Abstract
ObjectivesSupportive social relationships have been found to be related to fewer sleep problems and better sleep quality. We examined associations between positive and negative support from the nominated close person across 15years of follow-up with sleep quality in older age. MethodsMRC National Survey of Health and Development study members reported sleep quality at age 68 (n=2446). Cumulative exposure to and changes in positive and negative support were derived from data at age 53, 60–64 and 68years. Pittsburgh Sleep Quality Index scores were regressed on social support measures adjusted for i) gender only then additionally ii) education, marital status, number in household, limiting illness, body mass index, caregiving, iii) and affective symptoms. ResultsGreater exposure to positive support and lower exposure to negative support over 15years were independently associated with better sleep quality at age 68. Sleep quality was poorer for those who experienced declining positive support or increasing negative support. Those who nominated their spouse/partner as their closest person at age 53 but not at age 68 had poorer sleep quality than those who nominated their spouse on both occasions. These associations were not explained by the covariates, including affective symptoms. ConclusionsBased on repeat data on support from the closest person, this study finds a link between declining social relationship quality and poor sleep quality. Whilst acknowledging that the association may be bi-directional, the study suggests that interventions to improve older people's social relationships may have benefits for sleep.
Highlights
Sleep disorders are more common among older compared with younger adults [1,2] and, in later life, have been linked to mortality and cardiovascular disease risk [3,4], physical symptoms, limitations and falls [5,6], cognitive decline [7] and poor health-related quality of life [8]
In an integrative model that considered combinations of positive and negative support, having a higher number of ties characterised by high positivity and low negativity was associated with better sleep quality whilst a higher number of ties characterised by high negativity and low positivity was associated with poorer sleep quality [11]
With both social support scales included together and adjusted for covariates, an inverse association between positive support and global sleep quality remained with some attenuation
Summary
Sleep disorders are more common among older compared with younger adults [1,2] and, in later life, have been linked to mortality and cardiovascular disease risk [3,4], physical symptoms, limitations and falls [5,6], cognitive decline [7] and poor health-related quality of life [8]. One national study of older married women found that overall social support across multiple sources was not associated with sleep disturbance, though quality of the marital relationship was [15]. This could indicate that close relationships are relevant for sleep in older age, as others have found [11], possibly because people tend to prioritise meaningful relationships as they age [16] and because of an increased risk of interpersonal life events such as widowhood and caregiving. In an integrative model that considered combinations of positive and negative support, having a higher number of ties characterised by high positivity and low negativity was associated with better sleep quality whilst a higher number of ties characterised by high negativity and low positivity was associated with poorer sleep quality [11]
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