ArticleNature and science of sleep2021
Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students.
Article in Nature and science of sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 45 citations in OpenAlex.
- Assessment of an App-Based Sleep Program to Improve Sleep Outcomes in a Clinical Insomnia Population: Randomized Controlled Trial.JMIR mHealth and uHealth · 2025Trial
- Physical activity and insomnia in adolescents: the chain mediating role of anxiety and short video addiction.Scientific reports · 2026Article
- REM Sleep Correlates of Trait Anxiety in Non-Clinical Adults: The Role of Sex and Age.Journal of sleep research · 2026Article
- Distinct Stress Appraisal Dimensions, Insomnia, and Physical Activity as Differential Pathways to Psychological Distress: A Cross-Sectional Study in Tunisian University Students.Healthcare (Basel, Switzerland) · 2026Article
- Sleep hygiene mediates anxiety and sleep quality in adults: mediation and network analysis.BJPsych open · 2026Article
- The effect of reading problems on emotional and behavioral problems in children: the chain mediating role of parenting stress and parental anxiety/depressive symptoms.BMC psychiatry · 2026Article
- Stress, pain intensity, and work productivity in individuals with chronic pain: a cross-sectional observational study.BMC public health · 2025Observational
- Disordered Eating Behaviors, Perceived Stress and Insomnia During Academic Exams: A Study Among University Students.Medicina (Kaunas, Lithuania) · 2025Article
- The Role of Rumination and Worry in the Bidirectional Relationship Between Stress and Sleep Quality in Students.International journal of environmental research and public health · 2025Article
- Clinical utility of the GAD-7 for detecting generalized anxiety in Quechua indigenous people.Frontiers in psychiatry · 2025Article
- Wuling capsule combined with sertraline in the therapy of anxiety and depression with insomnia in adolescents.World journal of psychiatry · 2024Article
- Insomnia mediates the relation between empathy and anxiety among nursing students: a latent moderated mediation model of self-compassion.BMC nursing · 2024Article
- Prevalence and correlates of generalized anxiety disorder and perceived stress among Sudanese medical students.BMC psychiatry · 2024Article
- Mediating Role of PERMA Wellbeing in the Relationship between Insomnia and Psychological Distress among Nursing College Students.Behavioral sciences (Basel, Switzerland) · 2023Article
- Stressors in university life and anxiety symptoms among international students: a sequential mediation model.BMC psychiatry · 2023Article
- Prevalence and factors associated with insomnia among medical students in China during the COVID-19 pandemic: characterization and associated factors.BMC psychiatry · 2023Article
- Article
- Insomnia in teachers at the time of resumption of in-person instruction at schools amidst the COVID-19 pandemic: A cross-sectional study.F1000Research · 2023Article
- Duration of Keeping an Exercise Habit and Mental Illness and Life Attitude among University Students.International journal of environmental research and public health · 2022Article
- Sleep Quality Worsens While Perceived Stress Improves in Healthcare Workers over Two Years during the COVID-19 Pandemic: Results of a Longitudinal Study.Healthcare (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh perceived stress and anxiety disorders are usually comorbid with each other, with stress often sequentially preceding the development of anxiety. While prior findings showed a causal role of sleep problems in anxiety, no study has assessed the role of insomnia as a mediator in the relationship between stress and anxiety.
methodsA cross-sectional study on university students (n = 475, age = 21.1+2.6 years) was conducted over 3 months. Participants completed self-report measures of Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), Perceived Stress Scale-10 (PSS-10), generalized anxiety disorder-7 scale (GAD-7), and a sociodemographic tool. The mediation effect model given by Baron and Kelly was used to determine the relationship.
resultsThe prevalence of insomnia and anxiety disorder was 43.6% and 21.9%, respectively. Stress was significantly associated with LSEQ-M (insomnia measure) (b = -.44, SE = 0.16, p<0.01), and high levels of anxiety (b = 0.25, SE = 0.03, p < 0.01). The indirect effect of stress on anxiety through LSEQ-M (insomnia measure) was significant (95% confidence interval [0.01, 0.04]). However, the indirect effect of anxiety on stress through LSEQ-M (insomnia measure) was non-significant (95% confidence interval [-.01, 0.04]).
conclusionsStudents having higher perceived stress levels and comorbid insomnia were also likely to have a higher anxiety level.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.