Mediating Role of PERMA Wellbeing in the Relationship between Insomnia and Psychological Distress among Nursing College Students

Background: Psychological distress is an important mental health problem in college students. Insomnia may be a major factor contributing to psychological distress. This study aimed to explore the indirect relationship between insomnia and psychological distress through the five PERMA wellbeing variables (i.e., positive emotions, engagement, relationships, meaning in life, and achievement) among nursing college students. Methods: A cross-sectional study was conducted in China using an online survey design. Mediation analyses were examined using the PROCESS macro version 4.1 for SPSS 27.0. A total of 1741 nursing college students completed the online survey. Results: Insomnia was positively associated with psychological distress (p < 0.01, r = 0.673), while negative associations were detected between PERMA wellbeing variables and insomnia (p < 0.01, r range = -0.176 and -0.272), as well as psychological distress (p < 0.01, r range = -0.196 and -0.386). The association between insomnia and psychological distress was partially mediated by the participants' positive emotions (indirect effect = 0.137, SE = 0.024, 95% CI boot = [0.094, 0.188]), engagement (indirect effect = -0.033, SE = 0.010, 95% CI boot = [-0.054, -0.017]), and meaning in life (indirect effect = 0.027, SE = 0.014, 95% CI boot = [0.001, 0.055]) but not their relationships or achievement of the PERMA wellbeing variables. Conclusions: The findings of this study suggest that the PERMA wellbeing variables, especially positive emotions, engagement, and meaning in life, could be potential mechanisms by which insomnia is associated with psychological distress. The mediating roles of PERMA wellbeing variables between insomnia and psychological distress could be incorporated into the health management of university administrations to promote the health and wellbeing of nursing college students.