The chain mediating role of anxiety and depression on the relationship between poor sleep quality and health-related quality of life in patients undergoing coronary interventional procedures

Purpose This study aims to investigate the chain mediating role of anxiety and depression between poor sleep quality and health-related quality of life (HRQoL) in patients who have undergone coronary interventional procedures, with the hope of improving the patients’ HRQoL. Methods We conducted a cross-sectional study from January 1 to June 30, 2025, involving coronary heart disease patients undergoing PCI at hospitals in Jiangsu Province. Data were collected using the general information questionnaire, the Pitts burgh sleep quality index (PSQI), the Generalized Anxiety Disorder 7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9) and the MOS item short fromhealth survey (SF-36). Results The analysis revealed that poor sleep quality significantly exacerbates impaired HRQoL, as demonstrated by the mediation effect model (bootstrap 95% CI: -10.472 to -0.724). Furthermore, poor sleep quality was found to heighten levels of both anxiety (bootstrap 95% CI: -5.714 to -0.220) and depression (bootstrap 95% CI: -5.728 to -0.085). Crucially, the results indicate that anxiety and depression significantly mediate the relationship between poor sleep quality and HRQoL (bootstrap 95% CI: -4.228 to -0.083). Conclusions The impact of poor sleep quality on HRQoL is mediated by anxiety and depression, with both direct and indirect effects observed. Additionally, the influence of depression appears to attenuate the mediating role of anxiety. Clinical interventions targeting anxiety and depression may therefore improve quality of life in patients after coronary interventional procedures.