain, anxiety, and worry The ratio of low frequency HRV to high frequency HRV. As a rule of thumb,.30 indicates a healthy level,.70 indicates a near-burnout level, and 1.00 indicates a burnout level. As shown in Figure 9, there was little variation in either LF scores or HF scores across the morning and afternoon time points. Low frequency HRV was consistently higher than high frequency HRV throughout the week, and the ratios averaged around.60, which indicates that these scores were most likely recorded during times of pressure or stress. Figure 9. Participants log LF/HF ratio scores in the morning and afternoon across the five-day working week. Scores closer to 1.00 indicate greater emotional strain (because LF is higher relative to HF scores). 10

2.4 Daily Hassles/ Uplifts Related to Coping & HRV To determine the effectiveness of certain coping strategies, we looked at the relationships between daily hassles and uplifts, coping strategies used, and the implications of this for HRV scores over the 5-day week. In summary, we found that: Engaging in more planning coping and positive reappraisal was associated with experiencing more daily uplifts at work (i.e., more goal attainment and also more positive interactions). Not only this, but more goal attainment and positive interaction was associated with higher HRV-HF scores, which means that these daily uplifts made people feel more relaxed, physiologically. When people encountered daily hassles (i.e., negative interactions, technical difficulties, and private life intrusions) at work, if they responded by trying to reorient their attention to something else more positive (i.e., using attention redeployment as a coping strategy), this was associated with higher HRV-HF scores, which means that an adaptive coping response (i.e., attention redeployment) helped them physiologically relax, despite the hassles they were faced with. Proactive Coping Planning Reappraisal Daily Uplifts Goal attainment Positive interactions HRV-HF More relaxed Better emotion regulation Daily Hassles Negative interactions Technical difficulties Private life intrusions Adaptive Coping Attention Redeployment HRV-HF More relaxed Better emotion regulation Figure 10. Summary of main relationships found among work events, coping, and HRV. Finally, it was also revealed that the more people used emotion suppression as a coping strategy, the more arousing and draining this was for them physiologically, as this coping strategy was found to increase HRV-LF scores. 11

3 Results: At Home 3.1 Recovery at Home Each night participants completed one survey at home before bed, where they were asked to estimate the amount of time they spent on various recovery activities that evening. Details about activity types are outlined in Table 4. Table 4. Recovery Activity Descriptions. Activity Type Work Volunteer Household Low Effort Social Physical Creative Other Includes Finishing or preparing for work-duties, doing one s private administration, answering or writing emails Meeting/ teleconference, emailing, finishing or preparing work for volunteer role, or actually doing volunteer-related work Cooking, doing the dishes, shopping, doing laundry, cleaning etc. Watching TV, taking a bath, reading a magazine or fiction book, listening to music Meeting with others, making a phone call in order to chat Sports, cycling, running, going to the gym, dancing Painting, playing music, doing some kind of craft Activities not covered by the other categories As Figure 11 shows, participants spent the most time on low-effort activities most evenings of the week, followed by household activities and social activities. The least amount of time was spent on volunteer activities and creative activities. Figure 11. Average time (in minutes) spent on recovery activities across the five-day working week. 12

3.2 Sleep Quality Participants HRV data during sleep was extracted from the recordings and compared across the working week. As indicated in Figure 12, sleep quality based on physiological measures was best on Monday and poorest on Friday. Although there was little variation in average sleep quality scores from Tuesday through Thursday, the trend seems to indicate that sleep quality worsens as the working week progresses. It is possible, however, that as people are more likely to go out on Friday evenings, poor sleep quality could be associated with alcohol consumption and/or fewer hours of sleep. Each morning, participants were also asked to rate their sleep quality upon waking using a 5-point scale ranging from 1 (very poor) to 5 (excellent). As indicated in Figure 13, there was little variation in the average scores reported by participants across the working week. Figure 12. Participants sleep quality during the working week as calculated by the LF/HF ratio. Scores closer to 1.00 indicate worse sleep quality. Figure 13. Participants self-reported sleep quality during the working week. Scores closer to 1.00 indicate worse sleep quality. 13

3.3 Sleep Quality Related to Recovery Activities To compare participants sleep quality with the type of recovery activities they engaged in, we first looked at the general relationships between the average time spent on each recovery activity and sleep quality (both physiological and self-reported) over the 5-day week. We found a significant positive relationship between physical activity and HRV, such that participants generally experienced greater relaxation after being active. Participants HRV-HF scores increased in relation to the amount of time spent engaging in physical activity. Increased HRV-HF is generally associated with more relaxation and thought to reflect better sleep quality. When looking at the relationship between recovery activity and self-reported sleep quality, we found a significant negative relationship between low effort recovery activities and self-reported sleep quality, such that increased time spent engaging in low effort activities was related to lower self-reported sleep quality upon waking the next morning. We then sorted the participants into groups by their primary recovery activity (as indicated by which activity had the highest average minutes across the five-day working week). Unfortunately, there were no significant differences in physiological sleep quality between the groups. We also compared self-reported sleep quality with recovery activities, but were unable to find significant differences here either. It is possible, however, that the sample size was too small to reliably measure these differences, and that having more people in the study would reveal a relationship. 14

Part III Conclusions & Resources 15

4 Conclusions In conclusion, this report has shed some light on how people cope with daily hassles and uplifts during the working day, and how they recover at home. At work, the type of events people experience most frequently include goal attainment (i.e., solving work-related problems, succeeding in tasks), followed by goal frustrations (i.e, experiencing work pressure and excessive demands). Looking at trends across the days of the week, work events were fairly stable, but participants reported experiencing more goal attainment on Monday, and fewer negative interactions on Friday, as compared to the rest of the week. When coping with stressors, we found that in general, people prefer to target the problems in a logical way by planning (for example, making lists), or focused more on containing their emotions by attempting to suppress them. Looking across the week, coping strategies were once again fairly stable, but participants used planning more often on Monday than the rest of the week. Also, there was a trend for positive reappraisal to decline as the week progressed. The average heart rate variability scores across the working week indicated that pressure or stress was commonly experienced most days, and more common in the middle of the working week. While at work, engaging in planning and positive reappraisal coping strategies was related to experiencing more daily uplifts, which was related to greater physiological relaxation. When experiencing daily hassles at work, using more adaptive coping strategies, such as attention redeployment, was also related to greater physiological relaxation. At home, people spent most of their time engaging in low effort activities, like reading, or watching television, followed by household activities. However, it is physical activity in the evenings that is positively associated with physiological sleep quality, and we also found that lower self-reported sleep quality is related to engaging in low-effort activity during the evenings after work. This indicates that passive evening activities, like watching TV, do not help with recovery, as this does not translate into improved sleep quality. Given these findings, in the next section we provide some tips and resources on how to manage daily stress. 16

5 Resources 5.1 Tips for Reducing Stress There are many ways of reducing stress that can be integrated into your daily routine. Here are six simple tips for reducing stress in the workplace and at home! Tip #1: Recover Daily. The benefits of simple daily work recovery can be greater than a holiday! Daily recovery includes taking regular breaks during working hours, psychologically detaching from work when you get home, and engaging in challenging and fun after work activities. o Article on recovery activities: http://theconversation.com/overworked-good-habits-not-holidays-are-the-answer- 17744 o Mobile app to help you take breaks during the day: http://www.raisedsquare.com/standup Tip #2: Reappraise/ Reframe Negative Thoughts. Changing the way you see or interpret a situation can decrease the stress or emotion you feel. You can reappraise negative thoughts by looking for the silver lining in a situation, trying to view stressful situations as positive challenges rather than threats, and acknowledging what you can learn from a negative experience. o Activity for practicing positive reframing: http://zonepositive.com/wp-content/uploads/exercise_reframing-the-situation.pdf o TED talk on positive reappraisal: http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend Tip #3: Enhance Your Experience of Positive Emotions. Experiencing positive emotions can have short and long term benefits for physical and psychological health. In addition, research has found that positive emotions can have a protective impact, and can relate to emotional resilience (Richman et al, 2005). One way to increase positive emotions is by taking part in activities that increase experiences of active positive emotions for example, watching an inspiriting video, or writing positive messages in a journal. 17

o Positive Psychology tools and resources: http://www.authentichappiness.sas.upenn.edu/ o Mobile app to help you track positive experiences: http://www.mindbloom.com Tip #4: Keep Physically Active. Regular exercise can improve cardiovascular health and be a simple way to reduce daily stress. Research has shown that individuals who exercise regularly have a lower resting heart rate and have higher HRV than sedentary individuals. Exercise does not have to be difficult; it can include everyday activities like mowing the lawn, or walking to the bus station. o This is a YouTube link on how important it is to do 30 minutes of exercise each day: http://www.youtube.com/watch?v=auains6higo&feature=youtu.be Tip #5: Practice Breathing and Meditation Techniques. Breathing and meditation techniques can reduce stress and be beneficial for cardiovascular health. Breathing also plays an important role in regulating heart rate variability. Practice taking long, deep breaths to get as much oxygen-rich air into your lungs as possible. o This is a YouTube link on how to do One Moment meditation. It only takes 1 minute http://youtu.be/f6effci12v8 Tip #6: Get Good Quality Sleep. Good quality sleep not only helps you to feel relaxed and refreshed, it can also enhance your physical and psychological well-being. To improve sleep quality, try to keep good sleep habits, including creating a restful sleep environment (e.g., no distractions such as tablets or phones), and maintaining a regular sleep schedule. o Mobile app to help you track sleep quality: http://www.sleepcycle.com 18

5.2 Further Reading Article about consequences of not getting enough sleep: Banks, S., & Dinges, D.F. (2007). Behavioural and physiological consequences of sleep restriction. Journal of Clinical Sleep Medicine, 3, 519-528. Article about the benefits of positive emotion: Richman, L. S., Kubzansky, L., Maselko, J., Kawachi, I., Choo, P. & Bauer, M. (2005). Positive emotion and health: Going beyond the negative. Health Psychology, 24, 422 429. Article about the importance of taking micro-breaks : Zacher, H., Brailsford, H.A., & Parker, S. L. (2014). Micro-breaks matter: a diary study on the effects of energy management strategies on occupational well-being. Journal of Vocational Behavior, 85 (3), 287-297. Article available via http://www.staceyparker.com.au Link to Wikipedia article explaining Heart Rate Variability (HRV): http://en.wikipedia.org/wiki/heart_rate_variability Copyright (2015) is owned by The University of Queensland (ABN 63 942 912 684, CRICOS Provider No: 00025B). This publication may be reproduced and communicated for noncommercial purposes to the public for the purposes of fair dealing as provided by the Copyright Act 1968, as long as the work is attributed to the author and their affiliation. The author maintains their moral rights in this work. Requests and inquiries should be directed to the author of this publication. 19