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Sleep Initiation and Maintenance Disorders / Kidney Failure, Chronic · Journal article
Renal Failure · July 9, 2026
Reinforces what was already believed, rather than introducing something new.
This cross-sectional study of 207 maintenance dialysis patients quantifies the independent associations of anxiety and insomnia with impaired health-related quality of life, and demonstrates that psychological resilience partially mediates the anxiety pathway but not the insomnia pathway. The findings suggest distinct mechanisms linking these psychological factors to quality of life, with implications for tailored psychosocial interventions.
Cross-sectional study. 207 adult patients undergoing maintenance dialysis. n = 207.
Each one-point increase in anxiety score was associated with a 1.61-point decrease in PCS and a 1.15-point decrease in MCS Each one-point increase in insomnia score was associated with a 1.01-point decrease in PCS and a 0.91-point decrease in MCS Psychological resilience partially mediated the association between anxiety and HRQoL (23.46% for PCS; 30.37% for MCS)
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Clinicians managing dialysis patients should recognize that anxiety and insomnia contribute independently to reduced quality of life through different mechanisms. Interventions targeting psychological resilience may be particularly effective for anxiety-related quality of life impairment, while insomnia may require direct symptom-focused treatment.
Cross-sectional study with multivariable regression and mediation analysis confirms known associations and quantifies mediating pathways in a well-defined clinical population.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians managing dialysis patients should recognize that anxiety and insomnia contribute independently to reduced quality of life through different mechanisms. Interventions targeting psychological resilience may be particularly effective for anxiety-related quality of life impairment, while insomnia may require direct symptom-focused treatment.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This study examined the associations of anxiety, insomnia, and psychological resilience with health-related quality of life (HRQoL) among maintenance dialysis patients and explored potential mediating roles. In this cross-sectional study, 207 adult patients undergoing maintenance dialysis were recruited. HRQoL was assessed using the Short Form-36 Health Survey (SF-36), generating Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Anxiety, insomnia, and psychological resilience were measured using the Generalized Anxiety Disorder-7 (GAD-7), Athens Insomnia Scale (AIS), and 25-item Connor-Davidson Resilience Scale (CD-RISC-25), respectively. Multivariable linear regression and bootstrap-based mediation analyses were conducted. Furthermore, subgroup analyses were conducted to examine the robustness of the results.Higher anxiety and insomnia scores were independently associated with lower PCS and MCS, whereas resilience was positively associated with both components. Each one-point increase in anxiety score was associated with a 1.61-point decrease in PCS and a 1.15-point decrease in MCS; corresponding decreases for insomnia were 1.01 and 0.91 points. Psychological resilience partially mediated the association between anxiety and HRQoL (23.46% for PCS; 30.37% for MCS), but no significant mediation was observed for insomnia. Subgroup analyses showed consistent associations for insomnia, while the anxiety-HRQoL relationship was modified by smoking status and diabetes. Anxiety and insomnia are independently associated with impaired HRQoL in dialysis patients. Psychological resilience partially explains the adverse impact of anxiety, but not insomnia, suggesting distinct patterns of association and potential targets for tailored psychosocial interventions.
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