Sleep Disturbance as a Mediator Between Self-Reported Nighttime Noise Annoyance and Depression, Anxiety, and Suicide: A Mediation Analysis.

OBJECTIVE

To examine whether sleep disturbance mediates associations between self-reported nighttime noise annoyance and depression, anxiety, and suicide risk in Taiwanese adults.

METHODS

We analyzed cross-sectional online survey data from 776 Taiwanese adults collected between December 2024 and May 2025. Self-reported nighttime noise annoyance from road traffic, railways, aircraft, and residential building vibrations was assessed on a 5-point verbal scale. Sleep disturbance was assessed with the Pittsburgh Sleep Quality Index (PSQI), and depression, anxiety, and suicide risk were assessed with validated self-report scales. Mediation analyses estimated total, natural direct, and natural indirect effects using 5000 bootstrap resamples.

RESULTS

Self-reported nighttime noise annoyance from road traffic, aircraft, and residential building vibrations was associated with poorer subjective sleep quality. Self-reported nighttime noise annoyance from all four sources was associated with longer sleep latency, more sleep disturbances, greater use of sleeping medication, worse daytime dysfunction, and higher global PSQI scores ( B  = 0.652-0.788; all P < 0.001), but not with sleep duration or habitual sleep efficiency. Significant natural indirect effects through sleep disturbance were observed for anxiety, depression, and suicide risk for road traffic annoyance ( B  = 0.076-0.463) and residential building vibration annoyance ( B  = 0.082-0.503); 95% confidence intervals excluded 0. For residential building vibration annoyance, 40.1%-63.6% of total associations were mediated.

CONCLUSION

Sleep disturbance may mediate associations between self-reported nighttime noise annoyance and depression, anxiety, and suicide risk. Populations reporting nighttime noise annoyance may benefit from sleep assessment and source-specific noise mitigation.