Research on the correlation characteristics and influencing factors of the severity of insomnia and emotional regulation difficulties

To examine the association between insomnia symptom severity and emotion regulation difficulties and identify potential moderators. This was a cross-sectional study in which participants completed demographics, lifestyle factors, and medical history, and the Insomnia Severity Index, Difficulties in Emotion Regulation Scale (DERS-16), the Hospital Anxiety and Depression Scale, and Hyperarousal Scale. Spearman correlation and ANCOVA were used to evaluate the ISI-DERS-16 relationship. Hierarchical regression tested whether ISI was independently associated with DERS-16. Single-variable and multi-variable moderation models (FDR-corrected), followed by simple slope analysis, identified significant moderators. Among 2,045 participants, ISI correlated positively with DERS-16 ( r = 0.786, P < 0.001). DERS-16 scores showed a stepwise increase with insomnia symptom severity ( P < 0.001), with the largest increase observed between the mild and moderate insomnia groups. After controlling for covariates, ISI was independently associated with 13% of the variance in DERS-16 scores. Depression (HADS-D), weekly exercise duration (minutes), and medical history were identified as three significant independent moderators of the association between ISI and DERS-16 ( P < 0.05). Multivariate moderation analysis revealed that as exercise duration increased, the slope of ISI on DERS-16 rose from 0.86 (0–30 min) to 1.38 (30–60), 1.47 (60–120), and 1.46 (> 120 min). Individuals with a medical history showed a steeper slope (1.62) than those without (1.38). Higher depression levels also yielded steeper slopes: 1.13 (low), 1.38 (moderate), and 1.64 (high). Insomnia symptom severity is positively associated with emotion regulation difficulties, and longer weekly exercise duration, prior medical history, and higher depression levels all show moderating effects on this association.