The Comparison of Effects of State and Trait Anxiety on the Components of Sleep Quality

  • Amir Bavafa Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Ali akbar Foroughi Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Behnam Khaledi-Paveh Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Amir abbas Taheri Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Farzane Fehrest Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Shahram Amiri Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
Anxiety, Sleep, Students


Background and Objective: College students suffer from sleep problems. The implications of sleep problems can affect different areas of students’ life, and this, in turn, can be influenced by other psychological characteristics such as anxiety. The aim of this study was to investigate the relationship between state and trait anxiety with components of students' sleep quality.

Materials and Methods: In this descriptive cross-sectional study, 365 students of Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2018, were selected randomly and evaluated by two questionnaires: Pittsburgh Sleep Quality Index (PSQI) and Spielberger's State-Trait Anxiety Inventory (STAI) with ethical considerations.

Results: There was a significant difference in sleep quality between different age groups (P < 0.001). As the age of study participants increased, the quality of sleep became poorer. The prevalence of poor sleep in students was about 63%. The highest level of correlation of state and trait anxiety was observed with the sleep latency, and the lowest level of correlation of trait anxiety was observed with the use of sleep medications.

Conclusion: Sleep quality is more influenced by trait anxiety and the use of sleep medications is more influenced by state anxiety. It can also be said that the anxiety of the state and trait together predict more subjective sleep quality and contribute less to the prediction of sleep duration.


1. Schubert CR, Cruickshanks KJ, Dalton DS, et al. Prevalence of sleep problems and quality of life in an older population. Sleep 2002; 25: 889-93.
2. Lee M, Choh AC, Demerath EW, et al. Sleep disturbance in relation to health-related quality of life in adults: The Fels Longitudinal Study. J Nutr Health Aging 2009; 13: 576-83.
3. Lund HG, Reider BD, Whiting AB, et al. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 2010; 46: 124-32.
4. Carney CE, Edinger JD, Meyer B, et al. Daily activities and sleep quality in college students. Chronobiol Int 2006; 23: 623-37.
5. Kenney SR, LaBrie JW, Hummer JF, et al. Global sleep quality as a moderator of alcohol consumption and consequences in college students. Addict Behav 2012; 37: 507-12.
6. Ranjbaran M. Prevalence of poor sleep quality in college students of Iran: Systematic review and Meta-analysis. Razi J Med Sci 2016; 23: 1-7. [In Persian].
7. Pilcher JJ, Walters AS. How sleep deprivation affects psychological variables related to college students' cognitive performance. J Am Coll Health 1997; 46: 121-6.
8. Taylor DJ, McFatter RM. Cognitive performance after sleep deprivation: does personality make a difference? Pers Individ Dif 2003; 34: 1179-93.
9. Yang RH, Hu SJ, Wang Y, et al. Paradoxical sleep deprivation impairs spatial learning and affects membrane excitability and mitochondrial protein in the hippocampus. Brain Res 2008; 1230: 224-32.
10. Rusovici DE. Neuroendocrine and health aspects of partial sleep loss [PhD Thesis]. University Park, PA: The Pennsylvania State University; 2001.
11. Medeiros AL, Mendes DBF, Lima PF, et al. The relationships between sleep-wake cycle and academic performance in medical students. Biol Rhythm Res 2001; 32: 263-70.
12. Kelly WE, Kelly KE, Clanton RC. The relationship between sleep length and grade-point average among college students. Coll Stud J 2001; 35: 84-6.
13. Buboltz WC, Jr., Brown F, Soper B. Sleep habits and patterns of college students: A preliminary study. J Am Coll Health 2001; 50: 131-5.
14. Taylor DJ, Mallory LJ, Lichstein KL, et al. Comorbidity of chronic insomnia with medical problems. Sleep 2007; 30: 213-8.
15. Eller T, Aluoja A, Vasar V, et al. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety 2006; 23: 250-6.
16. Brown FC, Buboltz WC, Jr., Soper B. Development and evaluation of the Sleep Treatment and Education Program for Students (STEPS). J Am Coll Health 2006; 54: 231-7.
17. Becker SP, Jarrett MA, Luebbe AM, et al. Sleep in a large, multi-university sample of college students: Sleep problem prevalence, sex differences, and mental health correlates. Sleep Health 2018; 4: 174-81.
18. Menz MM, Rihm JS, Salari N, et al. The role of sleep and sleep deprivation in consolidating fear memories. Neuroimage 2013; 75: 87-96.
19. Spoormaker VI, Montgomery P. Disturbed sleep in post-traumatic stress disorder: Secondary symptom or core feature? Sleep Med Rev 2008; 12: 169-84.
20. Xie B, Chen X, Xiao Z, et al. Evaluation on the whole night polysomnography in patients with anxiety. J Shanghai Jiaotong Univ 2006; 4: 005.
21. Spielberger CD, Smith LH. Anxiety (drive), stress, and serial-position effects in serial-verbal learning. J Exp Psychol 1966; 72: 589-95.
22. Spielberger CD, Gorsuch RL. Manual for the State-trait Anxiety Inventory. Palo Alto CA: Consulting Psychologists Press; 1983.
23. Horvath A, Montana X, Lanquart JP, et al. Effects of state and trait anxiety on sleep structure: A polysomnographic study in 1083 subjects. Psychiatry Res 2016; 244: 279-83.
24. Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.
25. Backhaus J, Junghanns K, Broocks A, et al. Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 2002; 53: 737-40.
26. Agargun MY, Kara H, Anlar O. The validity and reliability of the Pittsburgh Sleep Quality Index. Turkish Journal of Psychiatry 1996; 7: 107-15. [In Turkish].
27. Ohayon MM, Lemoine P, Arnaud-Briant V, et al. Prevalence and consequences of sleep disorders in a shift worker population. J Psychosom Res 2002; 53: 577-83.
28. Farrahi MJ, Nakhaee N, Sheibani V, et al. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath 2012; 16: 79-82.
29. Spielberger CD, Gorsuch RL, Lushene RE. STAI manual: For the State-trait Anxiety Inventory, "self-evaluation Questionnaire". Palo Alto, CA: Consulting Psychologists Press; 1970. p. 1-24.
30. Ensrud KE, Blackwell TL, Ancoli-Israel S, et al. Sleep disturbances and risk of frailty and mortality in older men. Sleep Med 2012; 13: 1217-25.
31. Del Brutto OH, Mera RM, Sedler MJ, et al. The effect of age in the association between frailty and poor
sleep quality: A population-based study in communitydwellers (The Atahualpa Project). J Am Med Dir Assoc 2016; 17: 269-71.
32. van den Berg JF, Miedema HM, Tulen JH, et al. Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons. Sleep 2009; 32: 1367-75.
33. Kische H, Ewert R, Fietze I, et al. Sex hormones and sleep in men and women from the general population: A cross-sectional observational study. J Clin Endocrinol Metab 2016; 101: 3968-77.
34. Madrid-Valero JJ, Martinez-Selva JM, Ribeiro do CB, et al. Age and gender effects on the prevalence of poor sleep quality in the adult population. Gac Sanit 2017; 31: 18-22.
35. Roehrs T, Kapke A, Roth T, et al. Sex differences in the polysomnographic sleep of young adults: A community-based study. Sleep Med 2006; 7: 49-53.
36. Bixler EO, Papaliaga MN, Vgontzas AN, et al. Women sleep objectively better than men and the sleep of young women is more resilient to external stressors: Effects of age and menopause. J Sleep Res 2009; 18: 221-8.
37. Ohayon MM, Reynolds CF 3rd. Epidemiological and clinical relevance of insomnia diagnosis algorithms according to the DSM-IV and the International Classification of Sleep Disorders (ICSD). Sleep Med 2009; 10: 952-60.
38. Chan-Chee C, Bayon V, Bloch J, et al. Epidemiology of insomnia in France. Rev Epidemiol Sante Publique 2011; 59: 409-22. [In French].
39. Zeek ML, Savoie MJ, Song M, et al. Sleep duration and academic performance among student pharmacists. Am J Pharm Educ 2015; 79: 63.
40. Mesquita G, Reimao R. Quality of sleep among university students: Effects of nighttime computer and television use. Arq Neuropsiquiatr 2010; 68: 720-5.
41. Azevedo MH, Bos SC, Soares MJ, et al. Longitudinal study on perfectionism and sleep disturbance. World J Biol Psychiatry 2010; 11: 476-85.
42. Augner C. Associations of subjective sleep quality with depression score, anxiety, physical symptoms and sleep onset latency in students. Cent Eur J Public Health 2011; 19: 115-7.
43. James B, Omoaregba J, Igberase O. Prevalence and correlates of poor sleep quality among medical students at a Nigerian university. Ann Nigerian Med 2011; 5: 1-5.
How to Cite
Bavafa A, Foroughi A akbar, Khaledi-Paveh B, Taheri A abbas, Fehrest F, Amiri S. The Comparison of Effects of State and Trait Anxiety on the Components of Sleep Quality. J Sleep Sci. 3(3-4):95-101.
Original Article(s)