["Journal of Clinical Psychology, EarlyView. ", "\nABSTRACT\n\nObjective\nThis study aimed to explore psychological distress (PD) patterns in pregnant women with recurrent pregnancy loss (RPL) during early pregnancy and to examine the association between sleep characteristics and these patterns.\n\n\nMethods\nA total of 203 pregnant women with RPL were recruited between October 2022 and April 2023 at the study hospital. The patients’ PD was assessed using the Patient Health Questionnaire‐9 and the Generalized Anxiety Disorder 7‐Item Questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was employed to measure the sleep conditions. Latent profile analysis and multivariable logistic regression were used to identify the patterns of PD in RPL women and connections between their sleep characteristics and these identified patterns.\n\n\nResults\nThree PD patterns were identified in participants, including “mild PD” (57.15%), “moderate PD” (36.45%), and “severe PD” (6.40%). Subjective sleep quality, sleep disturbance, sleep efficiency, diurnal dysfunction, and PSQI score in patients varied significantly among the different PD patterns (p < 0.05). Compared with “mild PD,” poor subjective sleep quality (Moderate: aOR= 2.76, 95%CI 1.37–5.56; Severe: aOR= 7.19, 95%CI 1.99–25.98) and diurnal dysfunction (Moderate: aOR= 3.1, 95%CI 1.62–5.97; Severe: aOR= 25.16, 95%CI 5.57–113.61) were significantly associated with “moderate” or “severe” PD. Addtionally, low sleep efficiency markedly increased the risk of “severe PD” (aOR= 28.76, 95%CI 1.09–759.02).\n\n\nConclusions\nThis study identified three distinct patterns of PD (mild, moderate, and severe) among women with RPL during early pregnancy. Specific sleep characteristics, including poor subjective sleep quality, diurnal dysfunction, and low sleep efficiency, were significantly associated with moderate/severe PD.\n"]