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Peer-reviewedCC BY 4.0Frontiers in Public Health

Study on the association between sleep quality and anxiety–depression symptoms in school-aged children

  • Jiao Chen1
  • Yiling Liu1
  • Qin Liu1
  • Fan Zhang1
  1. 1Research Center for Medicine and Social Development, College of Public Health, Chongqing Medical University
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Abstract

Background: To analyze the short-term longitudinal associations between sleep-related problems and anxiety, depression and the coexistence of anxiety and depression in school-aged children, and to provide the epidemiological evidence for mental health surveillance and risk assessment.

Methods: This study was part of a child and adolescent growth and development cohort in an urban district of Chongqing. Participants were recruited from grade 1–3 at three local primary schools. A total of 1,529 children (782 boys and 747 girls; average age = 8.00 ± 1.0 years) were included who completed two surveys. Sleep, anxiety, and depressive symptoms were assessed using the PSQI-5, GAD-7, and CDI-S, respectively. Binary logistic regression and multiple linear regression were used to examine the associations between baseline sleep levels, sleep change values (ΔPSQI), and follow-up emotional outcomes. Missing covariates were handled via multiple imputation.

Results: The total scores of PSQI-5, GAD-7, and CDI-S at the follow-up were all lower than those at the baseline ( p < 0.001). After adjusting for confounding factors and baseline emotional levels, a higher baseline PSQI independently predicted subsequent anxiety (OR = 1.144, p < 0.001), depression (OR = 1.097, p = 0.013), and coexisting symptoms (OR = 1.146, p = 0.003). The increases in ΔPSQI was positively associated with the aggravation of emotional symptoms (all p < 0.001).

Conclusion: Long-term poor sleep and decreased sleep quality may increase the risk of internalizing problems in school-aged children.

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Cite

BibTeXRIS
BibTeX
@article{chen2026study,
  title = {{Study on the association between sleep quality and anxiety–depression symptoms in school-aged children}},
  author = {Jiao Chen and Yiling Liu and Qin Liu and Fan Zhang},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1927475},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1927475/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Study on the association between sleep quality and anxiety–depression symptoms in school-aged children
AU  - Jiao Chen
AU  - Yiling Liu
AU  - Qin Liu
AU  - Fan Zhang
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1927475
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1927475/full
AB  - Background: To analyze the short-term longitudinal associations between sleep-related problems and anxiety, depression and the coexistence of anxiety and depression in school-aged children, and to provide the epidemiological evidence for mental health surveillance and risk assessment.  Methods: This study was part of a child and adolescent growth and development cohort in an urban district of Chongqing. Participants were recruited from grade 1–3 at three local primary schools. A total of 1,529 children (782 boys and 747 girls; average age = 8.00 ± 1.0 years) were included who completed two surveys. Sleep, anxiety, and depressive symptoms were assessed using the PSQI-5, GAD-7, and CDI-S, respectively. Binary logistic regression and multiple linear regression were used to examine the associations between baseline sleep levels, sleep change values (ΔPSQI), and follow-up emotional outcomes. Missing covariates were handled via multiple imputation.  Results: The total scores of PSQI-5, GAD-7, and CDI-S at the follow-up were all lower than those at the baseline ( p < 0.001). After adjusting for confounding factors and baseline emotional levels, a higher baseline PSQI independently predicted subsequent anxiety (OR = 1.144, p < 0.001), depression (OR = 1.097, p = 0.013), and coexisting symptoms (OR = 1.146, p = 0.003). The increases in ΔPSQI was positively associated with the aggravation of emotional symptoms (all p < 0.001).  Conclusion: Long-term poor sleep and decreased sleep quality may increase the risk of internalizing problems in school-aged children.
SN  - 2296-2565
ER  -