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The relationship between sleep-related worry and insomnia among shift-working nurses: the serial mediation of depression and anxiety.

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Title: The relationship between sleep-related worry and insomnia among shift-working nurses: the serial mediation of depression and anxiety.
Authors: Xie, Linxin (AUTHOR), Wu, Ao (AUTHOR), Yuan, Zijun (AUTHOR), Shu, Ting (AUTHOR), Jiang, Mengwei (AUTHOR), Liu, Detian (AUTHOR), Yang, Weiwei (AUTHOR), Xie, Hongzhen (AUTHOR)
Source: Psychology, Health & Medicine. Jun2026, Vol. 31 Issue 5, p1248-1264. 17p.
Subjects: Cross-sectional method, Effect sizes (Statistics), Pearson correlation (Statistics), Worry, Research funding, Insomnia, Statistical sampling, Questionnaires, Anxiety, Descriptive statistics, Surveys, One-way analysis of variance, Psychological tests, Data analysis software, Comparative studies, Factor analysis, Shift systems, Psychology of nurses, Sleep disorders, Mental depression, Disease risk factors, Disease complications, Psychosocial factors
Abstract: Shift-working nurses frequently experience insomnia as a consequence of irregular work schedules. This study aimed to examine the psychological mechanisms through which sleep-related worry contributes to insomnia, focusing on the roles of depressive and anxious emotions. Using convenience sampling, data on demographics, sleep-related worry, depression, anxiety, and insomnia were collected from 611 shift-working nurses. Mediation analyses were then performed with SPSS 27.0 and the PROCESS macro. Results indicated that the total effect of sleep-related worry on insomnia was 0.255 (bias-corrected 95% CI [[0.227, 0.283]), and the direct effect was 0.188 (bias-corrected 95% CI [0.155, 0.221]), accounting for 73.73% of the total effect. The independent indirect effect through depression was statistically significant (b = 0.045, bias-corrected 95% CI [0.015, 0.075]). The serial mediation effect through depression followed by anxiety was also statistically significant (b = 0.019, bias-corrected 95% CI [0.001, 0.039]), jointly accounting for 26.27% of the total effect. In contrast, the independent indirect effect of anxiety was not significant (b = 0.003, bias-corrected 95% CI [0.000, 0.009]). These findings suggest that depression serves as a key mediator between sleep-related worry and insomnia. Anxiety, although not independently significant, contributes additively to insomnia when combined with depression. Interventions that prioritize reducing sleep-related worry and strengthening emotional regulation could improve sleep quality and overall health, ultimately supporting both physical and psychological well-being. [ABSTRACT FROM AUTHOR]
Copyright of Psychology, Health & Medicine is the property of Taylor & Francis Ltd 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.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: The relationship between sleep-related worry and insomnia among shift-working nurses: the serial mediation of depression and anxiety.
– Name: Author
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  Data: <searchLink fieldCode="AR" term="%22Xie%2C+Linxin%22">Xie, Linxin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wu%2C+Ao%22">Wu, Ao</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yuan%2C+Zijun%22">Yuan, Zijun</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shu%2C+Ting%22">Shu, Ting</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jiang%2C+Mengwei%22">Jiang, Mengwei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liu%2C+Detian%22">Liu, Detian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yang%2C+Weiwei%22">Yang, Weiwei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Xie%2C+Hongzhen%22">Xie, Hongzhen</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychology%2C+Health+%26+Medicine%22">Psychology, Health & Medicine</searchLink>. Jun2026, Vol. 31 Issue 5, p1248-1264. 17p.
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  Data: <searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Effect+sizes+%28Statistics%29%22">Effect sizes (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Pearson+correlation+%28Statistics%29%22">Pearson correlation (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Worry%22">Worry</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Insomnia%22">Insomnia</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22One-way+analysis+of+variance%22">One-way analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+tests%22">Psychological tests</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Factor+analysis%22">Factor analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Shift+systems%22">Shift systems</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+of+nurses%22">Psychology of nurses</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+disorders%22">Sleep disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+complications%22">Disease complications</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Shift-working nurses frequently experience insomnia as a consequence of irregular work schedules. This study aimed to examine the psychological mechanisms through which sleep-related worry contributes to insomnia, focusing on the roles of depressive and anxious emotions. Using convenience sampling, data on demographics, sleep-related worry, depression, anxiety, and insomnia were collected from 611 shift-working nurses. Mediation analyses were then performed with SPSS 27.0 and the PROCESS macro. Results indicated that the total effect of sleep-related worry on insomnia was 0.255 (bias-corrected 95% CI [[0.227, 0.283]), and the direct effect was 0.188 (bias-corrected 95% CI [0.155, 0.221]), accounting for 73.73% of the total effect. The independent indirect effect through depression was statistically significant (b = 0.045, bias-corrected 95% CI [0.015, 0.075]). The serial mediation effect through depression followed by anxiety was also statistically significant (b = 0.019, bias-corrected 95% CI [0.001, 0.039]), jointly accounting for 26.27% of the total effect. In contrast, the independent indirect effect of anxiety was not significant (b = 0.003, bias-corrected 95% CI [0.000, 0.009]). These findings suggest that depression serves as a key mediator between sleep-related worry and insomnia. Anxiety, although not independently significant, contributes additively to insomnia when combined with depression. Interventions that prioritize reducing sleep-related worry and strengthening emotional regulation could improve sleep quality and overall health, ultimately supporting both physical and psychological well-being. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Psychology, Health & Medicine is the property of Taylor & Francis Ltd 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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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/13548506.2025.2594758
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 17
        StartPage: 1248
    Subjects:
      – SubjectFull: Cross-sectional method
        Type: general
      – SubjectFull: Effect sizes (Statistics)
        Type: general
      – SubjectFull: Pearson correlation (Statistics)
        Type: general
      – SubjectFull: Worry
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Insomnia
        Type: general
      – SubjectFull: Statistical sampling
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Surveys
        Type: general
      – SubjectFull: One-way analysis of variance
        Type: general
      – SubjectFull: Psychological tests
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Factor analysis
        Type: general
      – SubjectFull: Shift systems
        Type: general
      – SubjectFull: Psychology of nurses
        Type: general
      – SubjectFull: Sleep disorders
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: Disease complications
        Type: general
      – SubjectFull: Psychosocial factors
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    Titles:
      – TitleFull: The relationship between sleep-related worry and insomnia among shift-working nurses: the serial mediation of depression and anxiety.
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              M: 06
              Text: Jun2026
              Type: published
              Y: 2026
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