{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T19:04:04Z","timestamp":1767121444878,"version":"3.48.0"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>\n                    Mental health issues like anxiety and depression are prevalent worldwide, particularly affecting women of reproductive age (WRA). These conditions may impact sleep quality, which is crucial for overall well-being. However, no prior study in Bangladesh has examined the relationship between anxiety, depression, and sleep quality specifically among this demographic. Hence, this study aimed to assess anxiety and depressive symptoms and their association with sleep quality among WRA in Noakhali, Bangladesh. A cross-sectional study was conducted from May to June 2024 among 417 women aged 15\u201349 years in Noakhali, Bangladesh. Data were collected through a structured questionnaire assessing socio-demographic characteristics, anxiety (Generalized Anxiety Disorder [GAD-7]), depression (Patient Health Questionnaire [PHQ-9]), and sleep quality (Pittsburgh Sleep Quality Index [PSQI]). The prevalence of anxiety symptoms, depressive symptoms, and poor sleep quality among participants was 44.6%, 47.0%, and 36.9%, respectively. Women with anxiety and depressive symptoms had significantly higher PSQI scores than those without symptoms (p\u2009&lt;\u20090.05). Multiple linear regression analysis revealed that higher anxiety (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.243, p\u2009&lt;\u20090.001) and depressive (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.285, p\u2009&lt;\u20090.001) symptoms scores were associated with poorer sleep quality. In conclusion, a high burden of anxiety, depression, and poor sleep quality is evident among WRA in Noakhali. This study provides the first evidence from Bangladesh highlighting the strong link between mental health and sleep quality among WRA, underscoring the need for integrated mental and sleep health interventions in rural and underserved communities.\n                  <\/jats:p>","DOI":"10.1371\/journal.pgph.0005742","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T19:00:38Z","timestamp":1767121238000},"page":"e0005742","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mental health issues and their association with sleep quality among women of reproductive age in Noakhali, Bangladesh"],"prefix":"10.1371","volume":"5","author":[{"given":"Towhid","family":"Hasan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2899-7266","authenticated-orcid":true,"given":"Nahian","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abu Zafar Md","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md Didar","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1086-5003","authenticated-orcid":true,"given":"Marjia","family":"Sultana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"issue":"4","key":"pgph.0005742.ref001","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/02537176231220543","article-title":"Common Mental Disorders and Their Correlates: A Community-based Survey Among Women in Southern Karnataka, India","volume":"46","author":"RR Shenoy","year":"2024","journal-title":"Indian J Psychol Med"},{"key":"pgph.0005742.ref002","article-title":"Depression and Generalized Anxiety and Its Associations with Health Behaviors among Adult Women in Nepal: Results of a National Cross-sectional Survey in 2022","author":"AS 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Dhara","year":"2024","journal-title":"PLoS One"},{"issue":"1","key":"pgph.0005742.ref039","doi-asserted-by":"crossref","DOI":"10.1016\/j.whi.2011.07.004","article-title":"Predictors of sleep characteristics among women in southeast Texas","volume":"22","author":"AB Kachikis","year":"2012","journal-title":"Womens Health Issues"},{"issue":"1","key":"pgph.0005742.ref040","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/AIHB.AIHB_44_17","article-title":"Comparison of perceived sleep quality among urban and rural adult population by Bengali Pittsburgh Sleep Quality Index","volume":"8","author":"H Mondal","year":"2018","journal-title":"Adv Hum Biol"},{"key":"pgph.0005742.ref041","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2022.913821","article-title":"Poor Sleep Quality and Factors Among Reproductive-Age Women in Southwest Ethiopia","volume":"13","author":"B Bogale","year":"2022","journal-title":"Front 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