Emotion regulation as a moderator between anxiety symptoms and insomnia symptom severity

Insomnia is a common concern with many associated negative consequences. Previous research has established bivariate relationships between anxiety symptoms, emotion regulation, and insomnia symptom severity; however, limited research has examined how the interaction between emotion regulation and anxiety symptoms may be associated with insomnia symptom severity. A sample of 468 undergraduate participants and a subsample of 136 participants meeting a self-reported cutoff score for insomnia, completed questionnaires assessing anxiety, insomnia symptom severity, and emotion regulation difficulties. Among the general sample of all participants, the interaction between anxiety symptoms and both overall emotion regulation difficulties and limited access to emotion regulation strategies were associated with insomnia symptom severity. However, among the insomnia subsample, emotion regulation moderated this relationship, such that insomnia symptom severity increased as anxiety symptoms increased among those with high emotion regulation difficulties, but were unaffected by changes in anxiety symptoms among those with low emotion regulation difficulties. These findings suggest that maladaptive emotion regulation may be necessary for anxiety symptoms to have a negative influence on sleep difficulties, meaning that during treatment, it may be important to address both an individual's anxiety symptoms and emotion regulation difficulties, particularly among those with clinical levels of insomnia.