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Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students
High perceived stress and anxiety disorders are usually comorbid with each other, with stress often sequentially preceding the development of anxiety. While prior findings showed a causal role of sleep problems in anxiety, no study has assessed the role of insomnia as a mediator in the relationship...
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Published in: | Nature and science of sleep 2021-01, Vol.13, p.31-38 |
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creator | Manzar, Md Dilshad Salahuddin, Mohammed Pandi-Perumal, Seithikurippu R Bahammam, Ahmed S |
description | High perceived stress and anxiety disorders are usually comorbid with each other, with stress often sequentially preceding the development of anxiety. While prior findings showed a causal role of sleep problems in anxiety, no study has assessed the role of insomnia as a mediator in the relationship between stress and anxiety.
A cross-sectional study on university students (n = 475, age = 21.1+2.6 years) was conducted over 3 months. Participants completed self-report measures of Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), Perceived Stress Scale-10 (PSS-10), generalized anxiety disorder-7 scale (GAD-7), and a sociodemographic tool. The mediation effect model given by Baron and Kelly was used to determine the relationship.
The prevalence of insomnia and anxiety disorder was 43.6% and 21.9%, respectively. Stress was significantly associated with LSEQ-M (insomnia measure) (b = -.44, SE = 0.16, p |
doi_str_mv | 10.2147/NSS.S278988 |
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A cross-sectional study on university students (n = 475, age = 21.1+2.6 years) was conducted over 3 months. Participants completed self-report measures of Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), Perceived Stress Scale-10 (PSS-10), generalized anxiety disorder-7 scale (GAD-7), and a sociodemographic tool. The mediation effect model given by Baron and Kelly was used to determine the relationship.
The prevalence of insomnia and anxiety disorder was 43.6% and 21.9%, respectively. Stress was significantly associated with LSEQ-M (insomnia measure) (b = -.44, SE = 0.16, p<0.01), and high levels of anxiety (b = 0.25, SE = 0.03, p < 0.01). The indirect effect of stress on anxiety through LSEQ-M (insomnia measure) was significant (95% confidence interval [0.01, 0.04]). However, the indirect effect of anxiety on stress through LSEQ-M (insomnia measure) was non-significant (95% confidence interval [-.01, 0.04]).
Students having higher perceived stress levels and comorbid insomnia were also likely to have a higher anxiety level.</description><identifier>ISSN: 1179-1608</identifier><identifier>EISSN: 1179-1608</identifier><identifier>DOI: 10.2147/NSS.S278988</identifier><identifier>PMID: 33447116</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Analysis ; Anxiety ; Child development ; College students ; Comorbidity ; Confidence intervals ; Cross-sectional studies ; Generalized anxiety disorder ; Insomnia ; Mediation ; mediator ; Original Research ; Questionnaires ; Sleep ; Statistical analysis ; Stress ; Stress (Psychology) ; Surveys ; University students ; Young adults</subject><ispartof>Nature and science of sleep, 2021-01, Vol.13, p.31-38</ispartof><rights>2021 Manzar et al.</rights><rights>COPYRIGHT 2021 Dove Medical Press Limited</rights><rights>2021. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Manzar et al. 2021 Manzar et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c607t-a31aeb27c30235e369c6eba1aa56559a5029b709b3c1f597494e923cd88c2fb43</citedby><cites>FETCH-LOGICAL-c607t-a31aeb27c30235e369c6eba1aa56559a5029b709b3c1f597494e923cd88c2fb43</cites><orcidid>0000-0001-7306-5989 ; 0000-0002-5571-3310 ; 0000-0002-1706-6167 ; 0000-0002-8686-7259</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2478480550/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2478480550?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33447116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manzar, Md Dilshad</creatorcontrib><creatorcontrib>Salahuddin, Mohammed</creatorcontrib><creatorcontrib>Pandi-Perumal, Seithikurippu R</creatorcontrib><creatorcontrib>Bahammam, Ahmed S</creatorcontrib><title>Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students</title><title>Nature and science of sleep</title><addtitle>Nat Sci Sleep</addtitle><description>High perceived stress and anxiety disorders are usually comorbid with each other, with stress often sequentially preceding the development of anxiety. While prior findings showed a causal role of sleep problems in anxiety, no study has assessed the role of insomnia as a mediator in the relationship between stress and anxiety.
A cross-sectional study on university students (n = 475, age = 21.1+2.6 years) was conducted over 3 months. Participants completed self-report measures of Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), Perceived Stress Scale-10 (PSS-10), generalized anxiety disorder-7 scale (GAD-7), and a sociodemographic tool. The mediation effect model given by Baron and Kelly was used to determine the relationship.
The prevalence of insomnia and anxiety disorder was 43.6% and 21.9%, respectively. Stress was significantly associated with LSEQ-M (insomnia measure) (b = -.44, SE = 0.16, p<0.01), and high levels of anxiety (b = 0.25, SE = 0.03, p < 0.01). The indirect effect of stress on anxiety through LSEQ-M (insomnia measure) was significant (95% confidence interval [0.01, 0.04]). However, the indirect effect of anxiety on stress through LSEQ-M (insomnia measure) was non-significant (95% confidence interval [-.01, 0.04]).
Students having higher perceived stress levels and comorbid insomnia were also likely to have a higher anxiety level.</description><subject>Analysis</subject><subject>Anxiety</subject><subject>Child development</subject><subject>College students</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Cross-sectional studies</subject><subject>Generalized anxiety disorder</subject><subject>Insomnia</subject><subject>Mediation</subject><subject>mediator</subject><subject>Original Research</subject><subject>Questionnaires</subject><subject>Sleep</subject><subject>Statistical analysis</subject><subject>Stress</subject><subject>Stress (Psychology)</subject><subject>Surveys</subject><subject>University students</subject><subject>Young adults</subject><issn>1179-1608</issn><issn>1179-1608</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkt-LEzEQxxdRvOO8J98lIIgirclmN9n4INTij8Kdwq33HLLZ2TZlm9RN9rz-92bbenbFJDBh8plvmOGbJM8JnqYk4---leW0THkhiuJRck4IFxPCcPH45H6WXHq_xnFRITjLniZnlGYZJ4SdJ9uF9W5jjULXaoeuoTYqAAorQDfQqmCc9SuzRR8h_AKwqAwdeI-UrdHM3hsIu_dohuad835Sgh541Uaqr3fIWHRrzR103oTdPgc2-GfJk0a1Hi6P8SK5_fzpx_zr5Or7l8V8djXRDPMwUZQoqFKuKU5pDpQJzaBSRKmc5blQOU5FxbGoqCZNLngmMhAp1XVR6LSpMnqRLA66tVNrue3MRnU76ZSR-4TrllJ1wegWJNeMUJrGo5usYqzCPCNENI3Gum54FbU-HLS2fbWBWsc-OtWORMcv1qzk0t1JXuCU8zwKvD4KdO5nDz7IjfEa2lZZcL2XacaLvGCCDOjLf9C167s41QOVFTjP8V9qqWIDxjYu_qsHUTljTHCBOWORmv6HiruGjdHOQmNiflTwZlQQmQD3Yal67-WivBmzr07YFag2rLxr-71nxuDbA6gHm3TQPAyOYDmYWEYTy6OJI_3idNYP7B_L0t99vunX</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Manzar, Md Dilshad</creator><creator>Salahuddin, Mohammed</creator><creator>Pandi-Perumal, Seithikurippu R</creator><creator>Bahammam, Ahmed S</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove</general><general>Dove Medical Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-7306-5989</orcidid><orcidid>https://orcid.org/0000-0002-5571-3310</orcidid><orcidid>https://orcid.org/0000-0002-1706-6167</orcidid><orcidid>https://orcid.org/0000-0002-8686-7259</orcidid></search><sort><creationdate>20210101</creationdate><title>Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students</title><author>Manzar, Md Dilshad ; Salahuddin, Mohammed ; Pandi-Perumal, Seithikurippu R ; Bahammam, Ahmed S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c607t-a31aeb27c30235e369c6eba1aa56559a5029b709b3c1f597494e923cd88c2fb43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analysis</topic><topic>Anxiety</topic><topic>Child development</topic><topic>College students</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Cross-sectional studies</topic><topic>Generalized anxiety disorder</topic><topic>Insomnia</topic><topic>Mediation</topic><topic>mediator</topic><topic>Original Research</topic><topic>Questionnaires</topic><topic>Sleep</topic><topic>Statistical analysis</topic><topic>Stress</topic><topic>Stress (Psychology)</topic><topic>Surveys</topic><topic>University students</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manzar, Md Dilshad</creatorcontrib><creatorcontrib>Salahuddin, Mohammed</creatorcontrib><creatorcontrib>Pandi-Perumal, Seithikurippu R</creatorcontrib><creatorcontrib>Bahammam, Ahmed S</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Nature and science of sleep</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manzar, Md Dilshad</au><au>Salahuddin, Mohammed</au><au>Pandi-Perumal, Seithikurippu R</au><au>Bahammam, Ahmed S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students</atitle><jtitle>Nature and science of sleep</jtitle><addtitle>Nat Sci Sleep</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>13</volume><spage>31</spage><epage>38</epage><pages>31-38</pages><issn>1179-1608</issn><eissn>1179-1608</eissn><abstract>High perceived stress and anxiety disorders are usually comorbid with each other, with stress often sequentially preceding the development of anxiety. While prior findings showed a causal role of sleep problems in anxiety, no study has assessed the role of insomnia as a mediator in the relationship between stress and anxiety.
A cross-sectional study on university students (n = 475, age = 21.1+2.6 years) was conducted over 3 months. Participants completed self-report measures of Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), Perceived Stress Scale-10 (PSS-10), generalized anxiety disorder-7 scale (GAD-7), and a sociodemographic tool. The mediation effect model given by Baron and Kelly was used to determine the relationship.
The prevalence of insomnia and anxiety disorder was 43.6% and 21.9%, respectively. Stress was significantly associated with LSEQ-M (insomnia measure) (b = -.44, SE = 0.16, p<0.01), and high levels of anxiety (b = 0.25, SE = 0.03, p < 0.01). The indirect effect of stress on anxiety through LSEQ-M (insomnia measure) was significant (95% confidence interval [0.01, 0.04]). However, the indirect effect of anxiety on stress through LSEQ-M (insomnia measure) was non-significant (95% confidence interval [-.01, 0.04]).
Students having higher perceived stress levels and comorbid insomnia were also likely to have a higher anxiety level.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>33447116</pmid><doi>10.2147/NSS.S278988</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7306-5989</orcidid><orcidid>https://orcid.org/0000-0002-5571-3310</orcidid><orcidid>https://orcid.org/0000-0002-1706-6167</orcidid><orcidid>https://orcid.org/0000-0002-8686-7259</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Analysis Anxiety Child development College students Comorbidity Confidence intervals Cross-sectional studies Generalized anxiety disorder Insomnia Mediation mediator Original Research Questionnaires Sleep Statistical analysis Stress Stress (Psychology) Surveys University students Young adults |
title | Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students |
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