Network analysis of anxiety, depression, self-affirmation, and sleep disturbances in general hospital patients: a cross-sectional study

Sleep disorders are prevalent among general hospital patients, significantly impairing quality of life and exacerbating existing medical conditions, leading to prolonged hospital stays and increased costs. Current treatments primarily rely on pharmacological and psychological interventions, often neglecting the complex interactions between sleep disorders and emotional disturbances such as anxiety and depression, as well as psychological traits like self-affirmation. This study aims to address this gap by systematically exploring the multidimensional factors influencing sleep disorders and elucidating their interrelations. Utilizing a cross-sectional design, the research involved 5,523 hospital patients, employing standardized scales (PHQ-9, GAD-7, SA-9, and AIS-8) alongside multiple linear regression and network analysis methods to assess the impact of psychological factors on sleep disturbances. The results demonstrated that anxiety, depression, and self-affirmation are significantly associated with sleep disorders, with depression emerging as the strongest correlate. The network analysis revealed core symptoms and bridging pathways, notably highlighting the strong statistical associations of depressive symptoms with sleep disturbances. Additionally, no significant differences were observed in network structures across gender and marital status subgroups, suggesting that intervention strategies may maintain broad applicability. This research not only enriches the theoretical framework surrounding the comorbidity of sleep disorders and psychological symptoms but also provides critical insight for the development of targeted psychological health management strategies in hospital settings, emphasizing the need for comprehensive approaches that address both psychological and sleep health. The findings present innovative implications for future research and clinical practice, advocating for a nuanced understanding of psychological factors in sleep disorder interventions.