Research
Mixed
Insomnia is bidirectionally related to anxiety and depression, meaning insomnia predicts the onset of these mental health conditions and vice versa.
If you suffer from chronic insomnia, it is critical to screen for and treat anxiety or depression, as they likely fuel each other. Conversely, treating sleep problems may prevent the development of these mental health conditions. Do not treat sleep and mental health in isolation.
ModerateSupportsMEDIUM confidence
Best available evidence suggests that insomnia is bidirectionally related to anxiety and depression.
Why this rating
Based on a systematic review of 9 studies (8 longitudinal), but limited by heterogeneity and small sample sizes for specific subtypes.
Source
A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression
Pasquale K. Alvaro et al. · SLEEP · 2013
DOI 10.5665/sleep.2810
systematic_reviewCited 1,526×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Childhood sleep problems predict higher levels of depression and anxiety, but this relationship is not bidirectional (depression does not predict childhood sleep problems).Moderate
- Excessive daytime sleepiness (EDS) is not bidirectionally related to depression; anxiety predicts EDS, but EDS does not predict depression.Limited
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →