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Exploring the Association Between Psychological Inflexibility, Experiential Avoidance and Sleep-Related Problems
María Paula Zalamea-Delgado1, Estela Jiménez-López2,3, Arthur Eumann Mesas2
1School of Medicine, Universidad Espíritu Santo, Samborondón, Guayaquil 0901952, Ecuador.
Healthcare (Basel, Switzerland)
|July 28, 2026
Summary
Psychological inflexibility and experiential avoidance are linked to increased sleep problems in adolescents, including bedtime issues and daytime sleepiness. Further research is needed to confirm these associations.
Area of Science:
- Psychology
- Sleep Medicine
- Adolescent Health
Background:
- Adolescence is a critical developmental period with significant sleep changes, heightening vulnerability to sleep disturbances.
- Psychological inflexibility (PI) and experiential avoidance (EA) are linked to poor sleep in adults, but adolescent data is limited.
- This study investigates the relationship between PI, EA, and sleep issues in Spanish adolescents.
Purpose of the Study:
- To examine the association between psychological inflexibility, experiential avoidance, and sleep-related problems in a Spanish adolescent population.
- To assess the impact of PI and EA on various sleep domains, including bedtime, daytime sleepiness, awakenings, and sleep regularity/duration.
- To contribute to the understanding of mental health factors influencing adolescent sleep patterns.
Main Methods:
- Cross-sectional analysis of 623 adolescents (aged 12-17) from the Eating Healthy and Daily Life Activities (EHDLA) study.
- Psychological inflexibility and experiential avoidance assessed using the Spanish-validated Acceptance and Action Questionnaire-II (AAQ-II).
- Sleep-related problems screened using the BEARS questionnaire, with generalized linear models adjusted for covariates.
Main Results:
- Higher AAQ-II scores were significantly associated with increased odds of bedtime problems, excessive daytime sleepiness, nocturnal awakenings, and irregular/short sleep duration.
- Each point increase in AAQ-II score correlated with a 1.2% higher probability of reporting any sleep problem (p < 0.001).
- No significant association was found between AAQ-II scores and snoring.
Conclusions:
- Psychological inflexibility and experiential avoidance are positively associated with multiple sleep-related problems in adolescents.
- Findings suggest a link between certain psychological factors and adolescent sleep disturbances.
- Longitudinal and intervention studies are recommended to establish causality and inform clinical practice.
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