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Sleep and anxiety: From mechanisms to interventions
Abstract
Anxiety is the most common mental health problem worldwide. Epidemiological studies show that sleep disturbances, particularly insomnia, affect ∼50% of individuals with anxiety, and that insufficient sleep can instigate or further exacerbate it. This review outlines brain mechanisms underlying sleep and anxiety, by addressing recent human functional/structural imaging studies on brain networks underlying the anxiogenic impact of sleep loss, and the beneficial effect of sleep on these brain networks. We discuss recent developments from human molecular imaging studies that highlight the role of specific brain neurotransmitter mechanisms, such as the adenosinergic receptor system, on anxiety, arousal, and sleep. This review further discusses frontline sleep interventions aimed at enhancing sleep in individuals experiencing anxiety, such as nonbenzodiazepines/antidepressants, lifestyle and sleep interventions and cognitive behavioral therapy for insomnia. Notwithstanding therapeutic success, up to ∼30% of individuals with anxiety can be nonresponsive to frontline treatments. Thus, we address novel non-invasive brain stimulation techniques that can enhance electroencephalographic slow waves, and might help alleviate sleep and anxiety symptoms. Collectively, these findings contribute to an emerging biological framework that elucidates the interrelationship between sleep and anxiety, and highlight the prospect of slow wave sleep as a potential therapeutic target for reducing anxiety.
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“Cognitive models of insomnia and emerging data linking circadian factors to affective dysregulation suggest how pre-sleep anxiety amplifies threat monitoring and hyperarousal, thereby delaying sleep initiation [3,4].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [3]
In the citing paper
“The condition is often accompanied by mental distress and physical tension, further compounding sleep difficulty [3].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [3]
In the citing paper
“Sleep onset anxiety, a heightened state of worry and cognitive arousal occurring during the transition to sleep, functions as a transdiagnostic symptom cluster that increases vulnerability to insomnia rather than constituting a standalone disorder [3].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [3]
In the citing paper
“Sleep onset anxiety commonly occurs with generalized anxiety disorder (GAD), panic disorder (PD), and post-traumatic stress disorder (PTSD) [3].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [3]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,772
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32279-7 · Cited by 13,867
Large-scale brain networks and psychopathology: a unifying triple network model
Menon, V. (2011) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2011.08.003 · Cited by 4,168
Etkin, A., & Wager, T. D. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07030504 · Cited by 3,391
The Neurocircuitry of Fear, Stress, and Anxiety Disorders
Shin, L. M., & Liberzon, I. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.83 · Cited by 2,083
European guideline for the diagnosis and treatment of insomnia
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia‐Borreguero, D., Gjerstad, M., Gonçalves, M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12594 · Cited by 2,049
Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., Denberg, T. D., & for the Clinical Guidelines Committee of the American College of Physicians* (2016) · Annals of Internal Medicine · doi:10.7326/m15-2175 · Cited by 1,965
A Multidimensional Meta-Analysis of Psychotherapy for PTSD
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.2.214 · Cited by 1,938
Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults
Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996) · Biological Psychiatry · doi:10.1016/0006-3223(95)00188-3 · Cited by 1,831
Research works printed but not linked: 2
- Alonso, 2007, Overview of key data from the European study of the epidemiology of mental disorders (ESEMeD), J Clin Psychiatr, 68, 3
- Duval, 2015, Neural circuits in anxiety and stress disorders: a focused review, Therapeut Clin Risk Manag, 11, 115
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BackgroundPalagini, L., Miniati, M., Caruso, V., Alfi, G., Geoffroy, P. A., Domschke, K., Riemann, D., Gemignani, A., & Pini, S. (2024) · Neuroscience Applied · doi:10.1016/j.nsa.2024.103936 · Cited by 82
Xiao, T., Pan, M., Xiao, X., & Liu, Y. (2024) · BMC Psychology · doi:10.1186/s40359-024-02237-z · Cited by 76
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Bourke, M., Wang, H., McNaughton, S. A., Thomas, G., Firth, J., Trott, M., & Cairney, J. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102585 · Cited by 65
Groves, C. I., Huong, C., Porter, C. D., Summerville, B., Swafford, I., Witham, B., Hayward, M., KWAN, M. Y. W., & Brown, D. M. Y. (2024) · Journal of Activity Sedentary and Sleep Behaviors · doi:10.1186/s44167-024-00048-6 · Cited by 74
Wu, Z., Shen, Z., Xu, Y., Chen, S., Xiao, S., Ye, J., Zhang, H., Ma, X., Zhu, Y., Zhu, X., et al. (2023) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.14520 · Cited by 47
Uyanık, H., Şengür, A., Salvi, M., Tan, R., Tan, J. H., & Acharya, U. R. (2025) · Wiley Interdisciplinary Reviews Data Mining and Knowledge Discovery · doi:10.1002/widm.70002 · Cited by 53
“…Disorder (MDD) (Fava and Kendler 2000), Bipolar Disorder (Grande et al. 2016), Bipolar Depression (Malhi et al. 2003), Bipolar Mania (Li, Yuan et al. 2023), Anxiety (Saxena and Krug 2013; Chellappa and Aeschbach 2022), Anhedonia (Serretti 2023) and Stress (Cohen et al. 2007) are considered.”
Yan, Y., Li, J., Zhang, Y., Wang, H., Qin, X., Zhai, K., & Du, C. (2023) · Phytomedicine · doi:10.1016/j.phymed.2023.154853 · Cited by 45
Huang, M. T., Liu, K., Liang, C., Wang, Y., & Guo, Z. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04161-0 · Cited by 44
“And the appearance of anxiety may be associated with specific brain neurotransmitter mechanisms [71].”
BackgroundThe influence of sleep on fear extinction in trauma-related disorders
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BackgroundAcademic Burden and Emotional Problems Among Adolescents: A Longitudinal Mediation Analysis
Wang, J., Wang, Z., Yang, Y., Wang, T., Lin, H., Zhang, W., Chen, X., & Fu, C. (2025) · Journal of Adolescence · doi:10.1002/jad.12471 · Cited by 40
“Epidemiological studies reported that sleep disturbances, particularly insomnia, affected 50% of people with anxiety, and that insufficient sleep instigated or further exacerbated anxiety symptoms (Chellappa and Aeschbach 2022).”
Carpi, M., Palagini, L., Fernandes, M., Calvello, C., Geoffroy, P. A., Miniati, M., Pini, S., Gemignani, A., Mercuri, N. B., & Liguori, C. (2023) · Neuropharmacology · doi:10.1016/j.neuropharm.2023.109815 · Cited by 42
“Furthermore, comorbid insomnia is an indicator of increased morbidity and low responsiveness to treatment and was shown to be related to the severity of worry, fear, and hypervigilance (Chellappa and Aeschbach, 2022; Palagini et al., 2022).”
BackgroundJackson, C., Stewart, I. D., Plekhanova, T., Cunningham, P. S., Hazel, A. L., Al-Sheklly, B., Aul, R., Bolton, C. E., Chalder, T., Chalmers, J. D., et al. (2023) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(23)00124-8 · Cited by 35
“16,17 Furthermore, epidemiological studies have suggested that sleep disturbance is associated with respiratory disease, which can cause dyspnoea.”
BackgroundComorbidities and Risk Factors Associated With Insomnia in the Elderly Population
Mookerjee, N., Schmalbach, N. K., Antinori, G., Thampi, S., Windle-Puente, D., Gilligan, A., Huy, H., Andrews, M., Sun, A., Gandhi, R., et al. (2023) · Journal of Primary Care & Community Health · doi:10.1177/21501319231168721 · Cited by 34
Relationship between sleep and serum inflammatory factors in patients with major depressive disorder
Yang, Y., Gu, K., Meng, C., Li, J., Qiao, L., Zhou, X., Yan, D., Li, D., Pei, C., Lu, Y., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115528 · Cited by 36
Obstructive Sleep Apnea in Pregnancy: A Comprehensive Review of Maternal and Fetal Implications
Maniaci, A., Via, L. L., Pecorino, B., Chiofalo, B., Scibilia, G., Lavalle, S., & Scollo, P. (2024) · Neurology International · doi:10.3390/neurolint16030039 · Cited by 33
“Moreover, the psychological impact of OSA, including chronic fatigue and the stress of coping with a sleep disorder, can also weigh heavily on mental well-being, potentially triggering feelings of inadequacy or frustration that can spiral into more severe mood disorders [38].”
BackgroundShen, Z., Yang, X., She, T., Zhao, G., Dou, Z., Luo, Y., Lin, W., Dang, W., & Yu, S. (2023) · SLEEP · doi:10.1093/sleep/zsad296 · Cited by 35
Relationship of Sleep Disorder with Neurodegenerative and Psychiatric Diseases: An Updated Review
Xiao, X., Rui, Y., Jin, Y., & Chen, M. (2023) · Neurochemical Research · doi:10.1007/s11064-023-04086-5 · Cited by 35
“Anxiety is a common psychiatric disorder characterized by persistent feelings of fear and worry [71 ].”
Chen, Q., Dai, W., Li, G., & Ma, N. (2022) · Sleep and Biological Rhythms · doi:10.1007/s41105-022-00398-1 · Cited by 40
“The sleep loss can result in an abnormal top-down prefrontal control of emotional regulation, thereby directly affecting responses to negative emotions [55].”
BackgroundRestraint stress induced anxiety and sleep in mice
Xu, Y., Liu, G., Ji, Z.-Z., Li, Y.-Y., Wang, Y., Wu, X., Liu, J.-L., Ma, D.-X., Zhong, M., Gao, C., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1090420 · Cited by 31
Chen, S., Que, J., Chan, N. Y., Shi, L., Li, S. X., Chan, J. W. Y., Huang, W., Chen, X., Tsang, C. C., Ho, Y. L., et al. (2025) · PLoS Medicine · doi:10.1371/journal.pmed.1004510 · Cited by 35
“In contrast to the long-term effects of app-based CBT-I on insomnia, its anxiolytic effect observed at post-intervention did not sustain at follow-ups, despite the close relationship between insomnia and anxiety [39].”
Jiang, C., Chen, Y., & Sun, T. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1570173 · Cited by 33
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Zhou, Y., Huang, J., Baker, P. N., Liao, B., & Yu, X. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05203-y · Cited by 25
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BackgroundTang, Q., He, X., Zhang, L., Liu, X., Tao, Y., & Liu, G. (2023) · Behavioral Sciences · doi:10.3390/bs13080641 · Cited by 26
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Sun, L., Huo, X., Jia, S., & Chen, X. (2024) · Aging Clinical and Experimental Research · doi:10.1007/s40520-024-02745-3 · Cited by 24
“About 50% of patients with sleep disorders, especially insomnia, suffer from anxiety, which can be triggered or exacerbated by sleep deprivation [35] .”
BackgroundEthological computational psychiatry: Challenges and opportunities
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“For example, in generalized anxiety disorders and other mental health disorders patients often have disruptions of sleep, and their behavior, decision making, and other activities may be particularly mal-adaptive within the context of a sleepless night [16].”
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BackgroundMa, S., Chong, Y., Zhang, R., Quan, W., Gui, J., Li, L., Wang, J., Miao, S., Shi, X., Zhao, M., et al. (2024) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2024.118013 · Cited by 19
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“These approaches have been widely utilized to investigate the underlying neural mechanism of insomnia [20], MDD [21], and the treatment efficiency of taVNS [3,8].”
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Vanuk, J. R., Pace-Schott, E. F., Bullock, A., Esbit, S., Dailey, N. S., & Killgore, W. D. S. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.886816 · Cited by 19
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Scheer, F. A. J. L., & Chellappa, S. L. (2023) · Sleep Health · doi:10.1016/j.sleh.2023.07.012 · Cited by 17
Self-citationMurphy, M., Erridge, S., Holvey, C., Coomber, R., Rucker, J., & Sodergren, M. H. (2023) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12407 · Cited by 17
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Gou, Q., Li, M., Wang, X., Yuan, X., Yang, M., Li, J., Wang, B., Yang, D., Ren, X., Yang, M., et al. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2024.1433592 · Cited by 18
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Chen, Y., Zhao, Z., Ding, W., Zhou, Z., & Xiao, M. (2024) · Brain and Behavior · doi:10.1002/brb3.70123 · Cited by 15
Strete, E. G., Cincu, M.-G., & Sălcudean, A. (2025) · Medicina · doi:10.3390/medicina61071226 · Cited by 18
Yu, L., Peng, W. J., Lin, W., Luo, Y., Hu, D., Zhao, G., Xu, H., Dou, Z., Zhang, Q., Hong, X., et al. (2024) · SLEEP · doi:10.1093/sleep/zsae080 · Cited by 16
Li, L., Zhang, Y., Fan, M., & Cao, B. (2024) · BMC Psychology · doi:10.1186/s40359-024-01719-4 · Cited by 20
“…to the evidence from animal models and/or pharmacological work, a plethora of neurotransmitter and neuromodula-tor systems orchestrates sleep and emotional regulation, including but not limited to norepinephrine, acetylcholine, γ-aminobutyric acid (GABA), dopamine, glutamate, serotonin [17, 18].”
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Diniz, D. G., Bento‐Torres, J., da Costa, V. O., Carvalho, J. P. R., Tomás, A. M., de Oliveira, T. C. G., Soares, F. C., de Macedo, L. D. E. D., Jardim, N. Y. V., Bento-Torres, N. V. O., et al. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms251910757 · Cited by 19
Social support and anxiety, a moderated mediating model
Yang, L., Wang, N., Li, D., Zhao, X., Wen, M., Zhang, Y., & Liu, Y. (2025) · Scientific Reports · doi:10.1038/s41598-025-14336-x · Cited by 28
Peng, Y., Shao, Y., Li, Z., Cai, R., Bo, X., Qian, C., Chu, Q., Jiang, C., & Shi, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013189 · Cited by 18
“Consistent with previous studies [40,41], sleep quality influenced both the anxiety and the depression dimensions, and people who experienced anxiety and depression were also more likely to lose sleep [14].”
ResultKosendiak, A. A., Adamczak, B. B., Kuźnik, Z., & Makles, S. (2024) · Nutrients · doi:10.3390/nu16020278 · Cited by 19
“Studies have shown that anxiety and stress may contribute to the exacerbation of overall sleep quality, shortened sleep duration, and increased reliance on sleeping medication [67].”
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Wong, A. K. Y., Wang, D. T., Marco, D. J. T., Le, B. H. C., & Philip, J. A. M. (2023) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2023.05.020 · Cited by 15
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Leonard, S. I., Castiblanco, M. R., Chang, A., Belloir, J. A., Caceres, B. A., Bruzzese, J., & Jackman, K. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2024.12.033 · Cited by 14
Qin, X., Liu, L., Yan, Y., Guo, X., Yang, N., & Li, L. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1512812 · Cited by 18
“This deterioration in sleep quality subsequently exacerbates anxiety levels, thereby creating a detrimental cycle (88).”
The brain in chronic insomnia and anxiety disorder: a combined structural and functional fMRI study
Xu, M., Li, B., Wang, S., Chen, C., Liu, Z., Ji, Y., Liu, K., & Niu, Y. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1364713 · Cited by 15
“For instance, individuals with both disorders may exhibit abnormal levels of neurotransmitters such as 5-hydroxytryptamine (5, 6), g - aminobutyric acid (7) and dopamine (8), which maintain a state of hyperarousal and stress (9).”
BackgroundSun, D., Zhu, X., & Bao, Z. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1296154 · Cited by 13
Peng, W., Xu, H., Zhang, C., Hu, Y., & Yu, S. (2024) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-024-04703-y · Cited by 13
“…using an echo-planar imaging (EPI) sequence with the following parameters: TR/TE of 2000/30 ms, flip angle of 90°, acquisition matrix of 64 × 64, matrix size of 3.75 × 3.75, FOV of 240 × 240 mm, slice thickness of 4 mm, 35 slices, voxel size of 3.75 × 3.75 × 3.2 mm [3], and total volume of 255.”
InfluentialPerceived stress mediates the longitudinal effect of sleep quality on internalizing symptoms
Meng, R., Xu, J., Luo, Y., Mastrotheodoros, S., Jiang, C., Garofalo, C., Mazzeschi, C., Nielsen, T., Fong, D., Dzierzewski, J. M., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.12.046 · Cited by 16
Tong, Y., Wen, K., Li, E., Ai, F., Tang, P., Wen, H., & Guo, B. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s516912 · Cited by 13
“29,30 The more severe the anxiety symptoms, the worse the sleep quality in OSA patients.”
Wang, H., Ding, Y., Dai, Y., Fan, Z., Wen, S., Wang, X., Yuan, J., Wu, Y., & Yu, L. (2025) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2025.152591 · Cited by 15
Yang, P., Nie, T., Sun, X., Xu, L., Ma, C., Wang, F., Long, L., & Chen, J. (2024) · Advanced Science · doi:10.1002/advs.202400205 · Cited by 11
Chronotype, sleep hygiene, and sleep characteristics among athletes of different disciplines
Borghi, S., Bizzozero, S., Vitale, J. A., Tallini, E., Corazza, F., Torre, A. L., Banfi, G., & Codella, R. (2024) · International Journal of Sports Medicine · doi:10.1055/a-2421-9310 · Cited by 14
“In particular, insomnia affects approximately 50 % of indi - viduals with anxiety, and insufficient sleep could instigate or fur - ther exacerbate it [35, 36].”
Mi, Y., Chen, K., Lin, S., Tong, L., Zhou, J., & Wan, M. (2024) · The EPMA Journal · doi:10.1007/s13167-024-00387-z · Cited by 12
“Currently, first-line treatment for anxiety disorders primarily includes antidepressants and interventions targeting sleep disorders, however, a considerable proportion of patients do not achieve optimal treatment outcomes [61].”
Che, X., Lu, Z., & Jin, Y. (2025) · Scientific Reports · doi:10.1038/s41598-025-11225-1 · Cited by 16
Tseitlin, L., Richmond-Hacham, B., Vita, A., Schreiber, S., Pick, C. G., & Bikovski, L. (2023) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2023.1140724 · Cited by 12
“Given that sleep disruption has been shown to exacerbate emotional vulnerability and increase anxiety (Chellappa and Aeschbach, 2022), it is most likely that its contribution to mice’s exhibition of anxiety-like behavior will emerge in longer-duration tests.”
BackgroundQiu, Q., Chai, G., Xie, S., & Wu, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1383042 · Cited by 12
Pelın, M., & Sert, H. (2025) · BMC Nursing · doi:10.1186/s12912-025-02793-8 · Cited by 13
Ou, K., & Ma, N. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043495 · Cited by 11
“Anxiety is a well-known risk factor for poor sleep quality [23].”
BackgroundZhang, D., Li, X., Zhang, M., Huang, A., Liu, Y., Wang, C., Yuan, T., Lei, Y., Liu, H., Hua, Y., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1328226 · Cited by 11
Dornellas, L. H., & Afonso, M. P. D. (2024) · Seven Editora eBooks · doi:10.56238/medestvida-002 · Cited by 11
Sleep disturbances and health-related quality of life in children with epilepsy: A caregiver survey.
Wiesmüller, L., Strauch, D., Schönberger, J., Antonio-Arce, V. S., Bast, T., Schubert-Bast, S., Syrbe, S., Jacobs, J., & Klotz, K. (2025) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2025.110613 · Cited by 9
“While reciprocal effects are well established for some comorbidities, e.g. anxiety disorder [34], this result is not surprising considering the variety of comorbidities care-givers described.”
Ma, C., Zhou, N., Ma, K., Niu, J., Mi, T., He, Z., Wen, Y., Liu, C., He, Z., & Niu, J. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1122803 · Cited by 10
“At present, quantitative electroencephalogram (EEG), functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and other technologies have been used to study the mechanism of fear-related sleep impairments (Zhang et al., 2019; Zhou et al., 2021; Chellappa and Aeschbach, 2022).”
BackgroundLuo, F., Lu, Y., Chen, C., Chang, D., Jiang, W., & Yin, R. (2023) · International Journal of General Medicine · doi:10.2147/ijgm.s444255 · Cited by 10
“28 Insomnia is a very common symptom in cancer patients, and some studies have shown that insomnia peaks after cancer diagnosis and during oncology treatment.”
Traumatic brain injury and sleep in military and veteran populations: A literature review
Landvater, J., Kim, S. Y., Caswell, K., Kwon, C., Odafe, E., Roe, G., Tripathi, A., Vukovics, C., Wang, J., Ryan, K., et al. (2024) · Neurorehabilitation · doi:10.3233/nre-230380 · Cited by 12
Cohen, A., Haimov, I., & Szepsenwol, O. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.11.003 · Cited by 10
Yang, X., Yang, Y., Yang, J., Ni, J., Li, H., Mu, X., & Wang, C. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.04.085 · Cited by 11
Disentangling Sleep's Role in Emotion processing
Sullivan, E. C., McCall, C., Henderson, L. M., & Cairney, S. A. (2025) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2025.109269 · Cited by 13
Arvin, P., Ghafouri, S., Bavarsad, K., Hajipour, S., Khoshnam, S. E., Sarkaki, A., & Farbood, Y. (2022) · Behavioural Brain Research · doi:10.1016/j.bbr.2022.114190 · Cited by 11
Sleep Disturbance and Immunological Consequences of COVID-19
Bocek, J., Praško, J. P., Genzor, S., Hodný, F., Vaněk, J., Pobeha, P., Bělohradová, K., & Ocisková, M. (2023) · Patient Preference and Adherence · doi:10.2147/ppa.s398188 · Cited by 12
“Depression and an extensive increase in anxiety are risk factors for insomnia.(14,15) Sleep deprivation also increases the risk of cerebrovascular accidents, obesity, diabetes mellitus, cancer, osteoporosis, and cardiovascular diseases.”
BackgroundLin, J., Kong, Y., Chen, H., Ding, X., & Zhou, W. (2023) · Clinical Rehabilitation · doi:10.1177/02692155231218535 · Cited by 10
Sleep is Essential for Mental Health: Potential Role of Slow Oscillations
Aquino, G., Alfì, G., Riemann, D. W., Laurino, M., Menicucci, D., Piarulli, A., Palagini, L., & Gemignani, A. (2024) · Current Sleep Medicine Reports · doi:10.1007/s40675-024-00277-w · Cited by 15
“A neurobiological key contribution is offered by the sleep-arousal system, particularly concerning the overlap between sleep regulation and anxiety circuitries [3 • , 89].”
Gong, L., Fang, C., Li, X., Wang, Z., Wang, S., Xu, R., Zhang, B., & Xi, C. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1119595 · Cited by 9
Liu, J., Hao, Q., Li, B., Zhang, R., Luo, G., & Sun, D. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05980-0 · Cited by 11
Wang, S., Hicks, M. H., Barrett, E. S., Martsenkovskyi, D., Голованова, І. А., Marchak, O., Ishchenko, L., Fiedler, N. L., & Haque, U. (2024) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001337 · Cited by 14
“Because direction of causality cannot be determined by our study and because bidirectional associations may exist (3,14,25,64), these findings suggest a variety of possibilities: In the physical domain, sleep disruption can increase somatic pain and contribute to medical conditions such as…”
Associations Between Cardiovascular Health (Life's Essential 8) and Mental Disorders
Xu, Y., Ning, W., Zhang, Y., Ba, Y., Liu, H., Liu, L., Wang, L., Guo, C., Xu, H., Weng, S., et al. (2024) · Clinical Cardiology · doi:10.1002/clc.70019 · Cited by 12
“Previous evidence has illustrated that behavioral and biological processes contributing to CVD were linked to depression and anxiety, which served as the foundation of our study [12, 22 – 24].”
BackgroundPrevention of Melasma During Pregnancy: Risk Factors and Photoprotection-Focused Strategies
Zhao, L., Fu, X., & Cheng, H. (2024) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s488663 · Cited by 12
“73”
BackgroundInfluentialChange in sleep, gastrointestinal symptoms, and mood states at high altitude (4500m) for 6 months
Kan, H., & Zhang, X. (2025) · Sleep And Breathing · doi:10.1007/s11325-024-03237-4 · Cited by 9
“Anxiety can trigger the body’s stress response, leading to sleep issues such as insomnia [39], while depression may induce insomnia through its effects on inflammatory cytokines, serotonin metabolites, and circadian rhythms [40].”
Over-the-counter products for insomnia in adults: A scoping review of randomised controlled trials
Salame, A., Mathew, S., Bhanu, C., Bazo‐Alvarez, J. C., Bhamra, S. K., Heinrich, M., Walters, K. R., & Frost, R. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.02.027 · Cited by 10
Metadata
- Authors
- Chellappa, S. L., & Aeschbach, D.
- Affiliations
- University of Cologne (DE)
- University of Bonn (DE)
- Corresponding author
- Chellappa, Sarah L.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 61
- Pages
- 101583
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W4200462974
- Cited by
- 509
- References
- 158
- Citations by year
- 2026: 111 · 2025: 170 · 2024: 135 · 2023: 71 · 2022: 21
- FWCI
- 9.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- elib (German Aerospace Center) (acceptedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Alexander von Humboldt Foundation
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- sleep, anxiety, insomnia, sleep deprivation, brain networks, arousal, cognitive behavioral therapy for insomnia, non-benzodiazepine hypnotics, antidepressants, lifestyle intervention, non-invasive brain stimulation, slow-wave sleep, sleep interventions
- MeSH terms
- Anxiety, Anxiety Disorders, Humans, Sleep Initiation and Maintenance Disorders, Sleep, Cognitive Behavioral Therapy
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