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. 2020 Mar:67:39-46.
doi: 10.1016/j.sleep.2019.10.018. Epub 2019 Nov 14.

The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report

Altanzul Narmandakh  1 , Annelieke M Roest  2 , Peter de Jonge  2 , Albertine J Oldehinkel  3
Affiliations

The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report

Altanzul Narmandakh et al. Sleep Med. 2020 Mar.

Abstract

Background: Previous studies have suggested a bidirectional association between sleep problems and anxiety symptoms in adolescents. These studies used methods that do not separate between-person effects from within-person effects, and therefore their conclusions may not pertain to within-person mutual influences of sleep and anxiety. We examined bidirectional associations between sleep problems and anxiety during adolescence and young adulthood while differentiating between person effects from within-person effects.

Methods: Data came from the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study including six waves of data spanning 15 years. Young adolescents (N = 2230, mean age at baseline 11.1 years) were followed every 2-3 years until young adulthood (mean age 25.6 years). Sleep problems and anxiety symptoms were measured by the Youth Self-Report, Adult Self-Report and Nottingham Health Profile. Temporal associations between sleep and anxiety were investigated using the random intercept cross-lagged panel model.

Results: Across individuals, sleep problems were significantly associated with (β = 0.60, p < 0.001). At the within-person level, there were significant cross-sectional associations between sleep problems and anxiety symptoms at all waves (β = 0.12-0.34, p < 0.001). In addition, poor sleep predicted greater anxiety symptoms between the first and second, and between the third and fourth assessment wave. The reverse association was not statistically significant.

Conclusions: Within-person associations between sleep problems and anxiety are considerably weaker than between-person associations. Yet, our findings tentatively suggest that poor sleep, especially during early and mid-adolescence, may precede anxiety symptoms, and that anxiety might be prevented by alleviating sleep problems in young adolescents.

Keywords: Anxiety symptoms; Bidirectional association; Random intercept cross-lagged panel model; Sleep problems.

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