Petak Ana, Maričić Jelena
Faculty of Croatian Studies, University of Zagreb, Borongajska Cesta 83d, 10000 Zagreb, Croatia.
Int J Environ Res Public Health. 2025 Jun 25;22(7):1001. doi: 10.3390/ijerph22071001.
Poor sleep is strongly associated with stress; however, the mediators of this relationship are not well understood. Cognitive arousal in the form of rumination and worry may mediate this relationship, but previous studies have primarily focused on patients with insomnia or employed cross-sectional designs. This study aimed to explore the causal relationship between sleep quality and stress using two-wave longitudinal data and examining the theoretical assumptions of insomnia models in a healthy, non-clinical student population. Research was conducted using a paper-and-pencil method. The sample included 302 undergraduate students from the University of Zagreb. Most of the participants were female (79.8%) and aged between 18 and 33 years, representing various fields of study. The research problem was examined through multiple mediation analysis. The results confirm our initial hypothesis regarding the bidirectional relationship between stress and sleep quality, which is partially mediated by rumination. The mediating effect of worry is significant only in parallel mediation; poor sleep quality leads to increased rumination ( < 0.01), which in turn predicts more worry ( < 0.01), and greater worry predicts more stress ( < 0.01). The effect sizes indicate that stress has a more significant impact on sleep problems ( = 0.345, < 0.01) than sleep problems have on stress ( = 0.203, < 0.01). These findings are important for planning preventive activities and therapeutic interventions.
睡眠不佳与压力密切相关；然而，这种关系的调节因素尚未得到很好的理解。以沉思和担忧形式出现的认知唤醒可能介导这种关系，但先前的研究主要集中在失眠患者或采用横断面设计。本研究旨在使用两波纵向数据探讨睡眠质量与压力之间的因果关系，并在健康的非临床学生群体中检验失眠模型的理论假设。研究采用纸笔方法进行。样本包括来自萨格勒布大学的302名本科生。大多数参与者为女性（79.8%），年龄在18至33岁之间，代表不同的研究领域。通过多重中介分析来研究该研究问题。结果证实了我们最初关于压力与睡眠质量之间双向关系的假设，这种关系部分由沉思介导。担忧的中介作用仅在平行中介中显著；睡眠质量差会导致沉思增加（<0.01），这反过来又预示着更多的担忧（<0.01），而更多的担忧预示着更多的压力（<0.01）。效应大小表明，压力对睡眠问题的影响（=0.345，<0.01）比对压力的影响（=0.203，<0.01）更大。这些发现对于规划预防活动和治疗干预措施具有重要意义。
