The following is a summary of the “Impact of rumination on sleep quality among patients with non‑alcoholic fatty liver disease: a moderated mediation model of anxiety symptoms and resilience,” published in the February 2023 issue of Psychiatry by Chang, et al.

Inadequate sleep increases the likelihood of developing NAFLD and speeds up the course of the illness. Finding out what influences NAFLD patients’ sleep quality is crucial. The current study aims to examine the influence of rumination on sleep quality, the role of anxiety symptoms in explaining this relationship, and the moderating role of resilience in this relationship. Patients with NAFLD participated in a cross-sectional study. They were asked to fill out the Pittsburgh Sleep Quality Index versions, the Ruminative Reactions Scale, the Generalized Anxiety Disorder 7-item scale, and the Resilience Scale. For this moderated mediation analysis, we used the PROCESS macro in SPSS v4.0.

Anxiety feelings were found to play a significant role in explaining the correlation between brooding, reflection, rumination, and poor sleep quality. Anxiety symptoms were found to be positively associated with brooding, introspection, and rumination, but this relationship weakened with rising levels of resilience. Resilience did not significantly attenuate the relationships between brooding, reflecting, and ruminating and poor sleep quality.

Hence, among patients with NAFLD, support was shown for a moderated mediation model, including anxiety symptoms and resilience, for understanding the impact of rumination on poor sleep quality. Anxiety symptoms played a significant role in explaining the correlation between rumination (which includes brooding and reflecting) and poor sleep quality in individuals with NAFLD. The moderating effect of resilience attenuated the positive correlation between ruminating and anxious feelings. To enhance NAFLD patients’ sleep, interventions should reduce rumination, lessen anxiety, and foster resilience.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-04572-8