Insomnia, anxiety and related disorders: a systematic review on clinical and therapeutic perspective with potential mechanisms underlying their complex link
Open accessAbstract
Anxiety and anxiety-related disorders are the most common mental disturbances, with dysregulation in emotions and cognition as central features. Since the function of sleep in regulating emotions, cognition stress response and inflammation is quintessential, sleep disturbances may be ideal modifiable factors in anxiety and related disorders. Accordingly, the aim of the review was to systematically review the association between insomnia symptoms and anxiety and related disorders. A systematic search has been conducted, and 93 papers have been selected for insomnia and General Anxiety Disorder, Panic Disorders, Social Anxiety Disorder, Separation anxiety, Obsessive Compulsive Disorder and Post Traumatic Stress Disorder, according to PRISMA. This review represents a comprehensive overview of clinical and therapeutic approaches to insomnia in the framework of anxiety and related disorders with a discussion of potential mechanisms underlying their complex link.
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In GAD, intrusive, uncontrollable thoughts often persist into the pre-sleep period, and heightened fear and tension in non-threatening contexts perpetuate sleep onset anxiety and insomnia symptoms.
“The intrusive, uncontrollable thoughts often persist into the pre-sleep period, and individuals with GAD frequently experience heightened fear and tension even in non-threatening contexts, perpetuating sleep onset anxiety and insomnia symptoms [1].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [1]
The review’s “Cognitive vulnerability” section links sleep-related worry and racing thoughts to GAD and says worry about sleep can exacerbate insomnia. Its Results section also reports difficulty falling asleep among patients with GAD. The cited passages do not establish that intrusive thoughts persist into the pre-sleep period or that fear and tension in non-threatening contexts perpetuate sleep-onset anxiety; no page numbers were available in our copy. (LLM, conf=0.83)
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Cites
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Self-citation
- Authors
- Palagini, L., Miniati, M., Caruso, V., Alfi, G., Geoffroy, P. A., Domschke, K., Riemann, D., Gemignani, A., & Pini, S.
- Affiliations
- Azienda Ospedaliera Universitaria Pisana (IT)
- Centre National de la Recherche Scientifique (FR)
- University of Freiburg (DE)
- University of Pisa (IT)
- Corresponding author
- Palagini, Laura
- ORCID
- Venue
- Neuroscience Applied
- Publisher
- Elsevier BV
- Published
- 2024
- Volume
- 3
- Pages
- 103936
- ISSN
- 2772-4085 (ISSN-L)
- PMC
- PMC12244189
- OpenAlex
- W4390650212
- Cited by
- 82
- References
- 153
- Citations by year
- 2026: 43 · 2025: 32 · 2024: 7
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neuroscience Applied (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- insomnia, anxiety disorders, generalized anxiety disorder, panic disorder, social anxiety disorder, separation anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, sleep disorders, insomnia treatment, stress response, inflammation
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