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May 10, 2026SLEEP0 citations

0142 Is the Sleep-Mood Link Universal? Path Analyses of How Anxiety, Depression, and Emotion Regulation Influence the Sleep-Mood Relationship

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KZKaiqi ZhangJBJeffrey Bedwell

Key Points

  • This research aims to explore how sleep quality relates to affect and perceived stress, particularly among those with anxiety and depression.
  • Conducted four path analyses with sleep quality as predictor and NA, PA, and PS as outcomes.
  • Included moderators: past-year diagnoses of depression/anxiety and emotion regulation strategies like suppression/reappraisal.
  • Analyzed data from a sample of 720 undergraduates using various validated psychological scales.
  • Poor sleep quality predicted higher negative affect, lower positive affect, and higher perceived stress (p < .001).
  • Having depression or anxiety diagnosis weakened the sleep quality-PS relationship (β = -.106, p = .010; β = -.136, p = .002).
  • Higher suppression associated with increased negative affect and perceived stress, while reappraisal linked to lower negative affect and higher positive affect.

Abstract

Abstract Introduction Previous research has established that sleep quality is closely linked to affect and stress. However, fewer studies distinguish its unique associations with negative affect (NA), positive affect (PA), and perceived stress (PS). Furthermore, how these relationships differ for people with depressive and anxiety disorders and those using different emotion regulation strategies is understudied. Methods We conducted four separate path analyses, with sleep quality as the predictor, NA, PA, and PS levels as outcomes, and one moderator per path analysis: self-reported past-year diagnoses of depression and anxiety, and levels of suppression/reappraisal emotion regulation strategies. We collected an online survey that included: the Pittsburgh Sleep Quality Index, Positive and Negative Affect Schedule, Perceived Stress Scale, Emotion Regulation Questionnaire, and self-reported depression and anxiety disorder diagnoses. After exclusions, data from 720 undergraduates (mean age = 21.10; 67% female) were analyzed (N = 510 for Emotion Regulation Questionnaire). Results Without moderators, poorer sleep quality predicted higher NA, lower PA, and higher PS (ps .001). Moderation analyses revealed that having depressive (β = -.106, p = .010) and/or anxiety disorder diagnoses (β = -.136, p = .002) weakened the relationship between sleep quality and PS. Higher use of suppression predicted higher NA and PS and lower PA, while higher use of reappraisal predicted lower NA and PS and higher PA. Higher use of suppression weakened the relationship between sleep quality and PA (β = .097, p = .028). Conclusion While poorer sleep quality was associated with higher PS, the strength of this relationship was significantly weaker for people with past-year depressive and/or anxiety disorders. Similarly, while poorer sleep quality was associated with lower PA, the strength was significantly weaker for people who use greater suppression as an emotion regulation strategy. Depression, anxiety, and suppression are all closely associated with affect and stress, suggesting that they explain more variance in NA, PA, and PS, leaving less additional variance for sleep quality to account for. These findings highlight the importance of sleep for affect and stress and the need for future research on the unique interaction of sleep, psychopathology, and emotion regulation. Support (if any)

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Cite This Study

Zhang et al. (2026) studied this question.

synapsesocial.com/papers/6a002222c8f74e3340f9d272https://doi.org/10.1093/sleep/zsag091.0142
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