Depression and anxiety are prevalent mental health disorders. While sleep duration has been extensively studied, sleep regularity may play a critical role. We aimed to examine associations between objectively measured sleep regularity and incident depression and anxiety and to investigate whether meeting recommended sleep duration modifies these associations.

In 79,666 UK Biobank participants without baseline depression or anxiety, wrist accelerometers worn for 7 days yielded a sleep regularity index (SRI) and average sleep duration. SRI was categorized as irregular (≤51), moderately irregular (52–70), or regular (≥71). Sleep duration was classified by age-specific recommendations (7–9 hours for ages 18–64 years; 7–8 hours for over 65 years). Cox regression models assessed associations between sleep parameters and mental health outcomes.

During a median follow-up of 7.5 years, 1,646 participants developed depression, and 2,097 developed anxiety. Compared to irregular sleepers, regular sleepers had a 38% lower depression risk (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.52–0.73) and a 33% lower anxiety risk (HR, 0.67; 95%CI, 0.58–0.77). Participants with both irregular sleep and nonrecommended duration exhibited the highest risks (depression HR, 1.91; 95%CI, 1.55–2.35; anxiety HR, 1.61; 95%CI, 1.35–1.93). Notably, irregular sleepers who met duration guidelines still faced elevated risks (depression HR, 1.48; 95%CI, 1.18–1.86; anxiety HR, 1.35; 95%CI, 1.11–1.64).

Greater sleep regularity is independently associated with lower depression and anxiety risk regardless of sleep duration, suggesting that sleep–wake consistency should be considered in mental health promotion strategies alongside traditional sleep duration recommendations.

Adverse Childhood Experiences (ACEs) are known to increase the risk of mental health challenges, and sleep is known to decrease risk. We investigated whether adequate sleep duration and sleep regularity would moderate the impact of ACE exposure on mental health risk.

We conducted secondary cross-sectional analyses on the 2020–2021 waves of the National Survey of Children’s Health (NSCH; N = 92,669). Logistic and ordinal regressions explored the impact of ACEs (total, household, community and single) and sleep (duration and irregularity) and related interactions on mental health diagnosis and symptom severity.

Known main effects of ACEs and sleep on mental health were replicated. Interactions between ACE exposure and sleep factors were not clinically significant, although some were statistically significant due to the large sample, such that adequate duration was associated with marginally increased risk of mental health diagnosis (Omnibus B = 0.048, p < 0.0001) and greater bedtime irregularity was associated with marginally decreased risk (Omnibus B = –0.030, p < 0.001).

Dichotomous and categorical assessments of sleep health may not be sensitive to interaction effects, compared with continuous data. Examining mental health symptoms (rather than diagnosis status) may also allow for a nuanced understanding of potential interactions.

Subjective cognition is a predictor of cognitive decline and previous work has identified age, education and depression as predictors of subjective cognition. This study aimed to investigate whether several sleep characteristics were associated with subjective cognition above-and-beyond known predictors.

Participants (N=3284, Mage=42.7 years, 48.5% female) completed an online study that included the Patient Health Questionnaire-4 (PHQ-4), Insomnia Severity Index (ISI), RU-SATED, Sleep Regularity Questionnaire (SRQ) and the 6-item PROMIS Cognitive Function. A 3-step hierarchical regression model predicted PROMIS Cognition scores, with Step 1 including age and education as predictors, Step 2 including age, education, and PHQ-4 scores, and Step 3 including all previous variables and sleep variables.

In Step 1 (R2=.03), age and education were significant predictors, while in Step 2 (R2=.36), PHQ-4 and education were significant, and age was no longer significant. In Step 3 (R2=.48), PHQ-4, ISI, RU-SATED, and SRQ scores were significant, while age and education were not significant. All steps accounted for a significant increase in variance (p’s<.001).

Sleep characteristics were associated with subjective cognition above-and-beyond known predictors of age, education and mood. Further research is needed to investigate whether changes in sleep characteristics are associated with changes in subjective cognition.