目的 探讨失眠对围绝经期及绝经后早期妇女生活质量的影响，以及焦虑、抑郁在围绝经期及绝经后早期妇女失眠与生活质量中的链式中介作用。方法 采用失眠严重程度指数量表、绝经期生存质量量表、医院焦虑抑郁量表对306名围绝经期及绝经后早期妇女进行横断面调查。通过Pearson相关分析研究围绝经期及绝经后早期妇女失眠、焦虑、抑郁以及生活质量之间的相关性；并通过链式中介模型变量回归分析焦虑和抑郁在失眠对生活质量影响中的中介效应。结果 围绝经期及绝经后早期妇女失眠严重程度指数量表得分为（5.66±4.61）分，失眠发生率为30.72%(94/306)。医院焦虑抑郁量表中焦虑亚量表得分为（4.19±3.47）分，焦虑症状发生率为16.01%(49/306)；抑郁亚量表得分为（3.93±3.40）分，抑郁症状发生率为16.34%(50/306)。绝经期生存质量量表得分为（2.55±1.05）分。Pearson相关性分析显示，焦虑、抑郁以及生活质量间存在相关性（r=0.38、r=0.29、r=0.46，均P <0.05）。中介效应分析显示，焦虑和抑郁在失眠对生活质量影响中的效应值为0.017，中介效应占总效应的25%。结论 围绝经期及绝经后早期妇女失眠的发生率较高，且通过焦虑和抑郁的链式中介效应对生活质量产生影响。提示应采取有效措施和干预手段改善围绝经期及绝经后早期妇女的睡眠状况，并应重视心理保健以缓解其焦虑抑郁情绪，进而提高围绝经期及绝经后妇女的生活质量。

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.