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Chronic Insomnia as a Risk Factor for Developing Anxiety and Depression
Open accessAbstract
STUDY OBJECTIVE: To study prospectively the relations of insomnia to the development of anxiety disorders and depression in a population-based sample. DESIGN: Cohort study based on data from 2 general health surveys of the adult population. SETTING: Two general health surveys in the adult population in Nord-Trøndelag County of Norway, HUNT-1 performed in 1984-6 and HUNT-2 in 1995-7 PARTICIPANTS: Participants without significant anxiety and depression in HUNT-1 were categorized according to the presence and absence of insomnia in the 2 surveys (N=25,130). MEASUREMENTS AND RESULTS: Anxiety disorders and depression in HUNT-2 were assessed by the Hospital Anxiety and Depression Scale and analyzed using multivariate logistic regression analysis adjusted for age, gender, education, comorbid depression/anxiety, and history of insomnia. Anxiety disorders in HUNT-2 were significantly associated with the group with insomnia in HUNT-1 only (OR 1.6; 95% CI, 1.1-2.3), the group with insomnia in HUNT-2 only (OR 3.4; 95% CI, 3.1-3.8), as well as with the group with insomnia in both surveys (OR 4.9; 95% CI, 3.8-6.4). Depression in HUNT-2 was significantly associated with the group with insomnia in HUNT-2 only (OR 1.8; 95% CI, 1.6-2.0), but not with the groups with insomnia in HUNT-1 only or with insomnia in both surveys. CONCLUSIONS: Only a state-like association between insomnia and depression was found. In addition to being a state marker, insomnia may be a trait marker for individuals at risk for developing anxiety disorders. Results are consistent with insomnia being a risk factor for the development of anxiety disorders.
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“Research indicates a bidirectional relationship between sleep and anxiety with findings suggesting anxiety can precede poor sleep and vice versa.”
From Do non-pharmacological sleep interventions affect anxiety symptoms? A meta-analysis (2022) · cites this paper as Neckelmann et al., 2007
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Metadata
- Authors
- Neckelmann, D., Mykletun, A., & Dahl, A. A.
- Affiliations
- Haukeland University Hospital (NO)
- Norwegian Institute of Public Health (NO)
- University of Oslo (NO)
- Corresponding author
- Neckelmann, Dag
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-07
- Volume
- 30
- Issue
- 7
- Pages
- 873-880
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC1978360
- OpenAlex
- W1526225438
- Cited by
- 665
- References
- 46
- Citations by year
- 2026: 24 · 2025: 28 · 2024: 40 · 2023: 49 · 2022: 49 · 2021: 47 · 2020: 37 · 2019: 40 · 2018: 31 · 2017: 39 · 2016: 26 · 2015: 37 · 2014: 45 · 2013: 29 · 2012: 39
- FWCI
- 32.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Norges Teknisk-Naturvitenskapelige Universitet
- Norwegian Institute of Public Health
- 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
- chronic insomnia, anxiety disorders, depression, risk factors, prospective cohort, mental health, HUNT study
- MeSH terms
- Adult, Aged, Anxiety Disorders, Chronic Disease, Depressive Disorder, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Surveys and Questionnaires, Risk Factors
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