Older adults with higher social and cognitive activity engagement may experience fewer insomnia symptoms, according to a cross-sectional secondary data analysis published in BMC Geriatrics based on data from the Health and Retirement Study (HRS). The HRS, a population-based longitudinal study (grant number NIA U01AG009740), has collected data since 1992 from Americans older than 50 years of age who are not institutionalized.
The researchers used data from 2016 collected from 3321 participants with a mean age of 75.62 years (range, 65-98). The participants had self-reported insomnia symptoms and their frequency on a 3-point scale and the frequency of their engagement in 21 different activities (6 social, 5 cognitive, 3 physical) on a 7-point scale, which was then collapsed to a 3-point scale. Higher points signified higher frequency. The mean activity engagement scores for the social, cognitive, and physical activity items were 1.39 (range, 1-3), 1.63 (range, 1-3), and 1.95 (range, 1-3), respectively. The mean score for insomnia symptoms was 6.72 (range, 4-12).
Male, White, and married respondents reported fewer insomnia symptoms. Participants who had no more than a high school level of education, those with the highest self-reported loneliness, and those who had at least 1 chronic disease and at least 1 activities of daily living (ADL) difficulty and sleep disorder displayed more insomnia symptoms.
The independent t-test analyzing differences in insomnia symptoms showed that the respondents with higher social activity (t=7.43), cognitive activity (t=5.57), and physical activity (t=7.20) had fewer insomnia symptoms (all P <.001).
After adjusting for other types of activities and all covariates, the researchers found that respondents with higher social activity engagement were more likely to report fewer insomnia symptoms (β= -0.04, P =.040), as were those with higher cognitive activity (β= -0.06, P =.007). Older respondents (β= -0.05, P =.012) and those who were male (β= -0.10, P <.001) were more likely to report fewer insomnia symptoms. Chronic disease (β=0.05), ADL difficulty (β=0.11), and greater loneliness (β=0.20) were associated with more insomnia symptoms (all P <.001).
Respondents with higher social activity engagement showed lower odds of more trouble falling asleep (odds ratio (OR)=0.71, 95% CI, 0.56-0.91). Those with higher cognitive activity engagement had lower odds of more trouble falling asleep (OR=0.77, 95% CI, 0.62-0.96) and more trouble with waking up too early (OR=0.68, 95% CI, 0.55-0.85).
Physical activity was not significantly associated with total insomnia symptoms, but those with higher physical activity engagement were less likely to report more nonrestorative sleep (OR=0.69, 95% CI, 0.57-0.82).
Limitations of the study include the fact that causal relationships among types of activity engagement and insomnia symptoms cannot be examined because of the cross-sectional nature of the study.
Kim DE, Roberts TJ, Moon C. Relationships among types of activity engagement and insomnia symptoms among older adults. BMC Geriatr. 2021;21(1):87. doi:10.1186/s12877-021-02042-y