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Negative illness perception is associated with increased insomnia in maintenance hemodialysis patients, partially mediated by fear of progression and moderated by self-compassion.

In a cross-sectional study of 332 maintenance hemodialysis patients in China, 55.72% reported insomnia. Illness perception was positively correlated with insomnia (r=0.629, p<0.01), and fear of progression mediated 17.5% of this relationship. Self-compassion moderated the effect, with higher self-compassion weakening the link between illness perception and fear of progression.

Last updated: Jul 24, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Illness perception and insomnia among patients with maintenance hemodialysis: a moderated mediation model of fear of progression and self-compassion.

observational

Huang Y, Chen M, Zhong S, Liu Y, Xu R, Li Y, Li K, Wei Y, Luo X · Renal failure (2026)

Participants: N/A
Duration: 5 months (January 2025 to May 2025)
Intervention: Observational study; no intervention tested. Examined associations between illness perception, fear of progression, self-compassion, and insomnia.
Outcome: Insomnia measured by Athens Insomnia Scale; illness perception by Brief Illness Perception Questionnaire; fear of progression by Fear of Progression Questionnaire-Short Form; self-compassion by Self-Compassion Scale-Short Form.
Effect Size: Mediation effect: 17.5% of total impact; correlation coefficients: r=0.629 (illness perception-insomnia), r=0.479 (fear of progression-insomnia), r=-0.451 (self-compassion-insomnia).
Population: 332 maintenance hemodialysis patients in Chongqing, China, studied from January 2025 to May 2025.

Result:

PubMed: 42478234DOI: 10.1080/0886022X.2026.2670075

Mechanism Graph

Negative illness perception increases fear of disease progression
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Fear of progression contributes to insomnia symptoms
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Self-compassion moderates the pathway from illness perception to fear of progression
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Result: Higher self-compassion reduces the impact of negative illness perception on fear of progression and insomnia

Limitations

  • ⚠Cross-sectional design prevents causal inference
  • ⚠Single-center study in Chongqing, China, limiting generalizability
  • ⚠Self-report measures may introduce bias

Frequently Asked Questions

What percentage of maintenance hemodialysis patients had insomnia in this study?▼

55.72% of the 332 patients studied reported significant insomnia.

How does self-compassion affect insomnia in dialysis patients?▼

Higher self-compassion was negatively correlated with insomnia (r=-0.451) and moderated the relationship between illness perception and fear of progression, reducing the impact of negative illness perceptions on sleep problems.

What role does fear of progression play in insomnia among these patients?▼

Fear of progression partially mediated the relationship between illness perception and insomnia, accounting for 17.5% of the total effect.

What interventions are suggested based on these findings?▼

The authors suggest implementing short self-compassion exercises or cognitive-behavioral therapy for insomnia (CBT-I) during dialysis sessions to improve sleep quality.

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References

  1. 1.Huang Y, Chen M, Zhong S, Liu Y, Xu R, Li Y, Li K, Wei Y, Luo X. "Illness perception and insomnia among patients with maintenance hemodialysis: a moderated mediation model of fear of progression and self-compassion.." Renal failure, 2026. PMID: 42478234 DOI: 10.1080/0886022X.2026.2670075
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.