Outpatient Service By Famous Specialists, The First Affiliated Hospital of China Medical University, Shenyang, China.
Department of Clinical Nutrition, The First Affiliated Hospital of China Medical University, Shenyang, China.
BMC Psychiatry. 2023 Feb 2;23(1):84. doi: 10.1186/s12888-023-04572-8.
Poor sleep raises the risk of non-alcoholic fatty liver disease (NAFLD) and hastens disease progression. It is critical to figure out what factors impact the sleep quality of NAFLD patients. The present study aimed to investigate the role of anxiety symptoms in accounting for the impact of rumination on sleep quality and the moderating role of resilience on the associations of rumination with anxiety symptoms and sleep quality.
In the cross-sectional study, 285 NAFLD patients completed the Chinese version of the Pittsburgh Sleep Quality Index, the Ruminative Responses Scale, the Generalized Anxiety Disorder 7-item scale, and the 14-item Resilience Scale to measure sleep quality, rumination (including brooding and reflection), anxiety symptoms, and resilience, respectively. The PROCESS macro for SPSS v4.0 procedure was applied to perform moderated mediation analysis.
The roles of anxiety symptoms in accounting for the positive associations of brooding, reflection and rumination with poor sleep quality were revealed. It was found that there was a significant moderating role of resilience on the positive associations of brooding, reflection and rumination with anxiety symptoms, which were gradually reduced as resilience increased. The direct associations between brooding, reflection and rumination and poor sleep quality were not significantly moderated by resilience. Thus, a moderated mediation model involving anxiety symptoms and resilience for explaining the impact of rumination on poor sleep quality was supported among patients with NAFLD.
Rumination (including brooding and reflection) could be positively related to poor sleep quality, and anxiety symptoms had a significant role in accounting for the relationship among patients with NAFLD. Resilience showed a moderating role that could attenuate the positive association between rumination and anxiety symptoms. Interventions aimed at alleviating rumination, reducing anxiety symptoms, and enhancing resilience could improve the sleep quality of NAFLD patients.
睡眠质量差会增加非酒精性脂肪性肝病（NAFLD）的风险，并加速疾病进展。因此，了解哪些因素会影响 NAFLD 患者的睡眠质量至关重要。本研究旨在探讨焦虑症状在解释反刍对睡眠质量的影响中的作用，以及韧性在反刍与焦虑症状和睡眠质量之间的关系中的调节作用。
在这项横断面研究中，285 名 NAFLD 患者完成了匹兹堡睡眠质量指数中文版、反刍反应量表、广泛性焦虑障碍 7 项量表和 14 项韧性量表，分别用于评估睡眠质量、反刍（包括沉思和反省）、焦虑症状和韧性。采用 SPSS v4.0 程序 PROCESS 宏进行中介调节分析。
揭示了焦虑症状在解释沉思、反省和反刍与睡眠质量差之间的正相关关系中的作用。结果发现，韧性对沉思、反省和反刍与焦虑症状之间的正相关关系具有显著的调节作用，随着韧性的增加，这种正相关关系逐渐减弱。沉思、反省和反刍与睡眠质量差之间的直接关联不受韧性的显著调节。因此，在 NAFLD 患者中，反刍对睡眠质量差的影响可以通过焦虑症状和韧性来解释，这一调节中介模型得到了支持。
反刍（包括沉思和反省）可能与睡眠质量差呈正相关，焦虑症状在解释 NAFLD 患者之间的关系中起着重要作用。韧性表现出调节作用，可以减弱反刍与焦虑症状之间的正相关关系。针对缓解反刍、减轻焦虑症状和增强韧性的干预措施可能会改善 NAFLD 患者的睡眠质量。
