Analyzing Risk Factors for Adolescent Anxiety and Insomnia in the Context of the Sustainable Development Goals Health and Well-being Goal: A Nationwide Study in Taiwan

Abstract

Aligned with Sustainable Development Goal 3 (SDG 3), this study examined the prevalence of anxiety-induced insomnia and its associations with lifestyle, psychosocial, and demographic factors among Taiwanese adolescents. Data were drawn from the 2012–2016 Taiwan Adolescent Health Behavior Survey ( n = 18,020). Anxiety-related insomnia was classified into three levels based on self-reported frequency over the past year. Kendall’s tau-b correlation was used to assess associations with health behaviors, family and peer support, and demographic variables. Overall, 22.1% of adolescents reported experiencing anxiety-induced insomnia “often” or “always.” Higher risk was observed among females, older students, and those dissatisfied with their body image ( P < .0001). Unhealthy dietary habits (e.g., skipping breakfast, low fruit/vegetable intake, high-fat/sugar consumption), longer screen time, and fast food intake were positively associated with insomnia ( P < .0001). Protective factors included parental understanding, awareness of adolescents’ leisure activities, and peer support, while overcontrolling parental behavior (e.g., checking personal belongings) increased risk. Anxiety-induced insomnia is linked to multiple modifiable behavioral and psychosocial factors. These findings underscore the need for enhanced health education, family involvement, and school-based mental health screening. Such efforts support SDG 3’s goals to improve adolescent mental well-being and guide the development of targeted public health interventions.