Understanding the relationship of sleep-related problems with positive affect and negative affect in young people: Insights from the EHDLA study

Alejandro Unda-López; Fiorella Quiroz-Cárdenas; Pedro Juan Tárraga-López; Rodrigo Yañéz-Sepúlveda; Héctor Gutiérrez-Espinoza; Jorge Olivares-Arancibia; Masoud Rahmati; Lee Smith; Brendon Stubbs; José Francisco López-Gil

doi:10.1016/j.sleep.2025.106659

Understanding the relationship of sleep-related problems with positive affect and negative affect in young people: Insights from the EHDLA study

Sleep Med. 2025 Jul 2:134:106659. doi: 10.1016/j.sleep.2025.106659. Online ahead of print.

Affiliations

¹ Escuela de Psicología y Educación, Universidad de Las Américas, Quito, Ecuador.
² Vicerrectoría de Investigación y Postgrado, Universidad de Los Lagos, Osorno, Chile.
³ Faculty of Medicine, University of Castilla la Mancha, Castilla-La Mancha, Albacete, Spain; Gerencia de Atención Integrada de Albacete, Servicio de Salud de Castilla-La Mancha, Albacete, Spain.
⁴ Faculty Education and Social Sciences, Universidad Andres Bello, Viña del Mar, Chile.
⁵ Faculty of Education, Universidad Autónoma de Chile, Chile.
⁶ AFySE Group, Research in Physical Activity and School Health, School of Physical Education, Faculty of Education, Universidad de las Américas, Santiago, Chile.
⁷ Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran; CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France; CRSMP, Center for Mental Health and Psychiatry Research - PACA, Marseille, France.
⁸ Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom; Biruni University, Faculty of Medicine, Department of Public Health, Instanbul, Turkey.
⁹ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; Center for Sport Science and University Sports, University of Vienna, Wien, Austria.
¹⁰ School of Medicine, Universidad Espíritu Santo, Samborondón, Ecuador; Department of Communication and Education, Universidad Loyola Andalucía, Sevilla, Spain.

PMID: 40639229
DOI: 10.1016/j.sleep.2025.106659

Abstract

Background: The prevalence of sleep-related problems in adolescents has been recognized as a public health issue. Research on how specific sleep-related problems may be related to mood and affect variations in this age group is scarce. Therefore, the current study aims to explore the relationships between sleep-related problems and positive and negative affect in a sample of Spanish adolescents.

Methods: The present study uses a cross-sectional design based on secondary data collected in the Eating Healthy and Daily Life Activities (EHDLA) study. The sample consisted of 645 Spanish adolescents (Median age = 14.0) attending secondary schools in the Valle de Ricote in the Region of Murcia (Spain) during the 2021 and 2022 academic years. The BEARS (B = bedtime issues, E = excessive daytime sleepiness, A = night awakenings, R = regularity and duration of sleep, and S = snoring) sleep screening tool was used to assess sleep-related problems, whereas the Positive and Negative Affect Schedule 10-Children (PANAS-C10) was used to examine positive and negative affect.

Results: The findings show that the presence of sleep-related problems is associated with a lower positive affect score and a greater negative affect score. Specifically, the presence of bedtime problems (unstandardized beta coefficient [B] = -2.82; 95 % confidence interval [CI] -3.77 to -1.86; p < 0.001), excessive daytime sleepiness (B = -3.15; 95 % CI -4.01 to -2.29; p < 0.001), awakening at night (B = -3.53; 95 % CI -4.61 to -2.44; p < 0.001), and adequate regularity and duration of sleep (B = -2.00; 95 % CI -2.88 to -1.11; p < 0.001) were found to be associated with a lower positive affect score. On the other hand, the presence of bedtime problems (B = 2.09; 95 % CI 1.32 to 2.87; p < 0.001), excessive daytime sleepiness (B = 2.70; 95 % CI 2.01 to 3.40; p < 0.001), awakenings during the night (B = 2.15; 95 % CI 1.26 to 3.04; p < 0.001), and adequate regularity and duration of sleep (B = 0.90; 95 % CI 0.18 to 1.62; p < 0.05) were associated with a greater negative affect score. Furthermore, a greater number of sleep-related problems experienced simultaneously was related to a lower positive affect (B = -1.59 per problem; 95 % CI -1.93 to -1.26; p < 0.001) and a heightened negative affect (B = 1.10 per problem; 95 % CI 0.82 to 1.38; p < 0.001).

Conclusions: The presence of sleep-related problems and their increased frequency are associated with lower positive affect, whereas having these problems and experiencing multiple problems simultaneously are linked to greater negative affect. Future research should explore specific sleep-related problems and their potential impact on different health-related outcomes in this age group while considering other covariates or confounding variables. Public health efforts should be aimed at providing education on sleep and promoting sleep hygiene, improving the health of adolescents and young adults.

Keywords: Sleep-related issues; emotional state; mood; sleep disturbances; young adults.