29 factors linked to chronic exhaustion identified

A study by the University of Copenhagen offers a more complex perspective on the growing problems of sleep disorders and mental health issues among young people.

The findings were published in the journal BMC Medicine.

The authors note that sleep disturbances, anxiety, and depressive symptoms are becoming increasingly common among people aged roughly 18 to 40, and these conditions often occur simultaneously, reinforcing one another.

The key idea of the study is that these problems cannot be explained by a single cause. Instead, the researchers describe a system made up of many interconnected biological, psychological, and social factors. Their model includes 29 variables, among them stress levels, screen-use habits, smoking, physical activity, quality of social relationships, inflammatory processes in the body, and other indicators.

Based on expert assessments from specialists in sleep medicine, psychology, sociology, epidemiology, and biology, the team created a broader “interaction map” of these factors. The model identified 175 cause-and-effect relationships and potentially thousands of feedback loops capable of sustaining and worsening sleep and mood problems.

The main mechanism highlighted by the researchers is the presence of so-called self-reinforcing or “vicious” cycles. For example, stress and anxiety worsen sleep, poor sleep intensifies depressive symptoms, and those symptoms can lead to behaviors that further aggravate the situation. One example described in the study involves smoking: a person may start smoking more because of fatigue and stress, nicotine then worsens sleep quality, fragmented sleep increases depressive symptoms, and this in turn raises the likelihood of continued smoking.

As a result, the problem appears not as a simple linear “cause-and-effect” relationship, but as a network of mutually reinforcing processes in which changes in one factor can trigger cascading effects across many others.

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