Sleep hygiene mediates anxiety and sleep quality in adults: mediation and network analysis

BACKGROUND: Sleep hygiene plays a crucial role in mental well-being, yet its influence on the relationship between anxiety and sleep quality in young adults remains underexplored. AIMS: This study examines whether sleep hygiene mediates the bidirectional association between anxiety and sleep quality, identifying key behavioural targets for intervention. METHOD: A cross-sectional study was conducted with 405 randomly selected college students who completed validated assessments of sleep hygiene, anxiety and sleep quality. Mediation and network analyses were employed to investigate the underlying mechanisms. RESULTS: Sleep hygiene significantly mediated the relationship between anxiety and sleep quality, emphasising the role of consistent sleep-wake schedules. Network analysis identified irregular sleep patterns and specific sleep quality components - wakefulness behaviours, sleep initiation and self-reported sleep quality - as primary factors. CONCLUSION: These findings highlight sleep hygiene as a modifiable, non-pharmacological strategy to mitigate anxiety and improve sleep quality. Future research should explore longitudinal interventions.