A recent study published in Psychological Reports has shed light on the relationship between sleep effort, anxiety, and depression. The findings indicate that the amount of effort it takes to fall asleep can act as a mediating factor between anxiety and depression, and vice versa. The study highlights the importance of sleep health and hygiene as preventive measures for mental health issues, especially when it comes to insomnia disorder.
Sleep effort refers to the amount of mental and physical work needed to achieve and maintain a good night’s sleep. This includes feelings of anxiety about sleep and its effects, which can make it harder to fall asleep and lead to sleep avoidance. Researchers propose that sleep effort can be an important factor to consider in the assessment and treatment of insomnia.
As people who experience sleep disturbances, such as insomnia, are more likely to develop symptoms of anxiety and depression, the current study aims to investigate whether sleep efforts act as a mediator between depression and anxiety, and vice versa.
To investigate this relationship, the study assessed 1,927 college students aged between 18 and 23 years old. The students completed an online questionnaire that included sociodemographic information, a self-assessment scale to evaluate depression and anxiety (Hospital Anxiety and Depression Scale), and a self-assessment scale for sleep effort (Glasgow Sleep Effort Scale).
Those with a higher level of sleep effort agree with statements such as “I put too much effort into sleeping when it should come naturally” and “I put off going to bed at night for fear of not being able to sleep.”
Sleep effort was found to partially mediate the effect of depression on anxiety, and the effect of anxiety on depression, by approximately 23% and 14%, respectively. Moreover, when controlling for sex, age, and marital status, sleep effort remained a significant mediator for both effects.
In general, the study suggests that sleep effort plays a bidirectional role in mediating the relationship between anxiety and depression. The findings highlight the importance of prioritizing sleep health and hygiene to prevent mental health problems.
“Sleep effort is one of the many factors that underlie the maintenance of insomnia and precedes other mental disorders such as anxiety and depression,” the researchers concluded. “In turn, anxiety and depression may increase the likelihood that an individual will experience insomnia. The examination of their relationship, if any, is important for an effective and efficient treatment. In this sense, it may be beneficial in preventing the development of anxiety, depression and insomnia.”
It is important to note that the study has some limitations. For example, it only looked at college students in Portugal during the COVID-19 pandemic, which may have affected the results in terms of anxiety, depression, and insomnia and its design does not allow for the determination of causality. However, it underscores the importance of paying attention to sleep health as a key preventive measure for mental health problems.
Future research could investigate the relationship between sleep effort and mental health in a different population using longitudinal designs to determine causality.
The study, “The Role of Sleep Effort as a Mediator Between Anxiety and Depression“, was authored by Cristina Borges, Jason G. Ellis, and Daniel Ruivo Marques.