The Role of Sleep Disturbances in Depression and Anxiety: A Literature Review

Abstract

Background. Sleep disturbances are among the most frequent comorbid symptoms of mood and anxiety disorders. Contemporary evidence indicates they are robust predictors and likely contributory factors in the onset, maintenance, and relapse of these conditions.

Objective. To review and synthesize contemporary evidence on the associations between sleep disturbances and depression and anxiety, focusing on epidemiological data, mechanistic insights, and treatment implications.

Methods. A narrative review was conducted using PubMed and PMC databases, covering the years 2011–2025. Keywords included sleep disturbance, insomnia, circadian rhythm, depression, and anxiety. Preference was given to meta-analyses, longitudinal studies, and randomized controlled trials (RCTs).

Results. Sleep problems, especially insomnia and short sleep duration, predict the onset of depression and anxiety, with odds ratios of approximately 2–3. Disturbances are bidirectionally linked with mood disorders through mechanisms such as hyperarousal, dysregulated circadian rhythms, altered neurotransmission, and inflammation. Interventions improving sleep—especially cognitive-behavioural therapy for insomnia (CBT-I) and digital CBT-I—produce small to moderate reductions in depressive and anxiety symptoms.

Conclusions. Sleep disturbances are not merely symptoms of psychiatric illness but modifiable risk factors and therapeutic targets. Integrating sleep-focused assessment and intervention into mental health and primary care can improve clinical outcomes and possibly prevent new-onset depression or anxiety.