The relationship between anxiety and depression symptoms in insomnia patients: a network analysis

Abstract Anxiety and depressive symptoms are both common in insomnia patients, and they share a critical bidirectional relationship. The available research suggests that transitioning from a disorder-level analysis to a symptom-level analysis may provide a clearer understanding of these relationship...

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Main Authors: Yu Liu, Zirong Zhu, Jiaran Yan, Yuanyuan Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-09746-w
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author Yu Liu
Zirong Zhu
Jiaran Yan
Yuanyuan Wang
author_facet Yu Liu
Zirong Zhu
Jiaran Yan
Yuanyuan Wang
author_sort Yu Liu
collection DOAJ
description Abstract Anxiety and depressive symptoms are both common in insomnia patients, and they share a critical bidirectional relationship. The available research suggests that transitioning from a disorder-level analysis to a symptom-level analysis may provide a clearer understanding of these relationships. A total of 1571 insomnia patients were enrolled in this study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), anxiety symptoms were evaluated using the Hamilton Rating Scale for Anxiety (HAM-A), and depressive symptoms were evaluated using the Hamilton Rating Scale for Depression (HAM-D). Subsequently, a network analysis was conducted for the statistical analysis. Among the present sample, the prevalences of depression and anxiety were 87.1% and 88.0%, respectively. We found that the strongest regularized partial correlations existed in the network between “C3: Sleep duration” and “C4: Habitual sleep efficiency” (r = 0.91). Two other strong regularized partial correlations were observed between “B3: Cognitive disturbance” - “B7: Hopelessness” (r = 0.36), “A2: Psychic anxiety” - “B5: Retardation” (r = 0.28). In addition, the item “C3: Sleep duration” had the highest strength centrality in the network, followed by “C1: Subjective sleep quality”, “C4: Habitual sleep efficiency”, “A2: Psychic anxiety”, “B1: Anxiety/Somatization”. The findings highlight the crucial role of the strongest regularized partial correlations and bridge symptoms in relation to depression and anxiety. Targeted interventions for clinical control of anxiety and depressive symptoms in insomnia patients are promising.
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spelling doaj-art-c15e4ce3befa4ff3bf630b586f1eebf12025-08-20T03:04:25ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-09746-wThe relationship between anxiety and depression symptoms in insomnia patients: a network analysisYu Liu0Zirong Zhu1Jiaran Yan2Yuanyuan Wang3Department of Neurology, The Air Force Hospital of Northern Theater PLADepartment of Neurology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Nursing, The Air Force Hospital of Northern Theater PLADepartment of Neurology, The Air Force Hospital of Northern Theater PLAAbstract Anxiety and depressive symptoms are both common in insomnia patients, and they share a critical bidirectional relationship. The available research suggests that transitioning from a disorder-level analysis to a symptom-level analysis may provide a clearer understanding of these relationships. A total of 1571 insomnia patients were enrolled in this study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), anxiety symptoms were evaluated using the Hamilton Rating Scale for Anxiety (HAM-A), and depressive symptoms were evaluated using the Hamilton Rating Scale for Depression (HAM-D). Subsequently, a network analysis was conducted for the statistical analysis. Among the present sample, the prevalences of depression and anxiety were 87.1% and 88.0%, respectively. We found that the strongest regularized partial correlations existed in the network between “C3: Sleep duration” and “C4: Habitual sleep efficiency” (r = 0.91). Two other strong regularized partial correlations were observed between “B3: Cognitive disturbance” - “B7: Hopelessness” (r = 0.36), “A2: Psychic anxiety” - “B5: Retardation” (r = 0.28). In addition, the item “C3: Sleep duration” had the highest strength centrality in the network, followed by “C1: Subjective sleep quality”, “C4: Habitual sleep efficiency”, “A2: Psychic anxiety”, “B1: Anxiety/Somatization”. The findings highlight the crucial role of the strongest regularized partial correlations and bridge symptoms in relation to depression and anxiety. Targeted interventions for clinical control of anxiety and depressive symptoms in insomnia patients are promising.https://doi.org/10.1038/s41598-025-09746-wNetwork analysisInsomniaAnxietyDepressionBridge symptoms
spellingShingle Yu Liu
Zirong Zhu
Jiaran Yan
Yuanyuan Wang
The relationship between anxiety and depression symptoms in insomnia patients: a network analysis
Scientific Reports
Network analysis
Insomnia
Anxiety
Depression
Bridge symptoms
title The relationship between anxiety and depression symptoms in insomnia patients: a network analysis
title_full The relationship between anxiety and depression symptoms in insomnia patients: a network analysis
title_fullStr The relationship between anxiety and depression symptoms in insomnia patients: a network analysis
title_full_unstemmed The relationship between anxiety and depression symptoms in insomnia patients: a network analysis
title_short The relationship between anxiety and depression symptoms in insomnia patients: a network analysis
title_sort relationship between anxiety and depression symptoms in insomnia patients a network analysis
topic Network analysis
Insomnia
Anxiety
Depression
Bridge symptoms
url https://doi.org/10.1038/s41598-025-09746-w
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