In an Ecuadorian survey, stress and anxiety predicted insomnia — demographics did not

Most of what is known about insomnia comes from high-income countries. Latin America contributes a small share of the literature, which means the risk factors treated as established have rarely been checked in the region. A study published on 14 November in Behavioral Sciences runs that check in Ecuador, and returns a result sharper than expected [s1].

What was measured

A community sample of 698 participants (31.7% men; mean age 25.6, SD 10.4) completed an online survey during nationwide electricity blackouts in Ecuador in 2024 [s1]. The instruments were the Insomnia Severity Index, the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorder scale (GAD-7), and a demographic questionnaire [s1].

Hierarchical linear regression was used to separate the contribution of each block of predictors [s1]. That design is what makes the result legible: rather than reporting which variables reach significance in one combined model, it shows how much additional variance each block explains once the previous one is accounted for.

The result

The demographic block — age, sex, employment status, and socioeconomic level — explained 0.7% of the variance in insomnia severity (R² = 0.007), and none of its variables was a significant predictor [s1].

Perceived stress, added next, explained a further 20.7% (ΔR² = 0.207, p < 0.001) [s1]. Generalised anxiety added 7.4% on top of that (ΔR² = 0.074, p < 0.001), with both contributing independently (β ≈ 1.96 and β ≈ 2.67) [s1]. Interaction effects with socioeconomic status were non-significant [s1].

Together, the psychological factors explained close to a third of the variance in insomnia severity [s1].

What this does and does not show

This is a cross-sectional online survey. Every measure was self-reported and collected at one point in time, which means the direction of the relationship is not established: stress and anxiety may drive insomnia, insomnia may drive stress and anxiety, or a common factor may drive all three. The Insomnia Severity Index is a screening instrument, not a diagnosis.

Recruitment matters here too. The sample was gathered online during nationwide blackouts — a period of unusual disruption — and skews young (mean age 25.6) and is 31.7% men [s1]. It is a community sample, not a probability sample of Ecuadorian adults, and the results should not be read as national prevalence.

The null finding on demographics is the part most likely to be over-read. That age, sex, employment and socioeconomic level did not predict insomnia severity in this sample does not mean those factors are irrelevant to sleep in Ecuador. It means they added almost nothing once psychological distress was in the model, in a sample with limited demographic range.

How it sits against a European comparison

A longitudinal study published on 6 November in Sleep Health offers a useful contrast, because it asks a similar question with a much stronger design [s2]. It followed sleep quality across 13 waves of the COME-HERE survey from April 2020 to September 2024, using 8063 participants and over 60,000 observations drawn from representative samples in France, Germany, Italy, Spain, and Sweden [s2].

It found an upward trend in average sleep quality over the period, with fluctuations aligning with major COVID-19 waves [s2]. In multivariate regression, the key predictors of sleep quality were female gender, income, employment, physical activity, mental health, and social interactions, with financial security and mental health showing particularly strong associations [s2]. Those results held across country, gender, age, and education, and remained consistent from the height of the pandemic through the post-pandemic period [s2].

So the European data, with a longitudinal design and representative sampling, does find socioeconomic predictors mattering — income and employment among them [s2] — alongside mental health. The Ecuadorian study did not [s1]. The most parsimonious reading is not that the two regions differ, but that a cross-sectional online sample of 698 mostly young adults has limited power to detect socioeconomic gradients, while a 60,000-observation panel does not.

What it adds

The value of the Ecuadorian study is not the null on demographics. It is that a Latin American community sample reproduces the stress–anxiety–insomnia relationship at a magnitude consistent with the wider literature, in a region where that relationship had rarely been quantified [s1]. That is a modest contribution, and the authors present it as one: they argue for integrated psychological interventions to improve sleep health in Ecuador [s1], not for a change in how insomnia is understood.

This article is informational and does not constitute medical advice.

Sources

• [s1] Psychological and Demographic Predictors of Insomnia Severity: Evidence from a Community Sample in Ecuador. Behavioral Sciences, 14 November 2025. https://doi.org/10.3390/bs15111553
• [s2] Trajectories and predictors of sleep quality during and after the pandemic in five European populations. Sleep Health, 6 November 2025. https://doi.org/10.1016/j.sleh.2025.09.001