{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:32:04Z","timestamp":1765175524101,"version":"3.46.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["STI2030-Major Projects 2021ZD0201900STI2030-\u91cd\u5927\u9879\u76ee 2021ZD0201900"],"award-info":[{"award-number":["STI2030-Major Projects 2021ZD0201900STI2030-\u91cd\u5927\u9879\u76ee 2021ZD0201900"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Insomnia has emerged as a major concern among youth following the lifting of coronavirus disease 2019 (COVID-19) restrictions in China. This study aimed to explore the prevalence and influencing factors of insomnia, as well as its associations with mental health, in young students during this period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional survey was conducted among 82,873 students in Sichuan Province, China, using a self-designed questionnaire and standardized assessment tools. Chi-square tests, ANOVA with\n                      <jats:italic>post-hoc<\/jats:italic>\n                      test analyses, and logistic regression were employed to identify the prevalence and influencing factors of insomnia and its associations with mental health.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 28,178 (34.0%) students reported insomnia. Self-reported history of mental disorders, neglectful parenting, and initiating alcohol consumption during the pandemic were associated with higher odds of insomnia, whereas satisfaction with the academy, full recovery of daily routines, greatly improved family relationships, no change in friendships, and higher maternal education were associated with lower odds of insomnia (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Severe insomnia was strongly associated with depression, anxiety, and posttraumatic stress disorder (PTSD; ORs: 17.55, 3.35, and 17.45, respectively). Interaction effects were observed between mild to moderate insomnia and COVID-19 infection on depression, anxiety, and PTSD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following the lifting of COVID-19 restrictions, insomnia remained prevalent among young Chinese students. Preexisting self-reported mental disorders, neglectful parenting, and pandemic-related maladaptive behaviors increase the risk of insomnia, whereas positive lifestyle adjustments, stable relationships, and higher maternal education appear protective. A significant association was observed between insomnia severity and symptoms of depression, anxiety, and PTSD. These findings highlight the persistent links among social, behavioral, and demographic factors, sleep, and mental health, emphasizing the importance of addressing sleep disturbances after the public health crisis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1680558","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:29:46Z","timestamp":1765175386000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Insomnia of students following the lifting of COVID-19 restrictions in China: Prevalence, influencing factors, and associations with depression, anxiety, and PTSD"],"prefix":"10.3389","volume":"16","author":[{"given":"Hang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Hao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Yue","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lie","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jawad","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao-Mei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-Hua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang-Dong","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mao-Sheng","family":"Ran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2006.05.039","article-title":"Sleep problems, comorbid mental disorders, and role functioning in the national comorbidity survey replication","volume":"60","author":"Roth","year":"2006","journal-title":"Biol Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.193","article-title":"Insomnia","volume":"309","author":"Buysse","year":"2013","journal-title":"Jama"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12055","article-title":"Sleep patterns and insomnia among adolescents: a population-based study","volume":"22","author":"Hysing","year":"2013","journal-title":"J Sleep Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.smrv.2017.06.009","article-title":"Insomnia disorder in adolescence: Diagnosis, impact, and treatment","volume":"39","author":"de Zambotti","year":"2018","journal-title":"Sleep Med Rev"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-020-01541-4","article-title":"Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19","volume":"29","author":"Zhou","year":"2020","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000694","article-title":"Flattening the emotional distress curve: A behavioral health pandemic response strategy for COVID-19","volume":"75","author":"Kaslow","year":"2020","journal-title":"Am Psychol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000850","article-title":"Sleep in a pandemic: Implications of COVID-19 for sleep through the lens of the 3P model of insomnia","volume":"76","author":"Cox","year":"2021","journal-title":"Am Psychol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.05.018","article-title":"The immediate impact of the 2019 novel coronavirus (COVID-19) outbreak on subjective sleep status","volume":"77","author":"Lin","year":"2021","journal-title":"Sleep Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"113076","DOI":"10.1016\/j.psychres.2020.113076","article-title":"Insomnia during the COVID-19 pandemic in a Greek population","volume":"289","author":"Voitsidis","year":"2020","journal-title":"Psychiatry Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e13231","DOI":"10.1111\/jsr.13231","article-title":"Profiles of sleep changes during the COVID-19 pandemic: Demographic, behavioural and psychological factors","volume":"30","author":"Robillard","year":"2021","journal-title":"J Sleep Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1007\/s11920-013-0418-8","article-title":"Insomnia and its impact on physical and mental health","volume":"15","author":"Fernandez-Mendoza","year":"2013","journal-title":"Curr Psychiatry Rep"},{"key":"B12","doi-asserted-by":"publisher","first-page":"113264","DOI":"10.1016\/j.psychres.2020.113264","article-title":"Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown","volume":"291","author":"Guessoum","year":"2020","journal-title":"Psychiatry Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.smrv.2015.12.006","article-title":"Sleep and emotion regulation: An organizing, integrative review","volume":"31","author":"Palmer","year":"2017","journal-title":"Sleep Med Rev"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v11.i6.232","article-title":"COVID-19 impact on high school student\u2019s education and mental health: A cohort survey in China","volume":"11","author":"Ma","year":"2021","journal-title":"World J Psychiatry"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1089\/cyber.2023.0048","article-title":"Digital technology use and adolescent mental health before and during the COVID-19 pandemic: the roles of internet addiction and digital competence","volume":"26","author":"Tao","year":"2023","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e2014053","DOI":"10.1001\/jamanetworkopen.2020.14053","article-title":"Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic","volume":"3","author":"Shi","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B17","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jad.2021.05.028","article-title":"Association between perceived stress and depression among medical students during the outbreak of COVID-19: The mediating role of insomnia","volume":"292","author":"Liu","year":"2021","journal-title":"J Affect Disord"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.01.029","article-title":"Infection rates of 70% of the population observed within 3 weeks after release of COVID-19 restrictions in Macao, China","volume":"86","author":"Liang","year":"2023","journal-title":"J Infect"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291720004717","article-title":"The impacts of COVID-19 outbreak on mental health in general population in different areas in China","volume":"52","author":"Ran","year":"2022","journal-title":"psychol Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1186\/s12889-025-21968-1","article-title":"Effects of life rules on mental health and behavioral problems among adolescent and youth students: A survey after the lifting of COVID-19 restrictions in China","volume":"25","author":"Xiao","year":"2025","journal-title":"BMC Public Health"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.5.601","article-title":"The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response","volume":"34","author":"Morin","year":"2011","journal-title":"Sleep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Internal Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.jad.2020.01.032","article-title":"Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)","volume":"265","author":"Toussaint","year":"2020","journal-title":"J Affect Disord"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059","article-title":"The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation","volume":"28","author":"Blevins","year":"2015","journal-title":"J Traumatic Stress"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1672-7088.2018.28.005","article-title":"Reliability and validity of Insomnia Severity Index in clinical insomnia patients","volume":"34","author":"Bai","year":"2018","journal-title":"Chin J Prac Nurs."},{"key":"B26","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1186\/s12888-020-02859-8","article-title":"Are comparisons of mental disorders between Chinese and German students possible? An examination of measurement invariance for the PHQ-15, PHQ-9 and GAD-7","volume":"20","author":"Zhou","year":"2020","journal-title":"BMC Psychiatry"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.08.038","article-title":"Psychometric property study of the posttraumatic stress disorder checklist for DSM-5 (PCL-5) in Chinese healthcare workers during the outbreak of corona virus disease 2019","volume":"277","author":"Cheng","year":"2020","journal-title":"J Affect Disord"},{"key":"B28","doi-asserted-by":"publisher","first-page":"114153","DOI":"10.1016\/j.psychres.2021.114153","article-title":"Insomnia and other sleep-related problems during the remission period of the COVID-19 pandemic: A large-scale survey among college students in China","volume":"304","author":"Zhang","year":"2021","journal-title":"Psychiatry Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.ynstr.2016.09.001","article-title":"Interaction between circadian rhythms and stress","volume":"6","author":"Koch","year":"2017","journal-title":"Neurobiol Stress"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.1017\/S2045796025100243","article-title":"Mental health symptoms and associated factors for general population at the stable, recurrence, and end-of-emergency stages of the COVID-19 pandemic: a repeated national cross-sectional study","volume":"34","author":"Wang","year":"2025","journal-title":"Epidemiol Psychiatr Sci"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-022-01638-z","article-title":"A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID-19: a call to action","volume":"27","author":"Yuan","year":"2022","journal-title":"Mol Psychiatry"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5336","article-title":"Region-specific dissociation between cortical noradrenaline levels and the sleep\/wake cycle","volume":"39","author":"Bellesi","year":"2016","journal-title":"Sleep"},{"key":"B33","doi-asserted-by":"publisher","first-page":"109815","DOI":"10.1016\/j.neuropharm.2023.109815","article-title":"Clinical usefulness of dual orexin receptor antagonism beyond insomnia: Neurological and psychiatric comorbidities","volume":"245","author":"Carpi","year":"2024","journal-title":"Neuropharmacology"},{"key":"B34","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1186\/s12889-017-4784-8","article-title":"Cross-sectional associations between maternal parenting styles, physical activity and screen sedentary time in children","volume":"17","author":"Van der Geest","year":"2017","journal-title":"BMC Public Health"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2023.06.001","article-title":"The association between adverse childhood experiences and insomnia symptoms from adolescence to adulthood: Evidence from the Add Health study","volume":"9","author":"Desch","year":"2023","journal-title":"Sleep Health"},{"key":"B36","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12939-017-0559-1","article-title":"Influence maternal background has on children\u2019s mental health","volume":"16","author":"Arroyo-Borrell","year":"2017","journal-title":"Int J Equity Health"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.02.026","article-title":"Benefits of maternal education for mental health trajectories across childhood and adolescence","volume":"202","author":"Meyrose","year":"2018","journal-title":"Soc Sci Med"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2019.03.007","article-title":"Alcohol and sleep-related problems","volume":"30","author":"He","year":"2019","journal-title":"Curr Opin Psychol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2008.12.003","article-title":"Effects of nicotine on sleep during consumption, withdrawal and replacement therapy","volume":"13","author":"Jaehne","year":"2009","journal-title":"Sleep Med Rev"},{"key":"B40","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1038\/s41398-024-03002-x","article-title":"Association of lifestyle with sleep health in general population in China: a cross-sectional study","volume":"14","author":"Zheng","year":"2024","journal-title":"Trans Psychiatry"},{"key":"B41","doi-asserted-by":"publisher","first-page":"23349","DOI":"10.1038\/s41598-021-02702-4","article-title":"Lifestyle and mental health 1 year into COVID-19","volume":"11","author":"Barbieri","year":"2021","journal-title":"Sci Rep"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-014-0417-8","article-title":"Sleep difficulties and the development of depression and anxiety: a longitudinal study of young Australian women","volume":"17","author":"Jackson","year":"2014","journal-title":"Arch Women\u2019s Ment Health"},{"key":"B43","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.smrv.2018.10.006","article-title":"Insomnia as a predictor of mental disorders: A systematic review and meta-analysis","volume":"43","author":"Hertenstein","year":"2019","journal-title":"Sleep Med Rev"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.5665\/sleep\/31.10.1351","article-title":"Adolescent insomnia as a risk factor for early adult depression and substance abuse","volume":"31","author":"Roane","year":"2008","journal-title":"Sleep"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/31.11.1579","article-title":"Chronically restricted sleep leads to depression-like changes in neurotransmitter receptor sensitivity and neuroendocrine stress reactivity in rats","volume":"31","author":"Novati","year":"2008","journal-title":"Sleep"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3408","article-title":"Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial","volume":"37","author":"Talbot","year":"2014","journal-title":"Sleep"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e12710","DOI":"10.1111\/jsr.12710","article-title":"The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders","volume":"27","author":"Kalmbach","year":"2018","journal-title":"J Sleep Res"},{"key":"B48","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1146\/annurev-clinpsy-032813-153716","article-title":"The role of sleep in emotional brain function","volume":"10","author":"Goldstein","year":"2014","journal-title":"Annu Rev Clin Psychol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.smrv.2009.05.002","article-title":"Hyperarousal and insomnia: state of the science","volume":"14","author":"Bonnet","year":"2010","journal-title":"Sleep Med Rev"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2639","article-title":"Effects of stress throughout the lifespan on the brain, behaviour and cognition","volume":"10","author":"Lupien","year":"2009","journal-title":"Nat Rev Neurosci"},{"key":"B51","first-page":"459\u201382","article-title":"The relation of strength of stimulus to rapidity of habit-formation","volume-title":"J Comp Neurol Psychol","author":"Yerkes","year":"1908"},{"key":"B52","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.neubiorev.2019.06.030","article-title":"Average is good, extremes are bad\u201d - Non-linear inverted U-shaped relationship between neural mechanisms and functionality of mental features","volume":"104","author":"Northoff","year":"2019","journal-title":"Neurosci Biobehav Rev"},{"key":"B53","doi-asserted-by":"publisher","first-page":"109502","DOI":"10.5498\/wjp.v15.i10.109502","article-title":"Post-pandemic mental health: Understanding the global psychological burden and charting future research priorities","volume":"15","author":"Ding","year":"2025","journal-title":"World J Psychiatry"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.1067","article-title":"Neuropsychiatric ramifications of severe COVID-19 and other severe acute respiratory infections","volume":"79","author":"Clift","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02028-2","article-title":"How COVID-19 shaped mental health: from infection to pandemic effects","volume":"28","author":"Penninx","year":"2022","journal-title":"Nat Med"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1680558\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:29:48Z","timestamp":1765175388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1680558\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":55,"alternative-id":["10.3389\/fpsyt.2025.1680558"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1680558","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]},"article-number":"1680558"}}