Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials

Abstract

The extent to which sleep is causally related to mental health is unclear. One way to test the causal link is to evaluate the extent to which interventions that improve sleep quality also improve mental health. We conducted a meta-analysis of randomised controlled trials that reported the effects of an intervention that improved sleep on composite mental health, as well as on seven specific mental health difficulties. 65 trials comprising 72 interventions and N = 8,608 participants were included. Improving sleep led to a significant medium-sized effect on composite mental health (g+ = -0.53), depression (g+ = -0.63), anxiety (g+ = -0.51), and rumination (g+ = -0.49), as well as significant small-to-medium sized effects on stress (g+ = -0.42), and finally small significant effects on positive psychosis symptoms (g+ = -0.26). We also found a dose response relationship, in that greater improvements in sleep quality led to greater improvements in mental health. Our findings suggest that sleep is causally related to the experience of mental health difficulties. Future research might consider how interventions that improve sleep could be incorporated into mental health services, as well as the mechanisms of action that explain how sleep exerts an effect on mental health.

Lifestyle behaviours and mental health and wellbeing of tertiary students during COVID-19 lockdown in Australia: A cross-sectional study

“…Additionally, a systematic review by Spijkerman et al, [ 72 ] identified that online mindfulness interventions had benefits for depression and stress reduction [ 72 ]. Similarly, a 2021 meta-analysis of randomised controlled trials demonstrated that improving sleep quality improved mental health, including depression, anxiety, rumination and stress [ 69 ]. These findings are in line with a large meta-review of lifestyle psychiatry interventions which showed the critical role of modifiable lifestyle factors including physical activity, sleep, diet and smoking in the prevention and treatment of mental disorders [ 29 ].…”

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

“…Both decreased sleep duration or quality can adversely impact mental health [ 3 , 4 ], and conversely, most mental health disorders present with objective or subjective alterations in sleep [ 2 , 5 ]. The causal relation between altered sleep and decreased mental health is evidenced by the fact that improvements in sleep translate to improvements in mental health such as depression, anxiety, rumination and stress [ 6 ].…”

The Relationship between Personality Traits and COVID-19 Anxiety: A Mediating Model

“…Furthermore, research indicates that sleep quality reduces depression, anxiety, and stress [ 49 ]. Nevertheless, a few studies have also indicated a bi-directional relationship between sleep quality and anxiety [ 50 , 51 ].…”