Sleep-Related Metacognitive Process, Sleep Effort, and Depression Mediate the Influence of Viral Anxiety on Insomnia Severity

Background and Objective We aimed to figure out how viral anxiety, which is pandemic-related, affects insomnia severity and the mediating roles of depression, preoccupation with sleep, and sleep-related metacognition in the effect.Methods An online survey was conducted on 300 participants from the general population in South Korea. The Insomnia Severity Index (ISI), Stress and Anxiety to Viral Epidemics-6 (SAVE-6), Glasgow Sleep Effort Scale (GSES), Metacognition Questionnaire-Insomnia-14 (MCQI-14), and Patient Health Questionnaire-9 (PHQ-9) were used as standardized psychological scales to measure insomnia severity, viral anxiety, sleep preoccupation, sleep-related metacognition, and depression, respectively. Subsequent to the measurement, we conducted Pearson’s correlation, multiple linear regression, and bootstrapped mediation analyses to find the relationships among the analysis variables.Results Preoccupation with sleep (β=0.506, p<0.001), sleep-related metacognition (β=0.132, p<0.001), and depression (β=0.355, p<0.001) were identified as significant predictors of insomnia severity. However, viral anxiety did not directly affect insomnia severity but exerted an indirect influence through the mediators (β=-0.060, p=0.171). In the mediation analysis, depression (β=0.09, p<0.001), preoccupation with sleep (β=0.09, p<0.001), and sleep-related metacognition (β=0.07, p<0.001) mediated the relationship between viral anxiety and insomnia severity, stressing the role of cognitive-emotional factors in sleep disturbances.Conclusions The findings of the study show that viral anxiety contributes to insomnia through psychological pathways rather than through a direct route. Managing sleep preoccupation, sleep-related maladaptive beliefs, and depressive symptoms may help manage sleep issues during the pandemic.