Objective To explore the effects of insomnia on the quality of life in perimenopause and early postmenopausal women, and to examine the chain mediating role of anxiety and depression in the relationship between insomnia and quality of life in these women.

Methods A total of 306 perimenopausal and early postmenopausal women were assessed using Insomnia Severity Index Scale, Menopause-specific Quality of Life Scale, and Hospital Anxiety and Depression Scale. Pearson Correlation Analysis was used to analyze the correlation between insomnia, anxiety, depression, and quality of life in perimenopause and early postmenopausal women. A chain mediation model was constructed to analyze the mediating effects of anxiety and depression on the influence of insomnia on quality of life.

Results The mean score of the Insomnia Severity Index for perimenopausal and early postmenopausal women was (5.66 ± 4.61), with an incidence of insomnia of 30.72% (94/306). The score of anxiety scale was (4.19 ± 3.47), with an incidence of anxiety symptom of 16.01% (49/306). The score of depression scale was (3.93 ± 3.40), with an incidence of depressive symptoms of 16.34% (50/306). The score of Menopause-specific Quality of Life Scale was (2.55 ± 1.05). Correlation analysis revealed a correlation between insomnia, anxiety, depression, and quality of life in perimenopausal and early postmenopausal women (r = 0.38、r = 0.29、r = 0.46, all P < 0.05). The mediating effect analysis showed that the effect value of anxiety and depression in the impact of insomnia on quality of life was 0.017, and the mediating effect accounted for 25% of the total effect.

Conclusion The incidence of insomnia in perimenopausal and early postmenopausal women is high, affecting the quality of life through the chain mediating effect of anxiety and depression. Health care providers should take effective measures and interventions to improve the sleep status of perimenopausal and early postmenopausal women and pay attention to mental health care to alleviate anxiety and depression, thereby further improving the quality of life.