Emotional regulation and sleep quality: The role of anxiety and self-esteem in individuals with arterial hypertension

Manuscript (ελληνικά)
Published: Jul 24, 2026
DOI: https://doi.org/10.12681/psy_hps.42700
Keywords:
arterial hypertension, anxiety, sleep quality, emotional regulation, self-esteem
Magdalini Matsouki
Department of Psychology/ Faculty of Philosophy, Aristotle University of Thessaloniki
https://orcid.org/0009-0008-0316-6176
Areti Triantafyllou
Department of Medicine / Faculty of Health Sciences, Aristotle University of Thessaloniki
Abstract

 


 


 


 


Arterial hypertension (AH) is one of the most common chronic conditions and a major risk factor for cardiovascular diseases. Despite its often asymptomatic course, its progression without treatment carries a high risk of complications. The international literature suggests that AH is also associated with psychological factors that affect mental and emotional well-being. The aim of the present pilot study was to investigate anxiety, sleep quality, emotion regulation, and self-esteem in individuals with AH, as well as to examine the relationships among these variables. A total of 51 participants took part in the study and anonymously completed questionnaires on demographic characteristics and medical history, along with the following research instruments: the Generalized Anxiety Disorder-7 (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), the Difficulties in Emotion Regulation Scale (DERS), and the Rosenberg Self-Esteem Scale (RSES). Moderate levels of anxiety were observed in 33.3% of the participants. In addition, sleep quality was assessed as moderate to poor in 50.5% of the sample. Furthermore, self-esteem was recorded at relatively high levels in 75.5% of the participants, while emotion regulation was found to be at moderate to low levels in 58.9% of the sample. Poor sleep quality was associated with increased anxiety (Β = .43, p = .002), which in turn was related to reduced emotion regulation ability (Β= .32, p = .027). The direct relationship between sleep quality and emotion regulation was not found to be statistically significant (Β = −.01, p = .936), however, mediation analysis suggested a potential mediating role of anxiety, although the indirect effect was not statistically significant.. Additionally, self-esteem, acting as a moderating factor, appears to have a protective role by reducing the negative impact of anxiety on emotion regulation. Interventions aimed at enhancing self-esteem, reducing anxiety, and improving sleep quality may significantly contribute to improving the psycho-emotional well-being of individuals with AH.


 


 


 


 


 


 


 

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