Stressful life events and subjectively rated sleep quality among older adults in China: the roles of positive and negative attitudes towards ageing

Abstract

Sleep is an integral part of individuals' health and wellbeing. Despite evidence showing that social stressors are important contributors to older adults' sleep problems, how the accumulative stressful life events (SLEs) and ageing attitudes independently and jointly affect sleep quality among older adults in developing countries remains unclear. This study examined the effects of SLEs on subjectively rated sleep quality among older adults in China, and explored the potential mediating and moderating roles of positive and negative ageing attitudes on the above association. Using data from the 2014 China Longitudinal Ageing Social Survey, we had complete data for 7,780 older adults aged 60 and older. We employed logistic regression models and the Karlson–Holm–Breen decomposition method. Our findings indicated that SLEs significantly increased the risk of poor sleep quality, especially for those who had experienced two or more SLEs during the past year. Positive ageing attitudes were associated with lower odds of poor sleep quality, whereas negative ageing attitudes were related to higher odds of poor sleep quality. Moreover, the mediation analyses suggested that SLEs were associated with poor sleep quality via negative ageing attitudes. The moderating effects further documented that higher levels of positive ageing attitudes can significantly attenuate the deleterious impact of SLEs on sleep quality. The findings highlight the significance of SLEs for older adults' sleep quality and shed light on the importance of ageing attitudes to improve older adults' sleep in China as well as other low- and middle-income countries, where the social safety nets are still underdeveloped.

Family Members’ Abuse of Older Adults, Psychological Well-Being, and Sleep Quality Among Older Women and Men in China

“…First, the measurement of sleep needs improvement. Although previous research has used the single-item measure of sleep quality among older Chinese adults (Zhang, Lin, et al, 2022; Zhang, Ruan, et al, 2022), the response option used in this study was not fine-grained. Future sleep quality measures should use more detailed response options such as “often” or “frequently” or “on half” or “most” days to capture individuals’ sleep quality.…”

“…Response categories include "no," "sometimes," and "always." Following prior studies (Zhang, Lin, et al, 2022;Zhang, Ruan, et al, 2022), sleep quality was treated as a dichotomous variable. Respondents who answered "no" or "sometimes" were classified as having "good sleep quality" (reference), and respondents who answered "always" were classified as having poor sleep quality.…”

“…Covariates. Covariates included sociodemographic characteristics, socioeconomic status (SES), and physical health status (Smagula et al, 2016;Zhang, Ruan, et al, 2022). Sociodemographic characteristics included age (in years), gender (1 = female, 0 = male), marital status (1 = married, 0 = unmarried), residence (1 = urban, 0 = rural), and living arrangement (1 = living alone, 0 = living with others).…”

“…Sleep quality was measured by asking respondents: “Did you find it difficult to sleep well during the past week?” An item from the Center for Epidemiologic Studies Depression Scale (Radloff, 1977). Response categories include “no,” “sometimes,” and “always.” Following prior studies (Zhang, Lin, et al, 2022; Zhang, Ruan, et al, 2022), sleep quality was treated as a dichotomous variable. Respondents who answered “no” or “sometimes” were classified as having “good sleep quality” (reference), and respondents who answered “always” were classified as having poor sleep quality.…”

“…Given that sleep is socially dependent and highly responsive to stress (Irish et al, 2015), scholars have examined the association between social stressors and sleep in older adults. In this line of work, studies have found that older individuals' sleep is negatively affected by stressors such as childhood abuse and neglect (Poon & Knight, 2011) and stressful life events in the past year (e.g., death of family members, financial loss, and accidents) (Zhang, Ruan, et al, 2022). However, a common stressor in later life, elder abuse, has received little attention in this body of research.…”