Benefits of Reducing Stress: What Lower Stress Levels Do for Your Health

What is stress, and when does it become chronic?

The National Institute of Mental Health (NIMH) defines stress as the physical or mental response to an external cause, such as a heavy workload or an illness. A stressor can be a one-time or short-term event, or it can happen repeatedly over a long time.⁠⁴ The CDC describes stress as a normal part of life that can build a healthy sense of being able to solve problems; when it is long term, known as chronic stress, it can lead to worsening health problems.⁠¹⁶

The stress response starts in the brain. When a situation seems challenging, threatening or uncontrollable, the hypothalamus signals the pituitary gland, which signals the adrenal glands to release more cortisol, often called the stress hormone, alongside adrenaline. Heart rate and breathing speed up, blood sugar rises and blood flows to the large muscles: the fight or flight response. Once an acute stress passes, the body returns to its normal state.⁠¹ Chronic stress keeps that system switched on, and the American Psychological Association (APA) describes the continuous activation, more than any single episode, as what wears on the body’s other systems.⁠¹

Is some stress good for you? Positive effects of short-term stress

Some stress is useful. NIMH notes that stress can be positive, for example by spurring you to meet a deadline, as well as negative.⁠⁴ Stress lasting minutes to hours enhances some immune responses, and an immunology review describes short-term stress as a survival mechanism, while long-term stress suppresses or dysregulates immunity.⁠⁸ A meta-analysis of more than 300 studies found the same split: stressors lasting minutes were linked to an upregulation of parts of natural immunity, chronic stressors to suppression of both cellular and humoral immunity.⁠¹⁰ APA puts it simply: the body is well equipped to handle short bursts of stress, and the serious effects come when stress becomes long-term or chronic.⁠¹

How is stress different from anxiety?

NIMH draws the line this way: stress is generally a response to an external cause and goes away once the situation is resolved, while anxiety is internal, a persistent apprehension or dread that continues even without an immediate threat and interferes with daily life. Both can cause worry, tension, headaches or body pain, high blood pressure and lost sleep.⁠⁴ When stress feels unmanageable and its symptoms interfere with everyday life, make you avoid things or seem always present, NIMH says you may be at risk for an anxiety disorder.⁠⁴ In children, anxiety looks different again: anxiety in children.

What are the physical health benefits of reducing stress?

APA describes stress as affecting every system of the body: the muscles, breathing, heart and blood vessels, hormones, digestion, nerves and reproduction.⁠¹ NIMH lists effects on sleep and on the immune, digestive, cardiovascular and reproductive systems when the anxiety that stress brings does not go away.⁠⁴ The evidence that lowering stress helps is strongest for mood and distress, and weaker for physical outcomes such as blood pressure and heart attacks.⁠^2,3,15,17

Does lowering stress reduce the risk of heart disease?

Stress is a real but moderate risk factor. A meta-analysis of six cohort studies with 118,696 people found that high perceived stress was linked to a 27% higher risk of developing coronary heart disease (risk ratio 1.27).⁠⁹ A major review concludes that, compared with childhood adversity and classic risk factors such as smoking, high blood pressure and high cholesterol, the harm from stress in adulthood is generally less marked, but that stress acts as a trigger in people who already have heavy plaque in their arteries and worsens outcomes in people with existing heart or blood vessel disease.⁠¹⁹

Whether lowering stress prevents heart disease has been tested mainly in people who already have it. In a Swedish trial of 362 people discharged after a coronary event, a year of group cognitive behavioral therapy focused on stress management led to 41% fewer recurrent cardiovascular events and 45% fewer repeat heart attacks over an average of almost eight years; deaths were 28% lower, a difference that was not statistically significant.⁠²⁰ Across 35 trials with 10,703 people, a Cochrane review found that psychological treatments did not lower total deaths or non-fatal heart attacks but did cut cardiac deaths by 21%, on low-quality evidence.⁠¹⁷ The cardiovascular review notes that few scalable, evidence-based stress interventions are available yet.⁠¹⁹

Can reducing stress lower blood pressure?

Stress raises blood pressure in the moment: the stress hormones adrenaline, noradrenaline and cortisol make the heart beat faster and harder and send more blood to the large muscles, and the pressure falls once the stress passes. Long-term stress, with its ongoing rise in heart rate, stress hormones and blood pressure, increases the risk of hypertension.⁠¹ Lowering it through relaxation has a smaller effect than often claimed. A Cochrane review of 25 trials in people with raised blood pressure found relaxation therapies lowered systolic pressure by 5.5 mm Hg and diastolic by 3.5 mm Hg, but the trials were of poor quality, the effect was not significant in blinded trials or against sham therapy, and the authors judged the evidence for a causal effect weak.⁠¹⁵ A 2019 review of slow breathing exercises found a modest reduction, with short follow-up and a high risk of bias.⁠²¹ Anyone with high blood pressure should keep to the treatment plan from their health care provider.⁠²¹

How does chronic stress affect the immune system?

Duration is what matters. Segerstrom and Miller’s meta-analysis of more than 300 studies found that brief stressors such as exams tended to suppress cellular immunity, and that chronic stressors were associated with suppression of both cellular and humoral measures; older or ill people were more vulnerable.⁠¹⁰ People’s own reports of how stressed they felt generally did not track the immune changes.⁠¹⁰ In a landmark experiment, 394 healthy volunteers were given nasal drops containing a cold virus: the rate of clinical colds rose with psychological stress, from about 27% to about 47%, and smoking, alcohol, exercise, diet and sleep did not explain the difference.⁠⁵ APA adds that chronic stress can disrupt communication between the immune system and the stress hormone system, which has been linked to chronic fatigue, metabolic disorders, depression and immune disorders.⁠¹

How does stress affect digestion?

The gut has hundreds of millions of neurons in constant communication with the brain. Stress can make pain, bloating, nausea and discomfort felt more easily, change appetite, speed up or slow down how food moves through the bowel, and weaken the intestinal barrier, and it especially affects people with irritable bowel syndrome or inflammatory bowel disease.⁠¹ Contrary to popular belief, stress does not increase stomach acid or cause ulcers, which are caused by a bacterial infection, though ulcers can be more bothersome under stress.⁠¹

Does stress make pain worse?

It can. Muscles tense under stress, and chronic stress keeps them in a near-constant state of guardedness; tension-type headache and migraine are associated with chronic muscle tension in the shoulders, neck and head, and low back and arm pain has been linked to stress, especially job stress.⁠¹ APA reports that relaxation and other stress-relieving approaches reduce muscle tension and the incidence of some stress-related disorders such as headache, and NCCIH notes that relaxation techniques might help headache, low back pain and pain after surgery, though some of that evidence is low quality.⁠^1,21 Mindfulness programs improved pain by a small to moderate amount (effect size 0.33).⁠² For long-lasting pain in adults: persistent and chronic pain.

Can lowering stress help with diabetes and weight?

Stress is linked to both, but the evidence that lowering it prevents them is limited. A review by Hackett and Steptoe describes psychological stress as a predictor of new type 2 diabetes and as a prognostic factor in people who already have it.⁠¹⁸ APA notes that under stress people may eat much more or much less than usual, and that long-term stress-related changes in the immune and hormone systems have been linked to metabolic disorders including diabetes and obesity.⁠¹ On the treatment side, NCCIH reports evidence that deep breathing lowers blood sugar in people with type 2 diabetes, while the large meditation review found insufficient evidence of any effect on eating habits or weight.⁠^2,22

What are the mental health benefits of lower stress?

Stress that does not go away raises the risk of an anxiety disorder or depression.⁠⁴ The CDC lists feelings of fear, anger, sadness, worry, numbness or frustration, changes in appetite and energy, trouble concentrating and making decisions, nightmares and sleep problems, and greater use of alcohol and drugs as effects of stress.⁠¹⁶

How much do stress programs ease anxiety and depression?

By a small to moderate amount. The largest review of meditation programs, 47 trials with 3,515 participants and active control groups, found moderate evidence that mindfulness programs improved anxiety (effect size 0.38 at 8 weeks, 0.22 at 3 to 6 months) and depression (0.30 at 8 weeks, 0.23 at 3 to 6 months), and low evidence for stress and distress. It found no evidence that meditation was better than drugs, exercise or other behavioral therapies.⁠² In healthy adults, a meta-analysis of 29 studies of mindfulness-based stress reduction found a moderate effect overall (Hedges’ g 0.53 against control groups), a large effect on stress and moderate effects on anxiety, depression and distress, maintained at an average of 19 weeks.⁠²³

How are stress and sleep connected?

Stress disrupts sleep, but not equally in everyone. Kalmbach and colleagues call this sleep reactivity: people with highly reactive sleep sleep much worse under stress, and genetics, a family history of insomnia, female sex and environmental stress all shape how reactive sleep is. High sleep reactivity predicts later insomnia and is linked to depression and anxiety, and worry and rumination make it worse.⁠¹¹ Adults need 7 or more hours a night, and going to bed and getting up at the same time each day helps.⁠¹⁶ For long-term insomnia, the American College of Physicians strongly recommends cognitive behavioral therapy for insomnia as the first treatment, while relaxation techniques on their own do not seem especially promising for sleep.⁠²¹ A 2019 review found moderately strong evidence that mindfulness meditation improved sleep quality in people with sleep disturbances.⁠²² Sleep problems in children: sleep disorders.

Does lower stress help with everyday coping?

Learning what triggers your stress and which coping techniques work for you can reduce anxiety and improve daily life, though finding what works may take trial and error.⁠⁴ The CDC frames daily stress management as prevention: managing stress every day can stop it from becoming long-term.⁠¹⁶

Does lower stress improve focus and decision-making?

Stress works against the part of the brain that plans and decides. The prefrontal cortex, which handles our highest-order thinking, is the brain region most sensitive to stress: even quite mild acute stress that feels uncontrollable can cause a rapid, dramatic loss of prefrontal abilities, and longer stress changes the structure of prefrontal nerve cells.⁠²⁴ The CDC lists trouble concentrating and making decisions among the effects of stress.⁠¹⁶ That is the basis for the idea that lower stress means clearer thinking; when the meditation review looked at attention as an outcome, it found low or insufficient evidence of an effect.⁠²

What are the social benefits of reducing stress?

Anger and frustration are among the effects of stress the CDC lists, so fewer angry outbursts is the social benefit that follows most directly from lower stress; better nutrition, more sleep and lower blood pressure are physical ones.⁠^1,16 In parents of children with developmental disabilities, mindfulness programs improved parent-child relationships as well as stress.⁠²⁵

Relationships work in the other direction too: they buffer stress and protect health. APA names a healthy social support network, regular exercise and enough sleep as building blocks of stress management.⁠¹ A meta-analysis of 148 studies with 308,849 people found a 50% higher likelihood of survival for people with stronger social relationships (odds ratio 1.50), an influence comparable with well-established risk factors for death.⁠⁷ NIMH and the CDC both advise talking with friends, family or other people you trust about how you are feeling.⁠^4,16

How does stress affect parents of children with developmental needs?

Raising a child with autism or sensory processing differences adds a measurable load. A meta-analysis of studies with comparison groups found a large difference in parenting stress between parents of autistic children and parents of typically developing children, and a large difference against parents of children with other disabilities too, though that second comparison may mostly reflect Down syndrome.⁠¹³ In 82 midlife mothers of autistic adolescents and adults, those who had faced more negative life events showed a flatter morning cortisol response to daily stressors, which the authors read as the sustained toll of stress.⁠²⁶

Sensory differences are part of the picture. In 59 children aged 2 to 5 at an urban outpatient clinic, 55.9% had sensory processing difficulties, and their parents had significantly higher parenting stress than parents of children without them; stress was clinically elevated where sensory and behavioral difficulties occurred together.⁠²⁷ In 174 families of toddlers with autism, sensory over-responsivity at about 28 months predicted higher family impairment and parenting stress over the next two years, independent of autism severity and the mother’s own anxiety and depression, and explained 39 to 45% of the variance in family stress.⁠¹⁴ What over-responsivity looks like: sensory over-responsivity, and more in our sensory guides.

What helps reduce stress in parents and caregivers?

Several approaches have trial evidence. A meta-analysis of 14 trials with 1,078 parents of children with intellectual or developmental disabilities found that mindfulness-based programs reduced parents’ stress (standardized mean difference 0.26), depression (0.37), anxiety (0.35) and distress, and improved parent-child relationships, with programs of 8 weeks or more showing some benefit for relationships or stress.⁠²⁵ A meta-analysis of 14 randomized trials of cognitive behavioral therapy for parents of children with special needs found a moderate reduction in parental stress (0.57), with larger effects for parents of children with neurodevelopmental disorders.⁠¹² A network meta-analysis of 69 studies with 4,213 parents of autistic children ranked mindfulness-based programs highest for parenting stress and found cognitive behavioral therapy effective for anxiety and depression, with psychoeducation also helping.⁠²⁸

The gains may fade without support: an earlier meta-analysis found psychological interventions reduced parental stress right after treatment but not 3 to 6 months later.⁠²⁹ The authors of the sensory study suggest that identifying and addressing a child’s sensory problems could also lower parental stress.⁠²⁷ What CBT involves: CBT for anxiety.

Which ways of reducing stress have the best evidence?

These approaches have been tested in trials or large studies, and the size of the benefit differs between them.⁠^2,3,6,7,23

Does exercise reduce stress?

Yes. An umbrella review of 97 reviews covering 1,039 trials and 128,119 adults found that physical activity had medium effects on depression, anxiety and psychological distress compared with usual care, with the largest benefits in people with depression, HIV or kidney disease, in pregnant and postpartum women and in healthy people; higher-intensity activity brought bigger improvements.⁠³ Most of the reviews it pooled were rated critically low in quality.⁠³ The CDC suggests starting small and building up to 2½ hours a week, for example 20 to 30 minutes a day.⁠¹⁶

Do mindfulness and meditation reduce stress?

Modestly. The meditation review concluded that programs can produce small to moderate reductions in several negative dimensions of psychological stress, and that clinicians should be ready to discuss them with patients.⁠² NCCIH summarizes evidence that mindfulness meditation may help reduce stress symptoms including anxiety and depression and may improve sleep, that focused-attention meditation lowered blood pressure and cortisol in a 2017 review, and that 12 of 17 older yoga studies showed improvements in stress measures.⁠²² Heart rate variability biofeedback reduced self-reported stress and anxiety in a review of 24 studies.⁠²²

Does cognitive behavioral therapy help with stress?

Yes. In a meta-analysis of 36 workplace studies with 2,847 people, stress management programs had a medium to large overall effect (Cohen’s d 0.53), and cognitive-behavioral programs consistently produced larger effects than other types, although adding extra components reduced the effect.⁠⁶ In people with heart disease, psychological treatments reduced self-reported stress (standardized mean difference 0.56), on very low-quality evidence.⁠¹⁷ Identifying and challenging negative, unhelpful thoughts is one of the coping steps NIMH recommends.⁠⁴

What everyday habits help with stress?

The CDC and NIMH recommend similar daily steps:⁠^4,16

• Move. Start small and build up to 2½ hours of activity a week.⁠¹⁶
• Protect sleep. Keep a sleep routine and aim for 7 or more hours a night.⁠^4,16
• Make time to unwind. Deep breaths, stretching, meditation, a journal or time outdoors.⁠^4,16
• Take breaks from news and social media. Constant information about negative events can be upsetting.⁠¹⁶
• Connect. Talk with people you trust, or with a community or faith-based group.⁠¹⁶
• Eat regular, healthy meals. Limit caffeine and alcohol, and avoid smoking and drugs.⁠^4,16
• Practice gratitude. Write down specific things you are grateful for.⁠¹⁶
• Challenge unhelpful thoughts. Identify and question negative thinking.⁠⁴

Which stress-relief claims have weak evidence?

• Relaxation as a blood pressure treatment. Cochrane judged the evidence for a causal effect weak, and some of the apparent benefit was probably unrelated to relaxation itself.⁠¹⁵
• Meditation as better than other treatments. There is no evidence that meditation programs beat drugs, exercise or other behavioral therapies, and insufficient evidence of effects on attention, eating, sleep or weight.⁠²
• Relaxation alone for insomnia. It does not seem especially promising; cognitive behavioral therapy for insomnia is the recommended first treatment.⁠²¹
• Stress programs as a way to live longer with heart disease. Psychological treatments did not reduce total deaths in the Cochrane review.⁠¹⁷
• Lasting change from a short course. For parents, psychological programs reduced stress right after treatment but not 3 to 6 months later.⁠²⁹
• Feeling less stressed as proof the body has changed. In the immune meta-analysis, people’s own reports of stress generally did not track immune changes.⁠¹⁰

Relaxation techniques are generally safe for healthy people, but occasionally people report increased anxiety, intrusive thoughts or fear of losing control.⁠²¹

When does stress need professional help?

NIMH advises talking to a professional if you are struggling to cope or the symptoms of stress or anxiety do not go away; psychotherapy and medication are the two main treatments for anxiety, and many people benefit from both.⁠⁴ Signs that stress may be turning into an anxiety disorder include symptoms that interfere with everyday life, make you avoid things or seem always present.⁠⁴ APA suggests a licensed psychologist for extreme or chronic stress, and NCCIH advises seeing a health care provider for severe or long-lasting symptoms of any kind.⁠^1,21

Sources

1. American Psychological Association. Stress effects on the body. Last reviewed October 21, 2024. Checked October 11, 2026.
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   “Our bodies are well equipped to handle stress in small doses, but when that stress becomes long-term or chronic, it can have serious effects on your body.” “This long-term ongoing stress can increase the risk for hypertension, heart attack, or stroke.” “cortisol, often referred to as the ‘stress hormone’”; chronic stress “can result in impaired communication between the immune system and the HPA axis. This impaired communication has been linked to the future development of numerous physical and mental health conditions, including chronic fatigue, metabolic disorders (e.g., diabetes, obesity), depression, and immune disorders.” “Contrary to popular belief, stress does not increase acid production in the stomach, nor causes stomach ulcers.” “tension-type headache and migraine headache are associated with chronic muscle tension”; “Relaxation techniques and other stress-relieving activities and therapies have been shown to effectively reduce muscle tension, decrease the incidence of certain stress-related disorders, such as headache”. “Maintaining a healthy social support network; Engaging in regular physical exercise; Getting an adequate amount of sleep each night”; “if you are experiencing extreme or chronic stress, a licensed psychologist can help”.
2. Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine. 2014;174(3):357-368. PMID 24395196. Checked October 11, 2026.
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   “we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress”; “low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies).” “meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress”.
3. Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, Szeto K, O’Connor E, Ferguson T, Eglitis E, Miatke A, Simpson CE, Maher C. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine. 2023;57(18):1203-1209. PMID 36796860. Checked October 11, 2026.
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   “Ninety-seven reviews (1039 trials and 128 119 participants) were included.” “Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=-0.43, IQR=-0.66 to -0.27), anxiety (median effect size=-0.42, IQR=-0.66 to -0.26) and psychological distress (effect size=-0.60, 95% CI -0.78 to -0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms.”
4. National Institute of Mental Health. I’m So Stressed Out! Fact Sheet. NIH Publication No. 20-MH-8125. Checked October 11, 2026.
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   “Stress is the physical or mental response to an external cause, such as having a lot of homework or having an illness. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time.” Stress “Can be positive or negative. For example, it may inspire you to meet a deadline, or it may cause you to lose sleep.” “You could experience problems with sleeping, or with your immune, digestive, cardiovascular, and reproductive systems. You also may be at higher risk for developing a mental illness such as an anxiety disorder or depression.” “If you are struggling to cope, or the symptoms of your stress or anxiety won’t go away, it may be time to talk to a professional. Psychotherapy (also called talk therapy) and medication are the two main treatments for anxiety, and many people benefit from a combination of the two.” “Identify and challenge your negative and unhelpful thoughts.” “If you are in immediate distress or are thinking about hurting yourself, call or text” 988.
5. Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. New England Journal of Medicine. 1991;325(9):606-612. PMID 1713648. Checked October 11, 2026.
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   “394 healthy subjects were given nasal drops containing one of five respiratory viruses”; “the incidence of clinical colds ranged from approximately 27 percent to 47 percent” according to levels of stress; “Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association”.
6. Richardson KM, Rothstein HR. Effects of occupational stress management intervention programs: a meta-analysis. Journal of Occupational Health Psychology. 2008;13(1):69-93. PMID 18211170. Checked October 11, 2026.
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   “Thirty-six experimental studies were included, representing 55 interventions. Total sample size was 2,847.” “average length of intervention was 7.4 weeks. The overall weighted effect size (Cohen’s d) for all studies was 0.526”; “Cognitive-behavioral programs consistently produced larger effects than other types of interventions, but if additional treatment components were added the effect was reduced.” “Effects were based mainly on psychological outcome variables”.
7. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Medicine. 2010;7(7):e1000316. PMID 20668659. Checked October 11, 2026.
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   “Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships.” “The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality.”
8. Dhabhar FS. Effects of stress on immune function: the good, the bad, and the beautiful. Immunologic Research. 2014;58(2-3):193-210. PMID 24798553. Checked October 11, 2026.
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   “While long-term stress is generally harmful, short-term stress can be protective as it prepares the organism to deal with challenges.” “Short-term (i.e., lasting for minutes to hours) stress experienced during immune activation enhances innate/primary and adaptive/secondary immune responses.” “long-term stress suppresses or dysregulates innate and adaptive immune responses”.
9. Richardson S, Shaffer JA, Falzon L, Krupka D, Davidson KW, Edmondson D. Meta-analysis of perceived stress and its association with incident coronary heart disease. American Journal of Cardiology. 2012;110(12):1711-1716. PMID 22975465. Checked October 11, 2026.
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   “6 met our criteria (n = 118,696)”; “Meta-analysis yielded an aggregate risk ratio of 1.27 (95% confidence interval 1.12 to 1.45) for the magnitude of the relation between high perceived stress and incident CHD.” “high perceived stress is associated with a moderately increased risk of incident CHD.”
10. Segerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological Bulletin. 2004;130(4):601-630. PMID 15250815. Checked October 11, 2026.
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    “The present report meta-analyzes more than 300 empirical articles”; “Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity”; “Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures.” “Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.”
11. Kalmbach DA, Anderson JR, Drake CL. The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. Journal of Sleep Research. 2018;27(6):e12710. PMID 29797753. Checked October 11, 2026.
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    “Sleep reactivity is the trait-like degree to which stress exposure disrupts sleep, resulting in difficulty falling and staying asleep.” “genetics, familial history of insomnia, female gender and environmental stress influence how the sleep system responds to stress”; “high sleep reactivity predicts risk for future insomnia disorder”; “High sleep reactivity is also linked to risk of shift-work disorder, depression and anxiety. Importantly, stress-related worry and rumination may exploit sensitive sleep systems”; “dysregulation in the autonomic nervous system and hypothalamic-pituitary-adrenal axis”.
12. Qin Z, Lan J, He H, Yin J, Wang J. Dose-Response Meta-analysis of Cognitive Behavioral Therapy for Parental Stress in Parents of Children with Special Needs. Clinical Child and Family Psychology Review. 2026;29(1):90-104. PMID 41329409. Checked October 11, 2026.
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    “14 trials (n = 1007) were included in the primary analysis. There was substantial heterogeneity (I2 = 92.3%). Pooled results indicated that CBT significantly reduced parental stress (SMD = - 0.57; 95% CI - 1.00 to - 0.14”); “Interventions with moderate session duration” (about 90 minutes) “delivered once weekly over several weeks” (about 11 to 12 in total) “were associated with larger pooled effects”; larger effects “among parents of children with neurodevelopmental disorders (NDDs)”.
13. Hayes SA, Watson SL. The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders. 2013;43(3):629-642. PMID 22790429. Checked October 11, 2026.
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    “The experience of stress in families of children with ASD versus families of TD children resulted in a large effect size. Comparisons between families of children of ASD and families with other disabilities also generated a large effect size however, this result should be interpreted with caution as it may be associated with the specific experience of parenting a child with DS.”
14. Ben-Sasson A, Soto TW, Martinez-Pedraza F, Carter AS. Early sensory over-responsivity in toddlers with autism spectrum disorders as a predictor of family impairment and parenting stress. Journal of Child Psychology and Psychiatry. 2013;54(8):846-853. PMID 23336424. Checked October 11, 2026.
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    “families raising a child with ASD (n = 174)”; “At time 1 mean chronological age was 28.5 months.” “higher SOR scores on the ITSP at time 1 were associated with higher initial levels of family life impairment and parenting stress”; “These associations were independent of severity of ADOS social-communication symptoms, MSEL composite score, ITSEA externalizing and anxiety symptoms, and maternal affective symptoms”; “SOR at time 1 explained 39-45% of the variance in family stress and impairment variables.”
15. Dickinson HO, Campbell F, Beyer FR, Nicolson DJ, Cook JV, Ford GA, Mason JM. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database of Systematic Reviews. 2008;(1):CD004935. PMID 18254065. Checked October 11, 2026.
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    “The remaining 25 trials assessed 1,198 participants”; “relaxation resulted in small, statistically significant reductions in SBP (mean difference: -5.5 mmHg”) “and DBP (mean difference: -3.5 mmHg”). “The nine trials that reported blinding of outcome assessors found a non-significant net reduction”; “The 15 trials comparing relaxation with sham therapy likewise found a non-significant reduction”. “the evidence in favour of causal association between relaxation and blood pressure reduction is weak. Some of the apparent benefit of relaxation was probably due to aspects of treatment unrelated to relaxation.”
16. Centers for Disease Control and Prevention. Managing Stress. May 12, 2026. Checked October 11, 2026.
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    “Feeling stress can be a normal coping response and can forge a healthy sense of our ability to solve problems. However, when the stress is long term, known as chronic stress, it can lead to worsening health problems.” “Feelings of fear, anger, sadness, worry, numbness, or frustration”; “Trouble concentrating and making decisions”; “Nightmares or problems sleeping”. “Managing stress daily can prevent you from developing long-term stress.” “Adults need 7 or more hours per night.” “Start small and build up to” two and a half “hours a week. Break it into smaller amounts such as 20 to 30 minutes a day.”
17. Richards SH, Anderson L, Jenkinson CE, Whalley B, Rees K, Davies P, Bennett P, Liu Z, West R, Thompson DR, Taylor RS. Psychological interventions for coronary heart disease. Cochrane Database of Systematic Reviews. 2017;4(4):CD002902. PMID 28452408. Checked October 11, 2026.
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    “This review included 35 studies which randomised 10,703 people with CHD”; “Moderate quality evidence showed no risk reduction for total mortality”; “Low quality evidence found no risk reduction for non-fatal MI (RR 0.82, 95% CI 0.64 to 1.05), although there was a 21% reduction in cardiac mortality”; “stress (SMD -0.56, 95% CI -0.88 to -0.24; GRADE = very low)”.
18. Hackett RA, Steptoe A. Type 2 diabetes mellitus and psychological stress: a modifiable risk factor. Nature Reviews Endocrinology. 2017;13(9):547-560. PMID 28664919. “stress has a role in the aetiology of type 2 diabetes mellitus (T2DM) both as a predictor of new onset T2DM and as a prognostic factor in people with existing T2DM.” Checked October 11, 2026.
19. Kivimaki M, Steptoe A. Effects of stress on the development and progression of cardiovascular disease. Nature Reviews Cardiology. 2018;15(4):215-229. PMID 29213140. Checked October 11, 2026.
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    “Compared with childhood stress and adulthood classic risk factors, such as smoking, high blood pressure, and high serum cholesterol levels, the harmful effects of stress in adulthood are generally less marked. However, adulthood stress has an important role as a disease trigger in individuals who already have a high atherosclerotic plaque burden, and as a determinant of prognosis and outcome in those with pre-existing cardiovascular or cerebrovascular disease.” “However, few scalable, evidence-based interventions are currently available.”
20. Gulliksson M, Burell G, Vessby B, Lundin L, Toss H, Svardsudd K. Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Archives of Internal Medicine. 2011;171(2):134-140. PMID 21263103. Checked October 11, 2026.
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    “The study included 362 women and men 75 years or younger who were discharged from the hospital after a coronary heart disease event”; “a CBT program (intervention group, 192 patients), focused on stress management, with 20 two-hour sessions during 1 year”. “During a mean 94 months of follow-up, the intervention group had a 41% lower rate of fatal and nonfatal first recurrent CVD events”, “45% fewer recurrent acute myocardial infarctions”, “and a nonsignificant 28% lower all-cause mortality”.
21. National Center for Complementary and Integrative Health. Relaxation Techniques: What You Need To Know. Last updated June 2021. Checked October 11, 2026.
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    “A 2019 review of 17 studies involving 1,165 participants indicated that slow breathing exercises led to a modest reduction in blood pressure”; “The studies in this review, however, differed in how they were done and had short follow-up periods and high risk of bias.” “The American College of Physicians practice guidelines (2016) strongly recommend the use of cognitive behavioral therapy for insomnia (also called CBT-I) as the initial treatment for chronic insomnia.” “relaxation techniques on their own don’t seem to be especially promising for sleep.” “Relaxation techniques might help with pain after surgery, headache, low-back pain, and arthritis-related pain. Some of the supporting evidence, however, has been rated as low quality.” “occasionally, people report negative experiences such as increased anxiety, intrusive thoughts, or fear of losing control.” “If you have severe or long-lasting symptoms of any kind, see your health care provider.”
22. National Center for Complementary and Integrative Health. Stress. Last updated April 2022. Checked October 11, 2026.
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    “There is evidence that deep breathing reduces glycemia (the concentration of glucose or sugar in the blood) in people with type 2 diabetes”. “mindfulness meditation ... may help reduce symptoms of stress, including anxiety and depression, and may help improve sleep.” “A 2019 review of 18 studies found moderately strong evidence that mindfulness meditation interventions significantly improved sleep quality”; “A 2017 review ... found that this type of meditation reduced blood pressure and cortisol levels.” “Of 17 older studies of yoga for stress management included in a 2014 review, 12 showed improvements”. “One review of 24 studies involving a total of 484 participants found that HRV biofeedback is helpful for reducing self-reported stress and anxiety”.
23. Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of Psychosomatic Research. 2015;78(6):519-528. PMID 25818837. Checked October 11, 2026.
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    “A total of 29 studies (n=2668) were included.” “between group analyses (n=18; Hedge’s g=.53; 95% CI [.41, .64]”); “The obtained results were maintained at an average of 19 weeks of follow-up. Results suggested large effects on stress, moderate effects on anxiety, depression, distress, and quality of life”; “heterogeneity was high”.
24. Arnsten AF. Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience. 2009;10(6):410-422. PMID 19455173. Checked October 11, 2026.
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    “The prefrontal cortex (PFC) - the most evolved brain region - subserves our highest-order cognitive abilities. However, it is also the brain region that is most sensitive to the detrimental effects of stress exposure. Even quite mild acute uncontrollable stress can cause a rapid and dramatic loss of prefrontal cognitive abilities, and more prolonged stress exposure causes architectural changes in prefrontal dendrites.”
25. Yang T, Wang Y, Xu P, Tao Y. The Effectiveness of Mindfulness-Based Interventions in Improving the Mental Health of Parents of Children with Intellectual or Developmental Disabilities: A Systematic Review and Meta-Analysis. Journal of Autism and Developmental Disorders. 2026;56(8):2977-2991. PMID 40080346. Checked October 11, 2026.
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    “This systematic review included 15 studies (1124 participants), of which 14 were used for meta-analysis (1078 participants). The results indicate that mindfulness-based interventions reduced the stress levels [SMD = - 0.26, 95% CI (- 0.49, - 0.04)], depressive symptoms [SMD = - 0.37”], “distress [SMD = - 0.26”] “and anxiety symptoms[SMD = - 0.35”] “while also improving parent-child relationships”; “interventions lasting 8 weeks or more [SMD =- 0.41, 95% CI (-0.67, -0.14)] and those targeting only the parents [SMD = - 0.26, 95% CI (- 0.44, - 0.08)] showed some positive effects in improving parent-child relationships or parent stress.”
26. Wong JD, Seltzer MM, Greenberg JS, Hong J, Almeida DM, Coe CL. Stressful life events and daily stressors affect awakening cortisol level in midlife mothers of individuals with autism spectrum disorders. Aging and Mental Health. 2012;16(8):939-949. PMID 22640177. Checked October 11, 2026.
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    “82 mothers from the Adolescents and Adults with Autism Study (AAA) participated in a Daily Diary Study.” “we observed a flatter cortisol level of daily stressors in mothers who experienced a greater number of negative life events in the previous period.” “These findings highlight the sustained toll that global and everyday stressors have on awakening cortisol level of midlife and aging mothers of individuals with ASD.”
27. Gourley L, Wind C, Henninger EM, Chinitz S. Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children. Journal of Child and Family Studies. 2013;22(7):912-921. PMID 24443636. Checked October 11, 2026.
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    “Parents of 59 children ages two to five who attended an out-patient clinic in a low income, urban community”; “Children in this clinical population showed a high prevalence (55.9%) of sensory processing difficulties”; “Parents of children with sensory processing deficits had significantly higher levels of parental stress than parents of children without sensory deficits. Parenting stress levels were also clinically elevated for the cohort of children in which sensory processing difficulties and behavioral concerns co-existed.” “parental stress could be reduced if mental health clinicians were trained to identify and address sensory problems”.
28. Mo S, Bu F, Bao S, Yu Z. Comparison of effects of interventions to promote the mental health of parents of children with autism: A systematic review and network meta-analysis. Clinical Psychology Review. 2024;114:102508. PMID 39489145. Checked October 11, 2026.
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    “A total of 69 empirical intervention studies involving 4213 parents of autistic children were included”; “mindfulness-based interventions demonstrate the highest efficacy in reducing parenting stress, while cognitive behavioral therapy is effective in alleviating anxiety and depression in parents of children with autism. Psychoeducational interventions have shown significant benefits in mitigating parental anxiety, depression, and parenting stress”.
29. Sohmaran C, Shorey S. Psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities: A systematic review and meta-analysis. Journal of Advanced Nursing. 2019;75(12):3316-3330. PMID 31359461. Checked October 11, 2026.
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    “The meta-analysis found that psychological interventions significantly reduced parental stress at postintervention but not at 3-6 months’ postintervention. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety.”
30. 988 Lifeline. 988 Lifeline. SAMHSA. Call, text or chat; “The 988 Lifeline is available 24/7/365. Your conversations are free and confidential.” Checked October 11, 2026.
31. Samaritans. Contact Us. Contact page. “Whatever you’re going through, call us free any time, from any phone, on 116 123.” Checked October 11, 2026.
32. Find A Helpline. Find A Helpline. Directory of helplines. “+ 1,700 helplines in over 175 countries”; “You might just need to talk, or want information on supporting others.” Checked October 11, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child.