A systematic review of sleep disturbance in anxiety and related disorders

• Sleep disturbance is present in the majority of anxiety and related disorders.
• Sleep disturbance often exacerbates symptom severity.
• Role of sleep disturbance often depends on objective vs subjective assessment.
• Sleep disturbance may contribute to anxiety and related disorders.
• Understanding comorbid sleep and anxiety may have treatment implications.

Recent research suggests that sleep disturbance may be a transdiagnostic process, and there is increasing interest in examining how sleep disturbance may contribute to anxiety and related disorders. The current review summarizes and synthesizes the extant research assessing sleep in anxiety and related disorders. The findings suggest that sleep disturbance exacerbates symptom severity in the majority of anxiety and related disorders. However, the nature of sleep disturbance often varies as a function of objective versus subjective assessment. Although sleep disturbance is a correlate of most anxiety and related disorders, a causal role for sleep disturbance is less clear. A model of potential mechanisms by which sleep disturbance may confer risk for the development of anxiety and related disorders is discussed. Future research integrating findings from basic sleep research with current knowledge of anxiety and related disorders may facilitate the development of novel treatments for comorbid sleep disturbance and clinical anxiety.