Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders

Background: Depression and anxiety disorders are highly prevalent among young adults, with evidence suggesting sleep problems as key risk factors. Objective: This study aimed to examine the association between insomnia and sleep characteristics with major depressive episode (MDE) and anxiety disorde...

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Main Authors: Mari Hysing, Allison G. Harvey, Ann Kristin Skrindo Knudsen, Jens C. Skogen, Anne Reneflot, Børge Sivertsen
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:Sleep Medicine: X
Online Access:http://www.sciencedirect.com/science/article/pii/S2590142725000011
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author Mari Hysing
Allison G. Harvey
Ann Kristin Skrindo Knudsen
Jens C. Skogen
Anne Reneflot
Børge Sivertsen
author_facet Mari Hysing
Allison G. Harvey
Ann Kristin Skrindo Knudsen
Jens C. Skogen
Anne Reneflot
Børge Sivertsen
author_sort Mari Hysing
collection DOAJ
description Background: Depression and anxiety disorders are highly prevalent among young adults, with evidence suggesting sleep problems as key risk factors. Objective: This study aimed to examine the association between insomnia and sleep characteristics with major depressive episode (MDE) and anxiety disorders, and the association after accounting for baseline mental health symptoms. Methods: We conducted a prospective cohort study using data from the Students’ Health and Wellbeing Study (SHoT), surveying Norwegian higher education students aged 18 to 35 (N = 53,362). A diagnostic assessment of 10,460 participants was conducted in 2023. Self-reported insomnia, sleep duration, sleep onset latency, and wake after sleep onset were recorded in 2022. MDE and five types of anxiety disorders were assessed after one year using a self-administered CIDI 5.0. Analyses adjusted for age, sex, baseline mental health symptoms, and somatic conditions. Results: Insomnia in young adults was associated with a significantly increased risk of MDE (adjusted RR = 3.50, 95 % CI = 3.18–3.84) and generalized anxiety disorder (GAD) (adjusted RR = 2.82, 95 % CI = 2.55–3.12) one year later. Sleep duration showed a reversed J-shaped association with mental disorders, with both short and, to a lesser extent, long sleep durations linked to elevated risks, even after adjusting for baseline mental health symptoms and somatic conditions. Although the associations were attenuated after adjustment, they remained statistically significant. Conclusion: Sleep disturbances, including insomnia and abnormal sleep durations, predict mental health issues in young adults, even after accounting for baseline mental health and somatic health. Addressing sleep problems early may help prevent subsequent mental health conditions in this population.
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spelling doaj-art-7b45ee258a0d444396ffe6f1fece56a82025-01-23T05:27:42ZengElsevierSleep Medicine: X2590-14272025-12-019100138Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disordersMari Hysing0Allison G. Harvey1Ann Kristin Skrindo Knudsen2Jens C. Skogen3Anne Reneflot4Børge Sivertsen5Department of Psychosocial Science, University of Bergen, Bergen, Norway; Corresponding author. Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Post box 7807, 5020 BERGEN, Norway.Department of Psychology, University of California, Berkeley, CA, USADepartment of Disease Burden, Norwegian Institute of Public Health, Bergen, NorwayDepartment of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway; Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, NorwayDepartment of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, NorwayDepartment of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Department of Research & Innovation, Helse-Fonna HF, Haugesund, NorwayBackground: Depression and anxiety disorders are highly prevalent among young adults, with evidence suggesting sleep problems as key risk factors. Objective: This study aimed to examine the association between insomnia and sleep characteristics with major depressive episode (MDE) and anxiety disorders, and the association after accounting for baseline mental health symptoms. Methods: We conducted a prospective cohort study using data from the Students’ Health and Wellbeing Study (SHoT), surveying Norwegian higher education students aged 18 to 35 (N = 53,362). A diagnostic assessment of 10,460 participants was conducted in 2023. Self-reported insomnia, sleep duration, sleep onset latency, and wake after sleep onset were recorded in 2022. MDE and five types of anxiety disorders were assessed after one year using a self-administered CIDI 5.0. Analyses adjusted for age, sex, baseline mental health symptoms, and somatic conditions. Results: Insomnia in young adults was associated with a significantly increased risk of MDE (adjusted RR = 3.50, 95 % CI = 3.18–3.84) and generalized anxiety disorder (GAD) (adjusted RR = 2.82, 95 % CI = 2.55–3.12) one year later. Sleep duration showed a reversed J-shaped association with mental disorders, with both short and, to a lesser extent, long sleep durations linked to elevated risks, even after adjusting for baseline mental health symptoms and somatic conditions. Although the associations were attenuated after adjustment, they remained statistically significant. Conclusion: Sleep disturbances, including insomnia and abnormal sleep durations, predict mental health issues in young adults, even after accounting for baseline mental health and somatic health. Addressing sleep problems early may help prevent subsequent mental health conditions in this population.http://www.sciencedirect.com/science/article/pii/S2590142725000011
spellingShingle Mari Hysing
Allison G. Harvey
Ann Kristin Skrindo Knudsen
Jens C. Skogen
Anne Reneflot
Børge Sivertsen
Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
Sleep Medicine: X
title Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
title_full Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
title_fullStr Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
title_full_unstemmed Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
title_short Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
title_sort mind at rest mind at risk a prospective population based study of sleep and subsequent mental disorders
url http://www.sciencedirect.com/science/article/pii/S2590142725000011
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