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Updated: Jul 13, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Chronic insomnia as a risk factor for developing anxiety and depression
Dag Neckelmann1, Arnstein Mykletun, Alv A Dahl
1Department of Psychiatry, Clinic ofPsychosomatic Medicine, Haukeland University Hospital, Bergen, Norway. dag.neckelmann@helse-bergen.no
Insomnia is a risk factor for developing anxiety disorders, but only a temporary association exists with depression. This study highlights insomnia
Area of Science:
- Psychiatry
- Epidemiology
- Sleep Medicine
Background:
- Insomnia is a common sleep disorder.
- Anxiety disorders and depression are prevalent mental health conditions.
- The relationship between insomnia and the development of these disorders requires further investigation.
Purpose of the Study:
- To prospectively examine the association between insomnia and the subsequent development of anxiety disorders and depression.
- To differentiate between state-like and trait-like associations of insomnia with these mental health conditions.
Main Methods:
- A prospective cohort study utilizing data from two large-scale Norwegian general health surveys (HUNT-1 and HUNT-2).
- Inclusion of 25,130 adult participants initially free from significant anxiety and depression.
- Assessment of insomnia, anxiety disorders, and depression using validated scales, with statistical analysis adjusted for relevant covariates.
Main Results:
- Insomnia in HUNT-1 was associated with anxiety disorders in HUNT-2 (OR 1.6).
- Insomnia present in HUNT-2 only (OR 3.4) or in both surveys (OR 4.9) showed a significant association with anxiety disorders in HUNT-2.
- Insomnia in HUNT-2 only was significantly associated with depression in HUNT-2 (OR 1.8), but insomnia in HUNT-1 only or in both surveys was not.
Conclusions:
- Insomnia appears to be a risk factor for the development of anxiety disorders, acting as both a state and a trait marker.
- The association between insomnia and depression is primarily state-like, suggesting it reflects a current condition rather than a long-term risk.
- These findings underscore the importance of addressing insomnia in the context of mental health.
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