Does insomnia increase anxiety?
Yes. In a 2019 meta-analysis of long-term studies, people with insomnia had about three times the odds of later developing an anxiety disorder. Researchers point to both physiological stress (hyperarousal) and worry during wakeful nights.
Risk data
Hertenstein et al. (2019) pooled studies that followed people for at least a year. Insomnia at the start predicted later anxiety disorders (odds ratio 3.23, six studies) and depression (odds ratio 2.83, ten studies).
The mechanism
Insomnia is associated with a state of hyperarousal, including activity in the body's stress system (the hypothalamic-pituitary-adrenal axis). Nighttime rumination can create a feedback loop: worry about sleep prevents sleep, which then validates the worry.
Breaking the cycle
CBT for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia, and some studies suggest it also eases anxiety symptoms.
Sources
- Hertenstein et al., Sleep Medicine Reviews, 2019. Insomnia as a predictor of mental disorders: a systematic review and meta-analysis
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