Loneliness and social isolation is associated with sleep problems among older community dwelling women and men with complex needs

Abstract

Sleep problems, loneliness and social isolation often increase with age, significantly impacting older adults’ health and wellbeing. Yet general population health empirical evidence is surprisingly scant. Using the largest national database to date, cross-sectional and longitudinal analyses was undertaken on 140,423 assessments from 95,045 (women: 61.0%) community living older adults aged ≥ 65 years having standardised home care assessments between 1 July 2012 and 31 May 2018 to establish the prevalence and relationships between insufficient sleep, excessive sleep, loneliness and social isolation. At first assessment, insufficient sleep (women: 12.4%, men: 12.7%) was more commonly reported than excessive sleep (women: 4.7%, men: 7.6%). Overall, 23.6% of women and 18.9% of men reported feeling lonely, while 53.8% women and 33.8% men were living alone. In adjusted longitudinal analyses, those who were lonely and socially isolated were more likely to experience insufficient sleep. Respondents with excessive sleep were more likely to live with others. Both loneliness and social isolation contributed to insufficient sleep, synergistically. Loneliness, social isolation and health-concerns may affect the restorative properties of sleep over and above the effects of ageing. Further research is warranted.

Loneliness and physical function impairment: Perceived health status as an effect modifier in community-dwelling older adults in Ghana

“…Impaired self-regulation may lead to a reduction in the capacity to seek health care which may worsen the general health status, leading to PFI in old age ( McCracken & Phillips, 2017 ). In addition, loneliness has been related to low levels of autonomy, coping, self-efficacy, self-esteem, and sleep disturbances ( Griffin et al, 2020 , McLay et al, 2021 ). These negative affects may, in turn, reduce the capacity to engage in intellectually stimulating activity to protect oneself against PFI ( Backe et al, 2018 , Lopez, 2017 ).…”

Validation of the geriatric sleep questionnaire

“…In this study, there were no differences according to gender as in another research [83]. However, in most studies, older women have more sleep issues than men [7,[15][16][17]. The different subject demographics and differences in methodological approaches could explain the divergences between the studies.…”

“…Knowledge of sleep hygiene could be lower among those with less education [78]; however, in the current study, we did not assess knowledge about sleep hygiene and, therefore, could not empirically explore this interpretation. Older adults without a partner tended to experience insufficient sleep [16,84], but we did not obtain a similar finding, probably because our sample was older and people got used to sleeping alone. Finally, those who resided in a rural area had worse sleep quality, similar to what was observed in other research [78,83].…”

“…The difficulty to stay awake during daylight activities was another question with poor psychometric qualities [39,42]. This question probably does not discriminate because, although napping in later life is more frequent, it does not accompany inadequate nighttime sleep in later life [11][12][13]16,43]. Moreover, many older adults cannot feel sleepiness due to a decline in the perception of stimuli or the presence of multiple chronic diseases [44].…”

“…Likewise, sleep disorders become more frequent in older people [5,6,14]. Risk factors for sleep disorders in old age include gender, being more common in women [7,[15][16][17]; older age [18,19]; lower education [20,21]; loneliness, institutionalization, social isolation [10,16,22,23]; less functionality [23,24]; chronic diseases [25][26][27]; and medication use [5,7,10].…”