Relationship between insomnia and quality of life: Mediating effects of psychological and somatic symptomatologies

Objectives: We aimed to explore the potential mediating effects of neuroticism, depressive and anxiety symptoms, and somatic symptoms in the relationship between insomnia and health-related quality of life (HRQoL). Methods: This was a cross-sectional family study, which recruited a total of 297 adolescents (eighty insomniacs as determined by clinical interview) and 318 parents (93 insomniacs). HRQoL was measured by short form-36 (SF-36) health survey. A series of questionnaires were employed to measure insomnia severity, neuroticism personality, and depressive, anxiety and somatic symptoms. Results: Participants with insomnia had lower HRQoL than those without insomnia (71.9 vs. 77.1, P < 0.001). Insomnia severity (as measured byInsomnia Severity Index) was significantly associated with HRQoL (correlation coefficient = −0.451, P < 0.001). A total of 53% of the variance of SF-36 could be explained by the mediation model, which showed that a large proportion of the variances in the association between insomnia severity and HRQoL was mediated by depressive symptoms, somatic symptoms, and neuroticism personality trait. Conclusions: The close associations between insomnia severity and impaired HRQoL are largely mediated by psychological symptomatology and personality dimension. Further prospective study is warranted to investigate the long-term impact of insomnia symptoms on HRQoL and the roles of mood and somatic symptoms.