Emotion dysregulation and sleep difficulties in generalized anxiety disorder

J Anxiety Disord. 2013 Mar;27(2):197-203. doi: 10.1016/j.janxdis.2013.01.008. Epub 2013 Feb 14.


Diagnostic criteria for generalized anxiety disorder (GAD) include sleep problems, which often persist even after successful treatment of the disorder. The purpose of this study was to examine emotion dysregulation as a potential contributor to sleep problems in GAD patients. Participants comprised two groups: 59 individuals diagnosed with GAD and 66 healthy controls. They were assessed for the presence of mood and anxiety disorders and then completed self-report questionnaires assessing problems with sleep and emotion regulation. Participants in the GAD group scored significantly higher on a number of sleep outcomes than did the control group. Importantly, difficulties with emotion regulation statistically mediated the relationship between GAD and a wide range of outcomes of sleep dysfunction independently of the effects of depression and secondary anxiety diagnoses. Emotion regulation difficulties that characterize GAD mediate the relationship between symptoms of this disorder and a wide range of sleep problems. Implications for treatment and future research directions are discussed.

MeSH terms

  • Adult
  • Analysis of Variance
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / physiopathology
  • Anxiety Disorders / psychology*
  • Case-Control Studies
  • Depression / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Emotions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / psychology*
  • Self Report
  • Sleep Wake Disorders / psychology*
  • Surveys and Questionnaires