Associations of loneliness and social isolation with actigraph and self-reported sleep quality in a national sample of older adults

Abstract

Study Objectives To examine associations of social isolation and loneliness with sleep in older adults, and whether associations differ for survey and actigraph sleep measures. Methods This study used data from The National Social Life, Health, and Aging Project (NSHAP), a nationally-representative study of community dwelling older adults born 1920-1947. A random one-third of participants in 2010/2011 were invited to participate in a sleep study (n = 759) that included survey questions, 72 hours of wrist actigraphy, and a sleep log. Perceived loneliness was measured using three questions from the UCLA Loneliness Scale. An index of social isolation was constructed from nine items that queried social network characteristics and social interactions. We used ordinary least squares and ordinal logistic regression to examine whether sleep measures were associated with loneliness and social isolation adjusted for potential sociodemographic confounders. Results Social isolation and loneliness had a low correlation (Spearman’s correlation = 0.20). Both loneliness and social isolation were associated with actigraphy measures of more disrupted sleep: wake after sleep onset (WASO) and percent sleep. Neither was associated with actigraph total sleep time. Increased loneliness was strongly associated with more insomnia symptoms and with shorter sleep duration assessed by a single question, but social isolation was not. More isolated individuals spent longer time in bed. Conclusions We found both loneliness and social isolation were associated with worse actigraph sleep quality, but their associations with self-reported sleep differed. Only loneliness was associated with worse and shorter self-reported sleep.

The Long-Term Public Health Impact of Social Distancing on Brain Health: Topical Review

“…From the literature reviewed, in both older adults and adolescents, loneliness and social isolation have been associated with worse sleep quality, typically in the form of sleep fragmentation [ 47 , 48 , 49 , 50 , 51 , 52 ]. Poor sleep quality has also been linked with a higher risk of cognitive decline and poorer neurocognitive health [ 53 , 54 ].…”

Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study

“…Several previous studies have specified that flourishing social relationships through social support 17,18 ) , and reduced social isolation 19,20 ) and loneliness 19 ) can improve sleep quality. Our results also corroborated this association in terms of social frailty, substantiating previous studies.…”

“…Rich social relationships improve mental health through stress-buffering, regularizing life rhythms, and promoting physical activities by meeting friends and going out, which in turn enhances sleep quality 17 ) . Several cross-sectional studies have shown that high social support is associated with good sleep quality 17,18) while social isolation and loneliness hamper the quality of sleep 19) . Moreover, in a longitudinal study, social isolation predicted poor sleep quality 20) , suggesting the possibility that the quality of sleep among older adults is hindered by social vulnerability.…”

Sleep and Daily Social Experiences as Potential Mechanisms Linking Social Integration to Nocturnal Blood Pressure Dipping

“…Greater social integration may also help to lessen the impact of negative psychological states that disturb sleep, such as stress (12,13), loneliness (14), and depression (15). Indeed, previous investigations have reported that greater social integration is associated with longer sleep duration, better sleep continuity, and greater regularity in sleep timing (16,17). Biobehavioral sleep characteristics may also be associated with patterns of nocturnal BP dipping via influences on inflammatory, autonomic, and metabolic pathways (18).…”