Cumulative Ecological Risk and Sleep Quality: The Mediating Role of Life Satisfaction and the Moderating Role of Sleep Beliefs

Most current research only explores factors influencing sleep quality from individual or family perspectives. However, sleep quality is closely related to the social environment. Based on the cumulative ecological risk theory, this study examines the cumulative effects of individual, family, interpersonal, work or study, community, and societal ecological factors on the sleep quality of the Chinese people. Data were sourced from an online survey about the sleep status of Chinese residents in 2021, with a sample of 5, 929 adults aged 18 to 71 years. Results indicate that, after controlling for demographic variables, cumulative ecological risk has a significant negative predictive effect on the sleep quality of Chinese residents. Moreover, when the number of risk factors exceeds 4, each additional risk factor has a greater negative impact on sleep quality, following a "positive acceleration" pattern. Cumulative ecological risk reduces sleep quality by lowering people's life satisfaction. Beliefs about the use of sleep medication play a moderating role in this process: the more rational beliefs individuals hold, the smaller the negative predictive effect of cumulative ecological risk on sleep quality. Additionally, this study examines age differences and differences in subjective status identification in the relationship between cumulative ecological risk and sleep quality. In conclusion, cumulative ecological risk has a negative impact on sleep quality, and promoting individual sleep quality requires collaborative efforts from individuals, families, organizations, and society.