Work

Association Between Uncertainty Stress and Insomnia Symptoms Among Chinese Patients with Type 2 Diabetes: The Mediating Role of Healthy Lifestyles Based on a Multicenter Cross-Sectional Survey

Year: 2026

Type: article

Abstract: Background: This study aimed to explore the association between uncertainty stress and insomnia symptoms and further examine the mediating mediating association of verify the mediating role of healthy lifestyles among Chinese patients with type 2 diabetes. Methods: A multicenter cross-sectional study was conducted based on 3361 patients with type 2 diabetes recruited from 26 community health service centers across China from November 2023 to March 2024. Pearson's correlation test was applied to explore the relationships among the key variables. Regression models were used to examine the mediating associations of healthy Lifestyles. Moreover, Sobel's test and the bootstrap method were employed to confirm the path effects in the models, ensuring the reliability and validity of the results. Results: Out of 3361 diabetes patients, participants had a mean age of 62.16 years, and 51.35% were male. 30.08% experienced insomnia. There was a significant correlation between uncertainty stress, healthy lifestyles, and Insomnia Symptoms (p < 0.01). Uncertainty stress was positively associated with Insomnia Symptoms (β = 0.49, p < 0.01) and negatively associated with on healthy lifestyles (β = - 0.02, p < 0.01). Healthy Lifestyles were negatively associated with insomnia symptoms (β = -0.62, p < 0.001). A small exploratory indirect association of uncertainty stress with insomnia symptoms through healthy lifestyles was observed (β = 0.015, p < 0.001). The Sobel and bootstrap tests confirmed the robustness of the regression analyses. Conclusions: Uncertainty stress was positively associated with insomnia symptoms in patients with type 2 diabetes, and healthy lifestyles may partially mediate this association. These findings suggest that reducing uncertainty stress and promoting healthy lifestyle behaviors may be promising targets for future interventions to improve sleep health among community-dwelling adults with type 2 diabetes.

Source: Diabetes Metabolic Syndrome and Obesity

DOI: 10.2147/dmso.s630672