Volume 24 Issue 5
May  2026
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Article Navigation >  Chinese Journal of General Practice  > 2026  >  24(5): 739-742
YAO Yufei, SUN Guozhen, LI Mingfang, BAO Zhipeng, WANG Lin. The mediating effect of loneliness on the relationship between alexithymia and sleep quality in patients with atrial fibrillation[J]. Chinese Journal of General Practice, 2026, 24(5): 739-742. doi: 10.16766/j.cnki.issn.1674-4152.004480
Citation: YAO Yufei, SUN Guozhen, LI Mingfang, BAO Zhipeng, WANG Lin. The mediating effect of loneliness on the relationship between alexithymia and sleep quality in patients with atrial fibrillation[J]. Chinese Journal of General Practice, 2026, 24(5): 739-742. doi: 10.16766/j.cnki.issn.1674-4152.004480
shu

The mediating effect of loneliness on the relationship between alexithymia and sleep quality in patients with atrial fibrillation

doi: 10.16766/j.cnki.issn.1674-4152.004480

  • Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, China

Funds:

 82270329

 PY2022002

  • Received Date: 2025-11-10
    Available Online: 2026-10-23
    Abstract
  •   Objective  To explore the impact of alexithymia on the sleep quality of patients with atrial fibrillation and the mediating role of loneliness in it, with the hope of providing a reference for the sleep management of patients with atrial fibrillation.  Methods  This study employed a convenience sampling method, selecting 300 patients with atrial fibrillation who visited the First Affiliated Hospital of Nanjing Medical University from January to September 2024. A general information questionnaire, the Toronto alexithymia scale-20 (TAS-20), the 6-item loneliness scale (ULS-6), and the Pittsburgh sleep quality index (PSQI) were used for assessment. The PROCESS macro program and the Bootstrap method were utilized for mediating effect analysis.  Results  The study found that patients with atrial fibrillation had poor sleep quality [7.00 (5.00, 11.00) points], were at the borderline level of alexithymia [55.00 (48.00, 61.00) points], and had a mild level of loneliness [13.00 (12.00, 15.00) points]. Patients who were older or of a lower education level had poorer sleep quality. Mediation effect analysis showed that the total effect size was 0.076, with alexithymia having a direct negative impact on sleep quality (effect=0.051), and loneliness partially mediating the impact of alexithymia on sleep quality (effect=0.025). All results were statistically significant (P < 0.05).  Conclusion  Alexithymia is a direct risk factor for sleep quality in patients with atrial fibrillation, and loneliness plays a partial mediating role between alexithymia and sleep quality. Therefore, clinical interventions for patients with atrial fibrillation and alexithymia should consider reducing loneliness to effectively improve sleep quality.

     

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    • References(24)
  • [1]
    国家心血管病中心, 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2024概要[J]. 中国循环杂志, 2025, 40(6): 521-559.

    National Center for Cardiovascular Diseases, Writing Group of Chinese Report on Cardiovascular Health and Diseases. Report on cardiovascular health and diseases in China 2024: an updated summary[J]. Chinese Circulation Journal, 2025, 40(6): 521-559.
    [2]
    KIM W, NA J O, THOMAS R J, et al. Impact of catheter ablation on sleep quality and relationship between sleep stability and recurrence of paroxysmal atrial fibrillation after successful ablation: 24-hour holter-based cardiopulmonary coupling analysis[J]. J Am Heart Assoc, 2020, 9(23): e017016. DOI: 10.1161/JAHA.120.017016.
    [3]
    胡光玲, 乔昕悦, 张林虹, 等. 心房颤动患者睡眠质量与生活质量的相关性分析[J]. 中华全科医学, 2021, 19(1): 24-26, 41. doi: 10.16766/j.cnki.issn.1674-4152.001720

    HU G L, QIAO X Y, ZHANG L H, et al. Correlation analysis of sleep quality and life quality in patients with atrial fibrillation[J]. Chinese Journal of General Practice, 2021, 19(1): 24-26, 41. doi: 10.16766/j.cnki.issn.1674-4152.001720
    [4]
    PREECE D A, MEHTA A, PETROVA K, et al. Alexithymia and emotion regulation[J]. J Affect Disord, 2023, 324: 232-238. doi: 10.1016/j.jad.2022.12.065
    [5]
    ALIMORADI Z, MAJD N R, BROSTRÖM A, et al. Is alexithymia associated with sleep problems?A systematic review and meta-analysis[J]. Neurosci Biobehav Rev, 2022, 133: 104513. DOI: 10.1016/j.neubiorev.2021.12.036.
    [6]
    CENé C W, BECKIE T M, SIMS M, et al. Effects of objective and perceived social isolation on cardiovascular and brain health: a scientific statement from the American Heart Association[J]. J Am Heart Assoc, 2022, 11(16): e026493. DOI: 10.1161/JAHA.122.026493.
    [7]
    中华医学会心血管病学分会, 中国生物医学工程学会心律分会. 心房颤动诊断和治疗中国指南[J]. 中华心血管病杂志, 2023, 51(6): 572-618.

    Chinese Society of Cardiology, Chinese Medical Association; Heart Rhythm Committee of Chinese Society of Biomedical Engineering. Chinese guidelines on diagnosis and management of atrial fibrillation[J]. Chinese Journal of Cardiology, 2023, 51(6): 572-618.
    [8]
    时景璞. 临床研究中样本量的估计方法[J]. 中国临床康复, 2003, 7(10): 1569-1571.

    SHI J P. The methods of sample size estimation in clinical study[J]. Chinese Journal of Clinical Rehabilitation, 2003, 7(10): 1569-1571.
    [9]
    WILLIAMS Z J, GOTHAM K O. Improving the measurement of alexithymia in autistic adults: a psychometric investigation and refinement of the twenty-item Toronto Alexithymia Scale[J]. Mol Autism, 2021, 12(1): 20. DOI: 10.1186/s13229-021-00427-9.
    [10]
    袁勇贵, 沈鑫华, 张向荣, 等. 多伦多述情障碍量表(TAS-20)的信度和效度研究[J]. 四川精神卫生, 2003, 16(1): 25-27.

    YUAN Y G, SHEN X H, ZHANG X R, et al. The reliability and validity of Toronto alexithymia scale(TAS-20)[J]. Sichuan Mental Health, 2003, 16(1): 25-27.
    [11]
    LILEBERZ J, SHAMAY-TSOORY S G, SAPORTA N, et al. Behavioral and neural dissociation of social anxiety and loneliness[J]. J Neurosci, 2022, 42(12): 2570-2583. doi: 10.1523/JNEUROSCI.2029-21.2022
    [12]
    肖蓉, 杜静雯. 6条目孤独感量表(ULS-6)是测量中国成年人群孤独感的有效工具[J]. 南方医科大学学报, 2023, 43(6): 900-905.

    XIAO R, DU J W. Reliability and validity of the 6-item UCLA Loneliness Scale(ULS-6)for application in adults[J]. Journal of Southern Medical University, 2023, 43(6): 900-905.
    [13]
    路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析[J]. 重庆医学, 2014, 43(3): 260-263.

    LU T Y, LI Y, XIA P, et al. Analysis on reliability and validity of the Pittsburgh sleep quality index[J]. Chongqing Medicine, 2014, 43(3): 260-263.
    [14]
    温忠麟, 叶宝娟. 中介效应分析: 方法和模型发展[J]. 心理科学进展, 2014, 22(5): 731-745.

    WEN Z L, YE B J. Analyses of Mediating Effects: The Development of Methods and Models[J]. Advances in Psychological Science, 2014, 22(5): 731-745.
    [15]
    MONTISCI R, SANCASSIANI F, MARCHETTI M F, et al. Alexithymia for cardiologists: a clinical approach to the patient[J]. J Cardiovasc Med (Hagerstown), 2023, 24(7): 392-395. doi: 10.2459/JCM.0000000000001487
    [16]
    ISOMATSU D, SATO A, SAKUMA Y, et al. The prognostic implications of living alone on long-term mortality in patients with chronic coronary syndrome after percutaneous coronary intervention[J]. Int Heart J, 2023, 64(4): 584-589. doi: 10.1536/ihj.23-063
    [17]
    HOANG P, KING J A, MOORE S, et al. Interventions associated with reduced loneliness and social isolation in older adults: a systematic review and meta-analysis[J]. JAMA Network Open, 2022, 5(10): e2236676. DOI: 10.1001/jamanetworkopen.2022.36676.
    [18]
    LU X, AN Z, XU Y, et al. Mediating effect of illness perception on the relationship between perceived family function and sleep quality among patients with atrial fibrillation[J]. Nurs Open, 2024, 11(11): e70085. DOI: 10.1002/nop2.70085.
    [19]
    HU L X, TANG M, HUA W, et al. Psychological disturbances and their association with sleep disturbance in patients admitted for arrhythmia diseases[J]. Neuropsychiatr Dis Treat, 2022, 18: 1739-1750. doi: 10.2147/NDT.S370128
    [20]
    BITTER T, WESTERHEIDE N, PRINZ C, et al. Cheyne-Stokes respiration and obstructive sleep apnoea are independent risk factors for malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapies in patients with congestive heart failure[J]. Eur Heart J, 2021, 32(1): 61-74.
    [21]
    O'CONNOR D B, ROGERSON O. Loneliness, sleep and daily stress: Evidence of direct and indirect effects[J]. Appl Psychol Health Well-Being, 2024, 16(4): 2302-2318. doi: 10.1111/aphw.12586
    [22]
    SHAH SGS, NOGUERAS D, VAN WOERDEN H C, et al. Evaluation of the effectiveness of digital technology interventions to reduce loneliness in older adults: systematic review and meta-analysis[J]. J Med Internet Res, 2021, 23(6): e24712. DOI: 10.2196/24712.
    [23]
    HUDSON J, ZARLING A, UNGAR R, et al. Older adults' experiences in a web-based intervention for loneliness[J]. Gerontol Geriatr Med, 2023, 9: 23337214231163004. DOI: 10.1177/23337214231163004.
    [24]
    闫珊, 沈慧, 顾智淳, 等. 新型智慧化管理模式在心房颤动患者社区随访管理中的效果评价[J]. 中华全科医学, 2024, 22(6): 1008-1012. doi: 10.16766/j.cnki.issn.1674-4152.003555

    YAN S, SHEN H, GU Z C, et al. Evaluation of the effect of a new intelligent management model in community follow-up management of patients with atrial fibrillation[J]. Chinese Journal of General Practice, 2024, 22(6): 1008-1012. doi: 10.16766/j.cnki.issn.1674-4152.003555
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