This study used a cross-sectional survey design to characterise common sleep difficulties in adults with pulmonary hypertension (PH) and to examine relationships between sleep problems, psychological distress and health-related quality of life (HRQoL). Data were collected from 111 adults recruited via PH associations internationally. The investigation relied on multiple validated self-report instruments to assess different sleep domains, mood symptoms and HRQoL.
The participant sample was predominantly female (82%) and identified as White (91%). The instruments employed were:
These measures were used in regression and parallel mediation analyses to explore associations between sleep variables, mood and HRQoL.
A large majority—79.8%—of participants were classified as having poor sleep quality according to the PSQI. The most frequently reported sleep-related problems were sleep disturbance and prolonged sleep latency, indicating difficulty maintaining sleep and taking longer to fall asleep. The abstract reports these patterns without providing item-level frequencies or numerical sleep latency durations.
Insomnia rates, measured by the ISI, were elevated at 35% of participants. Daytime sleepiness, measured by the ESS, was elevated in 33.6% of the sample. These sleep problems commonly co-occurred within individuals.
Clinical-level mood disturbance was also common: 40% of participants met threshold criteria for depression on the PHQ-9, and 29% met criteria for anxiety on the GAD-7. The abstract does not provide details about the distribution of severity levels beyond these clinical cutoff prevalences.
All forms of sleep difficulty assessed were associated with lower HRQoL as measured by emPHasis-10. Regression analyses were used to inspect relationships between sleep measures, mood measures and other PH variables; the abstract states these associations but does not report the exact regression coefficients, significance levels, or adjustment variables in the summary.
A series of parallel mediation analyses reported in the abstract indicated that the association between sleep difficulties and reduced HRQoL was partially mediated by depressive symptoms. In other words, worse sleep related to lower HRQoL both directly and indirectly through higher levels of depressive symptoms. The abstract does not include the numerical mediation effect sizes, confidence intervals, or the full list of covariates included in the mediation models.
Based on the observed high prevalence of poor sleep, insomnia and daytime sleepiness, together with frequent co-occurrence of depressive and anxiety symptoms and their association with poorer HRQoL, the authors recommend routine screening for both sleep difficulties and mood disturbance in people with PH. They highlight the importance of recognising multiple overlapping factors that influence sleep in this population.
The authors also call for further work to determine whether existing brief sleep interventions are effective in PH, given the complexity of factors affecting sleep quality in this group. The abstract does not specify particular interventions or trials; it emphasises the need for evaluation of existing approaches rather than proposing new therapies.
The report summarised in the abstract is limited by its cross-sectional design, which prevents causal inference regarding relationships between sleep, mood and HRQoL. The abstract does not present detailed statistical outputs (for example, regression coefficients, p-values, confidence intervals), nor does it describe response rates, recruitment timelines, or the representativeness of the sample beyond reported demographics. The predominance of White and female participants may limit generalisability. Further methodological details and full results would be found in the full article rather than the abstract; those details were not reported in the source abstract.