Background: This study was conducted aiming to determine the role of acceptance, psychological flexibility, and resilience in the sleep quality of pregnant women through the mediation of mindfulness. Materials and Methods: This was a descriptive-correlational study. The statistical population consisted of all pregnant women referred to Al-Zahra Hospital in Tabriz city in 2024. Based on Klein’s guidelines, a sample of 300 participants was selected (of whom 13 were excluded) using convenience sampling method. Data were collected using The Pittsburgh Sleep Quality Index (PSQI), The Acceptance and Action Questionnaire – version 2 (AAQ-II), The Psychological Flexibility Questionnaire (PFQ), The Connor-Davidson Resilience Scale (CD-RISC), and The Five Facet Mindfulness Questionnaire (FFMQ). Data analysis was conducted using Pearson's correlation coefficient in SPSS version 21 and structural equation modeling (SEM) in LISREL version 8.8. Results: The findings revealed that acceptance, resilience, and mindfulness have a direct and negative effect on the sleep quality of pregnant women (p < 0.05). The direct effects of psychological flexibility on mindfulness and sleep quality were not significant (p > 0.05). The investigation of indirect effects indicated that acceptance and resilience had an indirect and negative effect on the sleep quality of pregnant women through mindfulness (p < 0.05); however, the indirect effect of psychological flexibility on sleep quality through mindfulness was not significant (p > 0.05). Conclusion: According to the findings, it is suggested that acceptance and resilience along with mindfulness play a significant role in sleep quality of pregnant women and should be incorporated into relevant counseling programs.

Sleep Quality Acceptance Psychological Flexibility Resilience Mindfulness Pregnant Women.