Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/79310
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Type: Journal article
Title: A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression
Author: Alvaro, P.
Roberts, R.
Harris, J.
Citation: Sleep, 2013; 36(7):1059-1068
Publisher: Amer Academy Sleep Medicine
Issue Date: 2013
ISSN: 0161-8105
1550-9109
Statement of
Responsibility: 
Pasquale K. Alvaro, Rachel M. Roberts and Jodie K. Harris
Abstract: STUDY OBJECTIVES: To investigate whether sleep disturbances are bidirectionally related to anxiety and depression, and thus identify potential risk factors for each problem. DESIGN: A systematic review was conducted on 9 studies (8 longitudinal, 1 retrospective) that assessed bidirectionality between a sleep disturbance, and anxiety or depression. Treatment studies were excluded, along with those solely based on clinical samples or cohorts at high risk of suffering from a sleep disturbance, anxiety and depression. Eligible studies were identified by searching PubMed, PsychINFO, Embase, and Scopus databases, and reference lists of eligible studies. Publication dates ranged from the beginning of each database to December 2011. MEASUREMENTS AND RESULTS: Syntheses of longitudinal studies suggested insomnia and sleep quality were bidirectionally related to anxiety and depression, and depression/anxiety, respectively. Childhood sleep problems significantly predicted higher levels of depression and a combined depression/anxiety variable, but not vice-versa. A one-way relationship was found where anxiety predicted excessive daytime sleepiness, but excessive daytime sleepiness was not associated with depression. CONCLUSIONS: Definitive conclusions regarding bidirectionality cannot be made for most sleep disturbances due to the small number and heterogeneity of cohort samples used across studies. Nevertheless, best available evidence suggests insomnia is bidirectionally related to anxiety and depression. Clinical and theoretical implications are discussed.
Keywords: Anxiety; depression; insomnia; sleep disturbances; systematic review; blue
Rights: © Copyright 2013 Associated Professional Sleep Societies, LLC
RMID: 0020130299
DOI: 10.5665/sleep.2810
Appears in Collections:Psychology publications

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