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Sleep difficulties are associated with lower health-related quality of life in adults with pulmonary hypertension, partially mediated by depressive symptoms.

In a cross-sectional survey of 111 adults with pulmonary hypertension, 79.8% had poor sleep quality, and insomnia and daytime sleepiness were elevated (35% and 33.6%, respectively). All types of sleep difficulties were associated with lower HRQoL, and this association was partially mediated by depressive symptoms.

Last updated: Aug 13, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. How Do Sleep Difficulties Interact With Anxiety, Depression and Health-Related Quality of Life in Pulmonary Hypertension?

observational

Green JL, Costin V, Armstrong I, Thompson AR, Rawlings GH · The clinical respiratory journal (2026)

Participants: N/A
Duration: N/A (cross-sectional)
Intervention: None (observational study)
Outcome: Sleep quality (PSQI), insomnia severity (ISI), daytime sleepiness (ESS), anxiety (GAD-7), depression (PHQ-9), HRQoL (emPHasis-10)
Effect Size: N/A
Population: Adults with pulmonary hypertension (PH) recruited from PH associations globally (91% White, 82% female)

Result:

PubMed: 42538807DOI: 10.1111/crj.70220

Mechanism Graph

Sleep difficulties are prevalent in PH patients
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Sleep difficulties are associated with lower HRQoL
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Depressive symptoms partially mediate the association between sleep difficulties and HRQoL
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Result: Sleep difficulties impact HRQoL partly through depression

Limitations

  • ⚠Cross-sectional design prevents causal inference
  • ⚠Sample is predominantly White and female, limiting generalizability
  • ⚠Self-reported measures may be subject to recall bias

Frequently Asked Questions

What percentage of pulmonary hypertension patients have poor sleep quality?▼

79.8% of the 111 participants had poor sleep quality as measured by the Pittsburgh Sleep Quality Index.

Are sleep difficulties linked to depression in pulmonary hypertension?▼

Yes, depressive symptoms partially mediated the association between sleep difficulties and lower health-related quality of life.

What types of sleep difficulties were most common in this study?▼

Sleep disturbance and sleep latency issues were the most prevalent sleep-related difficulties.

What is the recommended clinical action based on this study?▼

The findings indicate the need to routinely screen for both sleep difficulties and mood disturbance in pulmonary hypertension patients.

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References

  1. 1.Green JL, Costin V, Armstrong I, Thompson AR, Rawlings GH. "How Do Sleep Difficulties Interact With Anxiety, Depression and Health-Related Quality of Life in Pulmonary Hypertension?." The clinical respiratory journal, 2026. PMID: 42538807 DOI: 10.1111/crj.70220
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.