Middle-Aged and Older Adults’ Symptoms of Insomnia Are Associated with Loneliness

Loneliness is associated with sleep disturbances among middle-aged and older adults, potentially leading to nights of insomnia.

In a study involving 9,430 adults aged 50 and above, researchers from New York University’s Rory Meyers College of Nursing and Duke University School of Nursing uncovered a significant connection between feelings of loneliness and symptoms of insomnia. These symptoms encompass difficulties in falling and staying asleep, premature waking, and nonrestorative sleep.

Researchers suggest that loneliness can trigger insomnia through various mechanisms, including heightened stress, anxiety, and increased vigilance. Addressing feelings of loneliness could hold the key to achieving better sleep quality and promoting healthier aging.

The research team analyzed data sourced from the Health and Retirement Study, a comprehensive survey of middle-aged and elderly adults across the United States. Their findings revealed that 16% of the participants developed at least one insomnia symptom over a span of six years. Sleep deprivation is known to elevate the risk of cardiovascular diseases and memory issues.

The study, which appears in the July edition of Psychiatry Research, employed Steptoe’s Social Isolation Index and the revised UCLA Loneliness Scale to gauge social isolation and loneliness levels. The latter scale, composed of 20 items, assessed the applicability of statements like “I feel left out” and “I have nobody to talk to.”

Bei Wu, PhD, the senior author, highlighted the difference between social isolation and loneliness, emphasizing that the latter is rooted in subjective perceptions. Wu, who holds the position of Dean’s Professor of Global Health at NYU Nursing and is also affiliated with the Department of Medicine and the School of Nursing at Duke, explained, “Loneliness represents a perceived discrepancy between one’s actual and desired social relationships. In our study, loneliness was linked with sleep problems, while social isolation wasn’t after we adjusted for health indicators.”  

Wu noted that as individuals age, they tend to encounter higher instances of social isolation and feelings of loneliness. She noted, “At middle age we still have work that connects us and we’re mobile so we can travel easily. But as we age our social network starts shrinking. Loss of family, loss of friends, loss of spouse and also our work position can disappear. Adults may have less mobility to engage in community events or get together with friends for lunch, dinner, etc. So, all these things certainly raise the risk for loneliness and social isolation among older adults.”  

How to feel less lonely

Bei Wu, a senior fellow at the Duke Center for the Study of Aging and Human Development and co-director of the NYU Aging Incubator, is engaged in collaborative efforts with colleagues from Duke School of Medicine. Their joint projects aim to enhance oral health for older adults with mild dementia and address cognitive well-being among Chinese American elderly individuals.

During the initial phases of the COVID-19 outbreak, Wu’s publication on the social isolation experienced by older adults prompted fresh inquiries into aging, particularly concerning sleep quality. Although spurred by the global crisis, the 2020 paper highlighted an enduring concern of social isolation that persists across age groups long after the pandemic’s conclusion. Earlier this year, the U.S. Surgeon General sounded an alert regarding the adverse effects of social isolation.

The intricate relationship between loneliness and sleep difficulties is multifaceted. One theory proposes that humans possess an inherent inclination to feel vulnerable in an environment they perceive as unsafe—an emotion often experienced by those grappling with loneliness. This heightened sense of vulnerability could inadvertently disrupt sleep through unconscious vigilance.

On a simpler note, loneliness might render individuals less equipped to manage the daily stresses of life, thereby leading to symptoms of insomnia. “We’re born to be socially connected and emotionally connected,” Wu remarked, emphasizing the role relationships play in supporting overall well-being.

Maintaining social connections could potentially aid older adults in evading insomnia. Researchers suggest engaging in social activities such as volunteering or joining clubs, participating in support groups for those experiencing grief or managing chronic health conditions, and leveraging technology-based interventions like video chats or companion robots.

Additional contributors to the study include Xiang Qi, PhD, as the first author; Susan K. Malone, PhD; and Yaolin Pei, all affiliated with NYU; as well as Zheng Zhu from NYU and Fudan University School of Nursing in Shanghai, China.

Funding for the study was partially provided by the National Institutes of Health (P30AG059304, P50MD017356).

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