The Role of Insomnia and Exercise in COVID-19 Worries for Psychological Distress in Hong Kong Chinese: A Moderated Mediation Model

ABSTRACT

Objective

To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency.

Methods

A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants’ insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress.

Results

A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14–0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02–0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency.

Conclusion

COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries.

Acknowledgments

We would like to thank Dr. Yeung for his support and all the research staff involved in this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical approval

Ethical approval was given by the Ethics Review Board of Hong Kong Polytechnic University (ref: HSEARS20210725001).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/15402002.2023.2270095

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.