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Cited by 165Sleep and related disordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMindfulness and Compassion Interventions

The association between worry and rumination with sleep in non-clinical populations: A systematic review and meta-analysis

Clancy, F., Prestwich, A., Caperon, L., Tsipa, A., O’Connor, D. B.·2020·Health Psychology Review
DOI 10.1080/17437199.2019.1700819
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Abstract

Associations have been found between perseverative cognition (PC: worry and rumination) and somatic markers of ill-health. Further studies have reported associations between sleep and both PC and poorer health. As such, sleep disturbance may represent a pathway between PC and ill-health. Therefore, studies assessing the relationship between PC and sleep in non-clinical populations were synthesised. Meta-analyses (k = 55) revealed small- to medium-sized associations between higher PC and poorer sleep quality (SQ, r = −0.28), shorter total sleep time (TST, r = −0.15) and longer sleep onset latency (SOL, r = −0.16). Variations included associations between SQ and rumination (r = −.33) and worry (r = −.23). Associations were stronger in studies measuring SQ via self-report rather than actigraphy, and where SOL and TST outcomes were cross-sectional. Associations with SOL were stronger when outcomes were from non-diary studies and when trait, rather than state PC, was measured, but weaker where studies incorporated more measures of PC. Effect sizes were generally larger where studies were higher quality and being female may act as a protective factor between PC and longer SOL. Therefore, there is a consistent association between PC and sleep which may partially explain the link between PC and ill-health.

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  • Cognitive processes play a major role in the onset and maintenance of sleep onset anxiety, particularly through patterns of rumination and worry.

    “Cognitive processes play a major role in the onset and maintenance of sleep onset anxiety, particularly through pa erns of rumination and worry [10].”

    From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [10]

    The Sleep Onset Latency section reports that both worry and rumination are associated with taking longer to fall asleep. But the paper examines sleep outcomes, not the onset or maintenance of sleep-onset anxiety; its discussion also says the causal direction between repetitive thinking and sleep is unknown. The claim therefore overstates what the review establishes. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • Worry involves perseverative thinking about future threats.

    “worry, which involves perseverative thinking about future threats [95,96]”

    From 10-Week Trajectories of Candidate Psychological Processes Differentially Predict Mental Health Gains from Online Dyadic versus Mindfulness Interventions: A Randomized Clinical Trial (2024) · cites this paper as [95]

  • Rumination and worry have significant associations with polysomnographic indices of disrupted sleep, and sleep disturbances, both in healthy people and in insomnia patients.

    “Rumination and worry are the two best-known aspects of repetitive thought (43), that have significant associations with polysomnographic indices of disrupted sleep (44), and sleep disturbances, both in healthy people (45), and in insomnia patients (46).”

    From The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia (2023) · cites this paper as [45]

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1 of the 100 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. *Kocoglu, D., Akin, B., Cingil, D., & Sari, E. (2013). Insomnia in rural communities and dysfunctional beliefs and attitudes about sleep as a risk factor of insomnia. Journal of Cognitive & Behavioral Psychotherapies, 13, 211 -225.
  2. Lauderdale, D. S., Knutson, K. L., Yan, L. L., Liu, K., & Rathouz, P. J. (2008). Sleep duration: How well do self -reports reflect objective measures? The cardia sleep study. Epidemiology, 19 (6), 838 -845.
  3. O'Connor, D. B., Armitage, C. J., & Ferguson, E. (2014). Randomized test of an implementation intention -based tool to reduce stress -induced eating. Annals of Behavioral Medicine, 49 (3), 331 -343.
  4. *Rodríguez -Muñoz, A., Notelaers, G., & Moreno -Jiménez, B. (2011). Workplace bullying and sleep quality: The mediating role of worry and need for recovery. Psicologia Conductual, 19 (2), 453 -469.

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Authors
Clancy, F., Prestwich, A., Caperon, L., Tsipa, A., & O’Connor, D. B.
Affiliations
  • University of Leeds (GB)
  • School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
Corresponding author
Clancy, F.
ORCID
Venue
Health Psychology Review
Publisher
Informa UK Limited
Published
2020-01-20
Volume
14
Issue
4
Pages
427-448
ISSN
  • 1743-7199 (ISSN-L)
  • 1743-7202
DOI
10.1080/17437199.2019.1700819
OpenAlex
W2999483757
Cited by
165
References
100
Citations by year
2026: 33 · 2025: 37 · 2024: 23 · 2023: 24 · 2022: 28 · 2021: 12 · 2020: 7
FWCI
2.59
Type
journal article
Language
en
Open access
closed
Locations
  • Health Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Funders
Economic and Social Research Council (1497400)
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 › Mindfulness and Compassion Interventions
Keywords
worry, rumination, perseverative cognition, sleep quality, total sleep time, sleep latency, sleep disorders, non-clinical population, sex differences, health outcomes
MeSH terms
Rumination, Cognitive, Anxiety, Humans, Sleep, Sleep Wake Disorders, Stress, Psychological

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