Insomnia and emotion dysregulation: a meta-analytical perspective integrating regulatory strategies and dispositional difficulties

Insomnia and emotion dysregulation are intricately related, yet their aggregate association across different domains of emotion dysregulation and the effect of moderating factors including health-related status, age, and gender remain unclear. This systematic review and meta-analysis synthesized data from 57 studies, pooling 119 effect sizes from correlational and 55 effect sizes from group comparison studies. By separate analyses, we assessed both the strength of the association and whether clinically significant insomnia symptoms exacerbate difficulty in regulating emotion. Correlational analyses revealed a significant association between insomnia symptoms and emotion dysregulation, primarily in individuals with serious health-related conditions (Fisher Z_{no-serious condition} = 0.22, Fisher Z_{serious-conditions} = 0.37, p < 0.00001). Group comparison analyses indicated that clinically significant insomnia symptoms present worse emotion dysregulation regardless of health-related status (Hedges’ g = 0.99, p = 0.01). The reliance on maladaptive emotion regulation strategies and difficulties in dispositional domains of emotion regulation, particularly impulsivity, were more strongly associated with insomnia than challenges related to adaptive strategies. Age and gender did not impact these associations in either type of study. These findings underscore a robust link between insomnia and emotion dysregulation, suggesting the potential benefits of integrating emotion regulation skills into insomnia management to improve therapeutic outcomes.