Perseverative Cognition as a Mediator Between Perceived Stress and Sleep Disturbance: A Structural Equation Modeling Meta-analysis (meta-SEM).

This article systematically reviews and meta-analyzes the role of perseverative cognition (PC)—defined as repetitive, negative thinking such as rumination and worry—in mediating the longitudinal relationship between perceived stress and subjective sleep disturbance in adults. Using meta-analytic structural equation modeling (meta-SEM) on eight longitudinal studies with 3,733 participants, the findings indicate that perceived stress significantly predicts increased PC, which in turn is associated with greater difficulties in falling asleep or maintaining sleep. The mediation effect of PC accounted for approximately 40% of the total association between stress and sleep disturbance, remaining significant after controlling for baseline sleep problems and demographic factors such as age and sex. The review highlights the importance of targeting PC in clinical interventions for stress-related sleep disturbances and calls for further research with standardized methodologies and more diverse populations.