Overanxious and underslept

Ben Simon, Eti; Rossi, Aubrey; Harvey, Allison G.; Walker, Matthew P.

doi:10.1038/s41562-019-0754-8

Cited by 177Sleep and Wakefulness ResearchSleep and related disordersSleep and Work-Related Fatigue

Overanxious and underslept

Ben Simon, Eti, Rossi, Aubrey, Harvey, Allison G., Walker, Matthew P.·2019·Nature Human Behaviour

DOI 10.1038/s41562-019-0754-8

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Abstract

Are you feeling anxious? Did you sleep poorly last night? Sleep disruption is a recognized feature of all anxiety disorders. Here, we investigate the basic brain mechanisms underlying the anxiogenic impact of sleep loss. Additionally, we explore whether subtle, societally common reductions in sleep trigger elevated next-day anxiety. Finally, we examine what it is about sleep, physiologically, that provides such an overnight anxiety-reduction benefit. We demonstrate that the anxiogenic impact of sleep loss is linked to impaired medial prefrontal cortex activity and associated connectivity with extended limbic regions. In contrast, non-rapid eye movement (NREM) slow-wave oscillations offer an ameliorating, anxiolytic benefit on these brain networks following sleep. Of societal relevance, we establish that even modest night-to-night reductions in sleep across the population predict consequential day-to-day increases in anxiety. These findings help contribute to an emerging framework explaining the intimate link between sleep and anxiety and further highlight the prospect of non-rapid eye movement sleep as a therapeutic target for meaningfully reducing anxiety.

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“Additionally, the c-ICNs have also been associated with autonomic nervous system (ANS) modulation [45–50] possibly helping to explain the ANS dysfunction consistently reported across psychopathologies [51, 52].”
From Infraslow closed-loop brain training for anxiety and depression (ISAD): a protocol for a randomized, double-blind, sham-controlled pilot trial in adult females with internalizing disorders (2022) · cites this paper as [45]
Ben Simon and colleagues report that the interaction between sleep deprivation and the magnitude of anxiety increase is accounted for by changes in medial-prefrontal cortex activity and associated medial-prefrontal cortex connectivity.
“Ben Simon and colleagues report that the interaction between sleep deprivation and the magnitude of anxiety increase is accounted for by changes in medial-prefrontal cortex activity and associated medial-prefrontal cortex connectivity. 51”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [51]

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Wu, H., Zhao, Z., Stone, W. S., Huang, L., Zhuang, J., He, B., Zhang, P., & Li, Y. (2008) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2008.07.013 · Cited by 62 · see citing works
Anxiety vulnerability is associated with altered anterior cingulate response to an affective appraisal task
Simmons, A. N., Matthews, S. C., Feinstein, J. S., Hitchcock, C. A., Paulus, M. P., & Stein, M. B. (2008) · Neuroreport · doi:10.1097/wnr.0b013e328305b722 · Cited by 58 · see citing works
Clinical and EEG Sleep Changes in Primary Dysthymia and Generalized Anxiety: A Comparison with Normal Controls
Arriaga, F., & Paiva, T. (2008) · Neuropsychobiology · doi:10.1159/000119471 · Cited by 51 · see citing works
Slow-wave sleep, diabetes, and the sympathetic nervous system
Dijk, D. (2008) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0711635105 · Cited by 44 · see citing works
Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder
Burklund, L. J., Torre, J. B., Lieberman, M. D., Taylor, S. E., & Craske, M. G. (2017) · Psychiatry Research - Neuroimaging · doi:10.1016/j.pscychresns.2016.12.012 · Cited by 38 · see citing works
Polysomnography in patients with post‐traumatic stress disorder
Yetki̇n, S., Aydın, H., & Özgen, F. (2010) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2010.02084.x · Cited by 38 · see citing works
Influence of the level of trait anxiety on sleep EEG of men and women
Sysoeva, Y. Y., & Verbitsky, E. V. (2013) · Human Physiology · doi:10.1134/s036211971306011x · Cited by 8 · see citing works

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Sorted by citations

Sleep disturbance and psychiatric disorders
Freeman, D., Sheaves, B., Waite, F., Harvey, A. G., & Harrison, P. J. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30136-x · Cited by 843 · see citing works
Self-citation
Sleep and anxiety: From mechanisms to interventions
Chellappa, S. L., & Aeschbach, D. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101583 · Cited by 509 · see citing works
Sleep Loss and the Socio-Emotional Brain
Simon, E. B., Vallat, R., Barnes, C. M., & Walker, M. P. (2020) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2020.02.003 · Cited by 248 · see citing works
Self-citation
Sleep loss and emotion: A systematic review and meta-analysis of over 50 years of experimental research.
Palmer, C. A., Bower, J. L., Cho, K. W., Clementi, M. A., Lau, S., Oosterhoff, B. J., & Alfano, C. A. (2023) · Psychological Bulletin · doi:10.1037/bul0000410 · Cited by 237 · see citing works
Sleep health early in the coronavirus disease 2019 (COVID-19) outbreak in the United States: integrating longitudinal, cross-sectional, and retrospective recall data
Gao, C., & Scullin, M. K. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.06.032 · Cited by 147 · see citing works
“When people are sleep deprived, they show greater anxiety/stress reactivity [11], greater tendencies to blame and punish others for mistakes [12], poorer job performance [13], and lower cognitive functioning [14].”
Background
TNF signaling pathway-mediated microglial activation in the PFC underlies acute paradoxical sleep deprivation-induced anxiety-like behaviors in mice
Liu, H., Huang, X., Li, Y., Xi, K., Han, Y., Mao, H., Ren, K., Wang, W., & Wu, Z. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.12.006 · Cited by 99 · see citing works
“PFC activity has been reported to be related to sleep deprivationinduced anxiety (Ben Simon et al., 2020).”
BackgroundInfluential
Making Sense of Sleep
Zhai, B., Perez-Pozuelo, I., Clifton, E. A. D., Palotti, J., & Guan, Y. (2020) · Proceedings of the ACM on Interactive Mobile Wearable and Ubiquitous Technologies · doi:10.1145/3397325 · Cited by 77 · see citing works
“Whilst the functions of sleep are not yet fully understood, it is known to restore energy, promote healing, rejuvenate physical systems, interact with the immune system and influence brain function, with manifold consequences including for memory consolidation and behaviour [16, 23, 42, 43].”
Background
Identification and Screening of Potential Bioactive Peptides with Sleep-Enhancing Effects in Bovine Milk Casein Hydrolysate
Qian, J., Zheng, L. P., Su, G., Huang, M., Luo, D., & Zhao, M. (2021) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.1c03937 · Cited by 72 · see citing works
Mendelian randomization analyses reveal causal relationships between brain functional networks and risk of psychiatric disorders
Mu, C., Dang, X., & Luo, X. (2024) · Nature Human Behaviour · doi:10.1038/s41562-024-01879-8 · Cited by 66 · see citing works
“Impaired medial prefrontal cortex (mPFC) activity is a recognized neural phenotype of highly anxious (ANX) individuals 22,23 , and the connectivity between the mPFC and amygdala has been reported to be negatively correlated with anxiety levels of individuals 24 .”
Association of long-term exposure to ambient air pollution with the incidence of sleep disorders: A cohort study in China
Yu, Z., Wei, F., Wu, M., Lin, H., Shui, L., Jin, M., Wang, J., Tang, M., & Chen, K. (2021) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2021.111956 · Cited by 63 · see citing works
The Role of Active Coping in the Relationship Between Learning Burnout and Sleep Quality Among College Students in China
Wang, Y., Xiao, H., Zhang, X., & Wang, L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00647 · Cited by 56 · see citing works
“Sleep is a periodic resting condition of the body and the nervous system that is crucial for university students’ learning, performance, and health (Suen et al., 2008; Simon et al., 2020).”
Background
Insomnia in patients with coronary heart disease: prevalence and correlates
Frøjd, L. A., Munkhaugen, J., Moum, T., Sverre, E., Nordhus, I. H., Papageorgiou, C., & Dammen, T. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9082 · Cited by 58 · see citing works
“38 Whetherinsomnia coexists as a precursor, a residual symptom, or a core symptom ofanxietyanddepressionneedsfurtherstudy.”
The association between sleep and psychological distress among New York City healthcare workers during the COVID-19 pandemic
Diaz, F., Cornelius, T. M., Bramley, S., Venner, H. K., Shaw, K., Dong, M., Pham, P., McMurry, C. L., Cannone, D. E., Sullivan, A. M., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.033 · Cited by 56 · see citing works
Lacticaseibacillus paracasei Lpc-37® improves psychological and physiological markers of stress and anxiety in healthy adults: a randomized, double-blind, placebo-controlled and parallel clinical trial (the Sisu study)
Patterson, E., Griffin, S. M., Ibarra, A., Ellsiepen, E., & Hellhammer, D. H. (2020) · Neurobiology of Stress · doi:10.1016/j.ynstr.2020.100277 · Cited by 53 · see citing works
“Indeed, stress is closely linked with sleep disruption which plays a central role in mediating psychiatric disorders (Simon et al., 2020).”
Background
Pilot study of the effects of ventilation and ventilation noise on sleep quality in the young and elderly
Lan, L., Sun, Y., Wyon, D. P., & Wargocki, P. L. (2021) · Indoor Air · doi:10.1111/ina.12861 · Cited by 50 · see citing works
Bifidobacterium longum 1714 improves sleep quality and aspects of well-being in healthy adults: a randomized, double-blind, placebo-controlled clinical trial
Patterson, E., Tan, H. T., Groeger, D., Andrews, M. W., Buckley, M. J. M., Murphy, E. F., & Groeger, J. A. (2024) · Scientific Reports · doi:10.1038/s41598-024-53810-w · Cited by 55 · see citing works
“Stress affects sleep 86 and vice versa 87 and anxiety can lead to poor sleep quality, but in the current study, whether reduced stress may have resulted in improved sleep quality warrants further investigation since there was also no observed effect of the intervention on stress or mood.”
Background
Depression alters the circadian pattern of online activity
ten Thij, M., Bathina, K. C., Rutter, L. A., Lorenzo‐Luaces, L., van de Leemput, I. A., Scheffer, M., & Bollen, J. (2020) · Scientific Reports · doi:10.1038/s41598-020-74314-3 · Cited by 42 · see citing works
A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors
Steffey, M. A., Griffon, D. J., Risselada, M., Buote, N. J., Scharf, V. F., Zamprogno, H., & Winter, A. L. (2023) · Frontiers in Veterinary Science · doi:10.3389/fvets.2023.1184525 · Cited by 51 · see citing works
“Sleep-deprived individuals show emotional disinhibition, heightened anxiety, and impaired emotional responsivity, feel lonelier, and behave in a less prosocial manner (104, 105).”
Background
Sleep loss leads to the withdrawal of human helping across individuals, groups, and large-scale societies
Simon, E. B., Vallat, R., Rossi, A., & Walker, M. P. (2022) · PLoS Biology · doi:10.1371/journal.pbio.3001733 · Cited by 45 · see citing works
“Second, sleep loss reliably decreases activity in, and disrupts functional connectivity between, numerous regions within the social cognition brain network [33], including the mPFC [34], TPJ, and precuneus [35].”
BackgroundSelf-citation
The influence of emotion regulation strategies and sleep quality on depression and anxiety
Sullivan, E. C., James, E., Henderson, L. M., McCall, C., & Cairney, S. A. (2023) · Cortex · doi:10.1016/j.cortex.2023.06.001 · Cited by 47 · see citing works
Sleeping stage classification based on joint quaternion valued singular spectrum analysis and ensemble empirical mode decomposition
Huang, Z. W., & Ling, B. W. (2021) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2021.103086 · Cited by 41 · see citing works
Sleep Loss Gives Rise to Intrusive Thoughts
Harrington, M. O., & Cairney, S. A. (2021) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2021.03.001 · Cited by 40 · see citing works
Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model
Akbar, S. A., Mattfeld, A. T., Laird, A. R., & McMakin, D. L. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104780 · Cited by 38 · see citing works
Mechanism of Salvia miltiorrhiza Bunge extract to alleviate Chronic Sleep Deprivation-Induced cognitive dysfunction in rats
Yin, C., Zhang, M., Jin, S., Zhou, Y., Ding, L., Lv, Q., Huang, Z., Zhou, J., Chen, J., Wang, P., et al. (2024) · Phytomedicine · doi:10.1016/j.phymed.2024.155725 · Cited by 39 · see citing works
The influence of big five personality traits on anxiety: The chain mediating effect of general self-efficacy and academic burnout
Wu, X., Zhang, W., Li, Y., Zheng, L., Liu, J., Jiang, Y., & Peng, Y. (2024) · PLoS ONE · doi:10.1371/journal.pone.0295118 · Cited by 36 · see citing works
Home confinement during the COVID-19: day-to-day associations of sleep quality with rumination, psychotic-like experiences, and somatic symptoms
Simor, P., Polner, B., Báthori, N., Ortega, R. S., Roy, A. V., Sáenz, A. A., González, A. L., Benkirane, O., Nagy, T., & Peigneux, P. (2021) · SLEEP · doi:10.1093/sleep/zsab029 · Cited by 37 · see citing works
“In addition, impaired fronto-limbic connectivity due to non-efficient sleep might provide the neural background of increased emotional reactivity to stressful situations, including lowered pain thresholds and somatic symptoms [22, 50].”
Background
Anxiety modifies the emotional effects of sleep loss
Palmer, C. A., & Alfano, C. A. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.12.001 · Cited by 33 · see citing works
Anxiolytic Effect of Increased NREM Sleep after Acute Social Defeat Stress in Mice
Feng, X., Zhao, H., Shao, Y., Lou, H., Zhu, L., Duan, S., & Yu, Y. (2020) · Neuroscience Bulletin · doi:10.1007/s12264-020-00473-y · Cited by 33 · see citing works
Monitoring Daily Sleep, Mood, and Affect Using Digital Technologies and Wearables: A Systematic Review
Hickman, R., D’Oliveira, T. C., Davies, A., & Shergill, S. S. (2024) · Sensors · doi:10.3390/s24144701 · Cited by 34 · see citing works
Prediction of depressive symptoms severity based on sleep quality, anxiety, and gray matter volume: a generalizable machine learning approach across three datasets
Olfati, M., Samea, F., Faghihroohi, S., Balajoo, S. M., Küppers, V., Genon, S., Patil, K. R., Eickhoff, S. B., & Tahmasian, M. (2024) · EBioMedicine · doi:10.1016/j.ebiom.2024.105313 · Cited by 31 · see citing works
How Smart Is It to Go to Bed with the Phone? The Impact of Short-Wavelength Light and Affective States on Sleep and Circadian Rhythms
Schmid, S. R., Höhn, C., Bothe, K., Plamberger, C., Angerer, M., Pletzer, B. A., & Hoedlmoser, K. (2021) · Clocks & Sleep · doi:10.3390/clockssleep3040040 · Cited by 32 · see citing works
Daily Relations Between Stress and Electroencephalography-Assessed Sleep: A 15-Day Intensive Longitudinal Design With Ecological Momentary Assessments
Yap, Y., Tung, N. Y. C., Collins, J., Phillips, A. J. K., Bei, B., & Wiley, J. F. (2022) · Annals of Behavioral Medicine · doi:10.1093/abm/kaac017 · Cited by 31 · see citing works
“For example, a recent study suggested the anxiolytic benefits of SWS, as longer SWS was associated with higher medial pre-frontal cortex activity (important for emotional regulation) and lower self-reported anxiety levels [14].”
BackgroundResultInfluential
The Negative Effects of Travel on Student Athletes Through Sleep and Circadian Disruption
Heller, H. C., Herzog, E. D., Brager, A. J., Poe, G. R., Allada, R., Scheer, F. A. J. L., Carskadon, M. A., de la Iglesia, H. O., Jang, R. S., Montero, A., et al. (2023) · Journal of Biological Rhythms · doi:10.1177/07487304231207330 · Cited by 30 · see citing works
Self-citation
Sleep deprivation-induced anxiety-like behaviors are associated with alterations in the gut microbiota and metabolites
Zhang, N., Gao, X., Li, Y., Xu, L., Zhou, G., Xu, M., Peng, L., Sun, G., Pan, F., Li, Y., et al. (2024) · Microbiology Spectrum · doi:10.1128/spectrum.01437-23 · Cited by 30 · see citing works
Motive control of unconscious inference: The limbic base of adaptive Bayes
Tucker, D. M., & Luu, P. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.05.029 · Cited by 28 · see citing works
“However, the reverse causality, where sleep restriction leads to increased anxiety, is not intuitive, but is now well documented (Simon et al., 2020).”
Background
Physicians prescribe fewer analgesics during night shifts than day shifts
Choshen‐Hillel, S., Sadras, I., Gordon‐Hecker, T., Genzer, S., Rekhtman, D., Caruso, E. M., Clements, K. L., Ohler, A., Gozal, D., Israel, S., et al. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2200047119 · Cited by 26 · see citing works
Uncovering the effects and mechanisms of tea and its components on depression, anxiety, and sleep disorders: A comprehensive review
Han, Z., Wang, L., Zhu, H., Tu, Y., He, P., & Li, B. (2024) · Food Research International · doi:10.1016/j.foodres.2024.115191 · Cited by 27 · see citing works
Gut Bless Your Pain—Roles of the Gut Microbiota, Sleep, and Melatonin in Chronic Orofacial Pain and Depression
Lassmann, Ł., Pollis, M., Żółtowska, A., & Manfredini, D. (2022) · Biomedicines · doi:10.3390/biomedicines10071528 · Cited by 25 · see citing works
“Non-rapid eye movement slow-wave oscillations (NREM-SW) also offer an ameliorating, anxiolytic benefit [38], but the role of NREM sleep can be considered separate from that”
Background
Memory control deficits in the sleep-deprived human brain
Harrington, M. O., Karapanagiotidis, T., Phillips, L., Smallwood, J., Anderson, M. C., & Cairney, S. A. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2400743122 · Cited by 24 · see citing works
The impact of sleep quality on the incidence of PTSD: Results from a 7-Year, Nationally Representative, Prospective Cohort of U.S. Military Veterans
DeViva, J. C., McCarthy, E., Southwick, S. M., Tsai, J., & Pietrzak, R. H. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102413 · Cited by 23 · see citing works
The relationship of fear-potentiated startle and polysomnography-measured sleep in trauma-exposed men and women with and without PTSD: testing REM sleep effects and exploring the roles of an integrative measure of sleep, PTSD symptoms, and biological sex
Richards, A. L., Inslicht, S. S., Yack, L. M., Metzler, T. J., Huie, J. R., Straus, L. D., Dukes, C., Hubachek, S. Q., Felmingham, K. L., Mathalon, D. H., et al. (2021) · SLEEP · doi:10.1093/sleep/zsab271 · Cited by 22 · see citing works
Left superior temporal sulcus morphometry mediates the impact of anxiety and depressive symptoms on sleep quality in healthy adults
Wang, Y., Jiang, P., Tang, S., Lu, L., Bu, X., Zhang, L., Gao, Y., Li, H., Hu, X., Wang, S., et al. (2021) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsab012 · Cited by 21 · see citing works
Ubi-SleepNet
Zhai, B., Guan, Y., Catt, M., & Plötz, T. (2021) · Proceedings of the ACM on Interactive Mobile Wearable and Ubiquitous Technologies · doi:10.1145/3494961 · Cited by 21 · see citing works
“It is a physiological process essential to maintain life and health [71], and it plays a major role in repairing the body tissues, removing toxic metabolic waste products from the brain, consolidating memory, restoring energy and enhancing immune defence [7, 10, 23, 57, 65].”
Background
Effectivity of (Personalized) Cognitive Behavioral Therapy for Insomnia in Mental Health Populations and the Elderly: An Overview
Mijnster, T., Boersma, G. J., Meijer, E., & Lancel, M. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12071070 · Cited by 22 · see citing works
The status and risk factors for anxiety/depression in patients with atrophic chronic gastritis: a cross-sectional study
Wu, H., Liang, G., Kong, M., Zhang, Y., Zhou, Y., Han, J., Hu, X., Li, Y., Li, Y., Qi, Z., et al. (2022) · Annals of Palliative Medicine · doi:10.21037/apm-22-730 · Cited by 21 · see citing works
Emotional Processing Following Digital Cognitive Behavioral Therapy for Insomnia in People With Depressive Symptoms
Tamm, S., Tse, K. Y. K., Hellier, J. M., Saunders, K. E. A., Harmer, C. J., Espie, C. A., Reid, M. J., & Kyle, S. D. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.61502 · Cited by 20 · see citing works
Sleep essentialism
Walker, M. P. (2021) · Brain · doi:10.1093/brain/awab026 · Cited by 20 · see citing works
Self-citation
Genome-wide association analysis of composite sleep health scores in 413,904 individuals
Goodman, M. O., Faquih, T. O., Paz, V., Nagarajan, P., Lane, J. M., Spitzer, B., Maher, M., Chung, J., Cade, B. E., Purcell, S., et al. (2025) · Communications Biology · doi:10.1038/s42003-025-07514-0 · Cited by 19 · see citing works
“We have added specific details of the effects as reviewer suggested.”
Intermittent Hypoxia Activates N-Methyl-D-Aspartate Receptors to Induce Anxiety Behaviors in a Mouse Model of Sleep-Associated Apnea
Fan, Y., Chou, M., Liu, Y., Liu, C.-K., Chen, C., & Chen, S. (2021) · Molecular Neurobiology · doi:10.1007/s12035-021-02321-0 · Cited by 18 · see citing works
Temporal network of experience sampling methodology identifies sleep disturbance as a central symptom in generalized anxiety disorder
Peng, J., Yuan, S., Wei, Z., Liu, C., Li, K., Wei, X., Yuan, S., Guo, Z., Wu, L., Feng, T., et al. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05698-z · Cited by 19 · see citing works
The new science of sleep: From cells to large-scale societies
Sharon, O., Simon, E. B., Shah, V. D., Desel, T., & Walker, M. P. (2024) · PLoS Biology · doi:10.1371/journal.pbio.3002684 · Cited by 17 · see citing works
Self-citation
Emotion Regulation Failures Are Preceded by Local Increases in Sleep-like Activity
Avvenuti, G., Bertelloni, D., Lettieri, G., Ricciardi, E., Cecchetti, L., Pietrini, P., & Bernardi, G. (2021) · Journal of Cognitive Neuroscience · doi:10.1162/jocn_a_01753 · Cited by 17 · see citing works
Sympathetic Neural Control in Humans with Anxiety‐Related Disorders
Bigalke, J. A., & Carter, J. R. (2021) · Comprehensive physiology · doi:10.1002/cphy.c210027 · Cited by 26 · see citing works
Functional connectivity of the left inferior parietal lobule mediates the impact of anxiety and depression symptoms on sleep quality in healthy adults
Lai, M., Gao, Y., Lu, L., Huang, X., Gong, Q., Li, J., & Jiang, P. (2023) · Cerebral Cortex · doi:10.1093/cercor/bhad253 · Cited by 18 · see citing works
Risk factors and prediction model of sleep disturbance in patients with maintenance hemodialysis: A single center study
Xu, R., Miao, L., Ni, J., Ding, Y., Song, Y., Yang, C. Z., Zhu, B., & Jiang, R. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.955352 · Cited by 15 · see citing works
“It has been well recognized that sleep deprivation can lead to anxiety (41), which in turn can contribute to decreased sleep quality (42).”
Background
Sleep spindles, stress and PTSD: The state of the science and future directions
Natraj, N., & Richards, A. L. (2023) · Neurobiology of Stress · doi:10.1016/j.ynstr.2023.100516 · Cited by 15 · see citing works
Hypogyrification in Generalized Anxiety Disorder and Associated with Insomnia Symptoms
Zhang, T., Xie, X., Li, Q., Zhang, L., Chen, Y., Ji, G., Hou, Q., Li, T., Zhu, C., Tian, Y., et al. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s358763 · Cited by 16 · see citing works
Alzheimer′s disease with sleep insufficiency: a cross-sectional study on correlations among clinical characteristics, orexin, its receptors, and the blood-brain barrier
Guo, P. F., Zhang, W., Lian, T., Zhang, W.-J., He, M., Zhang, Y.-N., Huang, Y. M., Ding, D.-Y., Guan, H., Li, J., et al. (2022) · Neural Regeneration Research · doi:10.4103/1673-5374.360250 · Cited by 14 · see citing works
“In SI, activity of medial prefrontal cortex and its connection with the limbic region were low, and this was accompanied by hyperactivity of the amygdala and prefrontal cortex and higher anxiety (Ben Simon et al., 2020).”
Dexmedetomidine Improves Anxiety-like Behaviors in Sleep-Deprived Mice by Inhibiting the p38/MSK1/NFκB Pathway and Reducing Inflammation and Oxidative Stress
Li, J., Zhang, H., Deng, B., Wang, X., Peng, L., Xu, S., Jing, Z., Xiao, Z., Sun, L., Gao, C., et al. (2023) · Brain Sciences · doi:10.3390/brainsci13071058 · Cited by 15 · see citing works
Altered sleep behavior in a genetic mouse model of impaired fear extinction
Fritz, E. M., Kreuzer, M., Altunkaya, A., Singewald, N., & Fenzl, T. (2021) · Scientific Reports · doi:10.1038/s41598-021-88475-2 · Cited by 15 · see citing works
An examination of bidirectional associations between physical activity and mood symptoms among individuals diagnosed and at risk for bipolar spectrum disorders
Walsh, R. F. L., Smith, L. T., Klugman, J., Titone, M. K., Ng, T. H., Goel, N., & Alloy, L. B. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104255 · Cited by 15 · see citing works
Sleep and Neuroaffective Development from Early to Late Adolescence
Baker, A. E., & McMakin, D. L. (2024) · Annual Review of Developmental Psychology · doi:10.1146/annurev-devpsych-010923-093914 · Cited by 12 · see citing works
The Effect of Perceived Stress on Insomnia Symptoms Among College Students: A Moderated Mediation Model
Lu, Z., Li, Y., Yan, Z., Qing-song, S., & Sun, W. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s471776 · Cited by 13 · see citing works
“15,16 Combining the physical and psychological effects of stress, stress can be interpreted as a predictor of insomnia symptoms.”
Background
Noradrenergic dysregulation in the locus coeruleus: Implications for neuropsychiatric disease pathophysiology- A systematic review
Mir, F. A., Jha, S. K., & Nehs, C. J. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106442 · Cited by 16 · see citing works
State-dependent and region-specific alterations of cerebellar connectivity across stable human wakefulness and NREM sleep states
Liu, J., Zou, G., Xu, J., Zhou, S., Qin, L., Sun, H., Zou, Q., & Gao, J. (2022) · NeuroImage · doi:10.1016/j.neuroimage.2022.119823 · Cited by 13 · see citing works
“Neocortico-cerebellar and subcortico-cerebellar networks are also involved in a wide range of cognitive functions, such as learning [27,28] and emotion regulation [4,29], which also require ̳offline‘ information processing during sleep [2,5].”
Background
Effect of fear of missing out on learning burnout in medical students: a moderated mediation
Ye, X., Li, Y., Liu, Y., Zheng, Q., Lin, Z., Zeng, Y., Lin, Z., Zhu, T., Chen, X., Chen, L., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1289906 · Cited by 18 · see citing works
Developmental alcohol exposure is exhausting: Sleep and the enduring consequences of alcohol exposure during development
Wilson, D. A., Sullivan, R. M., Smiley, J. F., Saito, M., & Raineki, C. (2024) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2024.105567 · Cited by 12 · see citing works
Analysis of Factors That Influenced the Mental Health Status of Public Health Workers During the COVID-19 Epidemic Based on Bayesian Networks: A Cross-Sectional Study
Peng, X., Pu, Y., Jiang, X., Zheng, Q., Gu, J., Zhou, H., & Deng, D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.755347 · Cited by 12 · see citing works
The utility of wearable headband electroencephalography and pulse photoplethysmography to assess cortical and physiological arousal in individuals with stress‐related mental disorders
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Gray matter volume alterations in de novo Parkinson's disease: A mediational role in the interplay between sleep quality and anxiety
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“30 Although our study was constrained by a modest sample size, the observed GMV changes in the FG and ITG are noteworthy and consistent with the anticipated neuroanatomical patterns in A-PD.”
BackgroundInfluential
Insomnia symptoms as long-term predictors of anxiety symptoms in middle-aged and older adults from the English Longitudinal Study of Ageing (ELSA), and the role of systemic inflammation
Zagaria, A., & Ballesio, A. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.09.020 · Cited by 9 · see citing works
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Sympathetic Neural Control in Humans with Anxiety‐Related Disorders
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Under slept and overanxious: the neural correlates of sleep-loss induced anxiety in the human brain
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The Impact of Sleep Deprivation on Anxiety and Affective Brain Function
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Impaired slow-wave sleep accounts for brain aging-related increases in anxiety
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Self-citation

Authors: Ben Simon, E., Rossi, A., Harvey, A. G., & Walker, M. P.
Affiliations: University of California, Berkeley (US)
Corresponding author: Walker, Matthew P.
ORCID: Ben Simon, Eti
Harvey, Allison G.
Walker, Matthew P.
Venue: Nature Human Behaviour
Publisher: Springer Science and Business Media LLC
Published: 2019-11-04
Volume: 4
Issue: 1
Pages: 100-110
ISSN: 2397-3374 (ISSN-L)
DOI: 10.1038/s41562-019-0754-8
OpenAlex: W2987569059
Cited by: 177
References: 96
Citations by year: 2026: 24 · 2025: 32 · 2024: 30 · 2023: 19 · 2022: 23 · 2021: 33 · 2020: 14 · 2019: 2
FWCI: 10.47
Type: journal article
Language: en
Update notices: correction (2020-11-30)
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Nature Human Behaviour (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Funders: National Institute on Aging (RF1AG054019, R01AG015019, R01AG031164)
National Institute of Mental Health (R01MH093537)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords: sleep deprivation, anxiety, medial prefrontal cortex, limbic system
MeSH terms: Adult, Amygdala, Anxiety, Anxiety Disorders, Electroencephalography, Female, Humans, Limbic System, Magnetic Resonance Imaging, Male, Nerve Net, Sleep Deprivation, Sleep Stages, Prefrontal Cortex, Young Adult, Functional Neuroimaging

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