Chain mediating effect of insomnia, depression, and anxiety on the relationship between nightmares and cognitive deficits in adolescents.
Journal of Affective Disorders February 1, 2023 Li-Gang Zhang, Ling-Fei Cheng, Ting-Ting Wang et al.
Nightmares, insomnia, depression, and anxiety are all linked to cognitive deficits in adolescents. An online survey of 6,014 adolescents found that females, senior high school students, and those with poor academic performance reported more nightmares, insomnia, and cognitive deficits; city dwellers had higher depression and anxiety scores. Cognitive deficits were positively correlated with nightmares, insomnia, depression, and anxiety. Insomnia, depression, and anxiety together acted as a chain mediating the relationship between nightmares and cognitive deficits: nightmares appear to affect cognition indirectly by first worsening insomnia, which then worsens depression and anxiety. Because the study was cross-sectional, causal relationships could not be determined, and reporting or volunteer bias may exist. Early identification and treatment of frequent nightmares may help reduce negative outcomes.