Associations between Sleep, Anxiety, and Error-Related Brain Activity in Youth

Due to the high prevalence of anxiety disorders and their associated impairment, elucidating neural mechanisms that underlie these disorders has been increasingly prioritized. Specifically, the error-related negativity (ERN) has been identified as a neural marker that indexes risk for anxiety across development. Approximately half of the variance in the ERN can be attributed to factors other than genetic inheritance, including factors such as parenting style and stressful life events. The present study sought to examine associations between the ERN and another factor — sleep difficulties. This study serves as a novel examination of the associations between self-reported naturalistic sleep difficulties, anxiety, and the ERN. In a sample of 221 females, ages 8 to 15 years old, we first examined the relations between chronic (i.e., over the past month) and recent (i.e., over the past week) sleep disturbances and the ERN. We then investigated whether a specific chronic or recent sleep difficulty uniquely predicts the ERN. In exploratory analyses, we assessed whether the ERN moderates and/or mediates the relationship between sleep difficulties and anxiety. Results indicated that youth who report chronically shorter sleep duration, chronically worse sleep, and recent shorter sleep duration on school days over the past week have a larger ERN. In addition, recent sleep duration on school days over the past week uniquely predicted the ERN. Exploratory analyses indicated the ERN moderates the associations between chronic sleep quality and total anxiety, as well as that between chronic sleep quality and child social anxiety. Finally, results suggested the ERN may partially mediate the link between sleep problems and anxiety. Future studies should clarify the direction of these associations via longitudinal designs.