The Role of Sleep Quality and Sleepiness in the Relationship Between Cognitive Flexibility and Fatigue.

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Title: The Role of Sleep Quality and Sleepiness in the Relationship Between Cognitive Flexibility and Fatigue.
Authors: Ozkutlu, Ozge (AUTHOR), Ozun, Ozgu Inal (AUTHOR)
Source: Psychiatric Quarterly. Dec2025, Vol. 96 Issue 4, p735-749. 15p.
Subjects: Sleep quality, Cognitive flexibility, Mediation (Statistics), Fatigue (Physiology), Adults, Drowsiness
Abstract: This study aimed to determine the pathways linking cognitive flexibility to fatigue through the serial mediation effect of sleep quality and sleepiness in 564 healthy adults using various scales, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Chalder Fatigue Scale, and Cognitive Flexibility Inventory. Analysis was performed using two mediating variables (sleep quality and sleepiness) with age and gender as covariates. The simple mediation effect was evaluated using the Causal Step. The indirect effect was examined using bootstrap method and Sobel test. The total and direct effects of cognitive flexibility on fatigue were both found to be statistically significant. The research model revealed three significant indirect effects: cognitive flexibility affecting fatigue through sleep quality, cognitive flexibility affecting fatigue through sleepiness and cognitive flexibility affecting fatigue through both sleep quality and sleepiness. Additionally, serial mediation analysis showed that the relationship between cognitive flexibility and fatigue is sequentially mediated by sleep quality and sleepiness (B = -0.064, SE = 0.013, 95% CI: -0.070 to -0.017). All effects were confirmed through the 95% confidence intervals, which did not include zero, and with significant p values. These findings highlight the role of sleep quality and sleepiness as serial mediators of the relationship between cognitive flexibility and fatigue. The study's major contribution is to provide insight on the independent and serial mediating role of sleep quality and sleepiness in the relationship between cognitive flexibility to fatigue. [ABSTRACT FROM AUTHOR]
Copyright of Psychiatric Quarterly is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The Role of Sleep Quality and Sleepiness in the Relationship Between Cognitive Flexibility and Fatigue.
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  Data: <searchLink fieldCode="AR" term="%22Ozkutlu%2C+Ozge%22">Ozkutlu, Ozge</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ozun%2C+Ozgu+Inal%22">Ozun, Ozgu Inal</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychiatric+Quarterly%22">Psychiatric Quarterly</searchLink>. Dec2025, Vol. 96 Issue 4, p735-749. 15p.
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  Data: <searchLink fieldCode="DE" term="%22Sleep+quality%22">Sleep quality</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+flexibility%22">Cognitive flexibility</searchLink><br /><searchLink fieldCode="DE" term="%22Mediation+%28Statistics%29%22">Mediation (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Fatigue+%28Physiology%29%22">Fatigue (Physiology)</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Drowsiness%22">Drowsiness</searchLink>
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  Label: Abstract
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  Data: This study aimed to determine the pathways linking cognitive flexibility to fatigue through the serial mediation effect of sleep quality and sleepiness in 564 healthy adults using various scales, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Chalder Fatigue Scale, and Cognitive Flexibility Inventory. Analysis was performed using two mediating variables (sleep quality and sleepiness) with age and gender as covariates. The simple mediation effect was evaluated using the Causal Step. The indirect effect was examined using bootstrap method and Sobel test. The total and direct effects of cognitive flexibility on fatigue were both found to be statistically significant. The research model revealed three significant indirect effects: cognitive flexibility affecting fatigue through sleep quality, cognitive flexibility affecting fatigue through sleepiness and cognitive flexibility affecting fatigue through both sleep quality and sleepiness. Additionally, serial mediation analysis showed that the relationship between cognitive flexibility and fatigue is sequentially mediated by sleep quality and sleepiness (B = -0.064, SE = 0.013, 95% CI: -0.070 to -0.017). All effects were confirmed through the 95% confidence intervals, which did not include zero, and with significant p values. These findings highlight the role of sleep quality and sleepiness as serial mediators of the relationship between cognitive flexibility and fatigue. The study's major contribution is to provide insight on the independent and serial mediating role of sleep quality and sleepiness in the relationship between cognitive flexibility to fatigue. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Psychiatric Quarterly is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s11126-025-10135-9
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      – Code: eng
        Text: English
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      – SubjectFull: Sleep quality
        Type: general
      – SubjectFull: Cognitive flexibility
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      – SubjectFull: Mediation (Statistics)
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      – SubjectFull: Fatigue (Physiology)
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      – SubjectFull: Adults
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      – SubjectFull: Drowsiness
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              Text: Dec2025
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              Y: 2025
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