Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 29:16:1444831.
doi: 10.3389/fpsyg.2025.1444831. eCollection 2025.

Perceived stress and sleep quality in young and middle-aged patients with coronary heart disease: the mediating role of perceived social support and mental health literacy

Ying Lu  1 , Juan Li  1 , Zhenzhen Cui  1 , Mengzhen Zheng  1 , Yuqin Zhao  1
Affiliations

Perceived stress and sleep quality in young and middle-aged patients with coronary heart disease: the mediating role of perceived social support and mental health literacy

Ying Lu et al. Front Psychol. .

Abstract

Background: Globally, there is an increasing emphasis on mental health, particularly its role in the recovery of patients with coronary heart disease (CHD). Although previous studies have shown that perceived social support (PSS), mental health literacy (MHL), perceived stress and sleep quality are significantly related, the interaction mechanism remains unclear.

Objectives: To explore the status of perceived stress, sleep quality, PSS and MHL in young and middle-aged patients with CHD and to test the mediating effect of PSS and MHL between perceived stress and sleep quality.

Methods: A convenience sample of 183 young and middle-aged patients with CHD was enrolled between September 2023 and January 2024. Data were collected using a demographic characteristics questionnaire, the mental health literacy scale, the perceived social support scale, the Chinese perceived stress scale, and the Athens insomnia scale. Pearson correlation analysis was conducted to examine relationships between variables, while linear regression analysis was used to assess the predictive effects of perceived stress, PSS, and MHL on sleep quality. Additionally, the PROCESS 4.2 macro for SPSS was employed to explore the mediating roles of PSS and MHL in the relationship between patients' perceived stress and sleep quality.

Results: Correlation analysis revealed that perceived stress in young and middle-aged patients with CHD was negatively correlated with MHL (r = -0.381, p < 0.001) and PSS (r = -0.244, p < 0.001), but positively correlated with sleep quality (r = 0.349, p < 0.001). Additionally, the chain mediating role of PSS and MHL (3.93%) between perceived stress and sleep quality was significant.

Conclusion: Perceived stress not only directly affected sleep quality in young and middle-aged patients with CHD but also could indirectly affect sleep quality through PSS and MHL.

Keywords: coronary heart disease; mental health; sleep quality; social support; stress.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Descriptive and correlation analysis of scores for variables.
Figure 2
Figure 2
Mediating model and regression coefficient of perceived social support and mental health literacy in the relationship between perceived stress and sleep quality.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Alan S., Vurgec B. A., Cevik A., Gozuyesil E., Surucu S. G. (2020). The effects of COVID-19 pandemic on pregnant women: perceived stress, social support and sleep quality. Yonago Acta Med. 63, 360–367. doi: 10.33160/yam.2020.11.016, PMID: - DOI - PMC - PubMed
    1. Alexim G. A., Rocha L. F., Dobri G. P., Rosa Junior A. D. S., Reis R. T. B., Nogueira A. C. C., et al. (2022). Clinical and economic impact of coronary artery bypass graft and percutaneous coronary intervention in young individuals with acute coronary syndromes and multivessel disease: a real-world comparison in a middle-income country. Front. Cardiovasc. Med. 9:1000260. doi: 10.3389/fcvm.2022.1000260, PMID: - DOI - PMC - PubMed
    1. Baldini V., Gnazzo M., Rapelli G., Marchi M., Pingani L., Ferrari S., et al. (2024). Association between sleep disturbances and suicidal behavior in adolescents: a systematic review and meta-analysis. Front. Psych. 15:1341686. doi: 10.3389/fpsyt.2024.1341686, PMID: - DOI - PMC - PubMed
    1. Cerezci-Duygu S., Ozdemir F., Karakas G. (2023). Relationship between physical activity level and stress perception: exploring factors during COVID−19 pandemic. J. Res. Health Sci. 23:e00585. doi: 10.34172/jrhs.2023.120, PMID: - DOI - PMC - PubMed
    1. Du L., Cai J., Yu J., Chen X., Yang X., Xu X., et al. (2024). Relations between posttraumatic growth and fear of progression among Young and middle-aged primary brain tumor patients: the parallel mediating role of perceived social support and illness uncertainty. World Neurosurg. 184, e794–e802. doi: 10.1016/j.wneu.2024.02.048, PMID: - DOI - PubMed

LinkOut - more resources