Associations Between Six Core Processes of Psychological Flexibility with Poor Sleep Outcomes: A Systematic Review and Meta-Analysis
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Lack of present moment awareness shows associations with poor sleep quality or insomnia.
“A recent systematic review and meta‐analysis (Zakiei et al., 2024) found that experiential avoidance, lack of present moment awareness, cognitive fusion and inaction show associations with poor sleep quality or insomnia.”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Zakiei et al., 2024
In the Zakiei et al. (2024) meta-analysis, cognitive fusion was inferred using a range of measures associated with this construct.
“Rather, in the Zakiei et al. (2024) meta‐analysis, cognitive fusion was inferred using a range of measures associated with this construct, including dysfunctional beliefs about sleep, cognitive pre‐sleep arousal, rumination, stress recovery processes, repetitive negative thinking and metacognitive beliefs about repetitive thoughts.”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Zakiei et al., 2024
Inaction shows associations with poor sleep quality or insomnia.
“A recent systematic review and meta‐analysis (Zakiei et al., 2024) found that experiential avoidance, lack of present moment awareness, cognitive fusion and inaction show associations with poor sleep quality or insomnia.”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Zakiei et al., 2024
Cognitive fusion shows associations with poor sleep quality or insomnia.
“A recent systematic review and meta‐analysis (Zakiei et al., 2024) found that experiential avoidance, lack of present moment awareness, cognitive fusion and inaction show associations with poor sleep quality or insomnia.”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Zakiei et al., 2024
Experiential avoidance shows associations with poor sleep quality or insomnia.
“A recent systematic review and meta‐analysis (Zakiei et al., 2024) found that experiential avoidance, lack of present moment awareness, cognitive fusion and inaction show associations with poor sleep quality or insomnia.”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Zakiei et al., 2024
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Zakiei, A., Nikzadi, H., & Komasi, S. (2026) · Annals of Indian Psychiatry · doi:10.4103/aip.aip_5_25
Self-citationZalamea-Delgado, M. P., Jiménez‐López, E., Mesas, A. E., Sepulveda, R. A. Y., Gutiérrez‐Espinoza, H., Arancibia, J. E. O., Ezzatvar, Y., Stubbs, B., Smith, L., Ridgell, L., et al. (2026) · Healthcare · doi:10.3390/healthcare14142183
Kıyak, S., & Polat, H. T. (2026) · Indian Journal of Gynecologic Oncology · doi:10.1007/s40944-026-01183-5
- Authors
- Zakiei, A., Khazaie, H., Rostampour, M., Moradi, M.-T., Rezaie, L., Komasi, S., & Rafihi-Ferreira, R. E.
- Affiliations
- Kermanshah University of Medical Sciences (IR)
- Corresponding author
- Komasi, Saeid
- ORCID
- Venue
- Current Sleep Medicine Reports
- Published
- 2024-03-22
- Volume
- 10
- Issue
- 2
- Pages
- 257-275
- ISSN
- 2198-6401 (ISSN-L)
- OpenAlex
- W4393093134
- Cited by
- 10
- References
- 89
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 1
- FWCI
- 0.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Current Sleep Medicine Reports (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- psychological flexibility, acceptance and commitment therapy, acceptance, cognitive defusion, mindfulness, committed action, self-as-context, values, insomnia severity, poor sleep quality, sleep disorders, age effects
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