Mechanisms underlying the association between anxiety and sleep architecture in healthy good sleepers: the role of pre-sleep arousal

Nicola Barclay, Greg Elder, Rachel Sharman, Alejandro Sanchez, Jason Ellis

Research output: Contribution to journalMeeting Abstractpeer-review

65 Citations (Scopus)


Objectives: Whilst clinically significant sleep disturbances are often comorbid with anxiety disorders, less extreme sleep disturbances are also associated with anxiety in the general population. However, understanding of the mechanism underlying this association is unclear. Associations between sleep architecture and anxiety, and the extent to which these associations were mediated by pre-sleep arousal, were examined in healthy, good sleepers.
Methods: Eighty five healthy, good sleepers (50.1% female; Age: M = 26.8 years, SD = 10.3 years) completed a 2-night in-lab polysomnographic study, the Hospital Anxiety and Depression Scale, and the Pre-Sleep Arousal Scale. Hierarchical linear regressions were performed to examine mediation models.
Results: Both increased anxiety and pre-sleep arousal were associated with decreased time in N1 (% of total sleep time) (r = - 0.25,P < 0.05; and r = - 0.29, P < 0.01, respectively); but increased time in REM (% of total sleep time) (r = 0.21, P = 0.05; and r = 0.24,P < 0.05, respectively). Hierarchical linear regressions indicated that these associations were reduced to non-significance in the presence of pre-sleep arousal.
Conclusions: Individuals with higher levels of state anxiety appear to spend more time in REM at the expense of stage 1 sleep –relationships which are mediated by heightened arousal. Such individuals may exhibit a greater REM requirement; or heightened arousal may continue throughout the night, manifesting in increased REM sleep. Decreased stage 1 sleep may thus be an artefact of subsequent increased REM. Alternatively; such individuals may exhibit more discrete transitions from wake to sleep, to some extent bypassing stage 1 sleep. Further analyses aim to determine whether such arousal is somatic, cognitive or cortical.
Original languageEnglish
Article numberP527
Pages (from-to)159-159
Number of pages1
JournalJournal of Sleep Research
Issue numberS1
Publication statusPublished - 1 Sept 2014


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