Prospective associations of social isolation and loneliness with poor sleep quality in older adults



There is evidence for negative associations between social isolation and loneliness and sleep quality in older adults. However, it is unclear to what extent these two factors independently affect sleep quality. This study examined the simultaneous associations of social isolation and loneliness with sleep quality in a longitudinal study of older adults.


Data were analyzed from the Social Environment and Biomarkers of Aging Study in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66.14, SD 7.26). Poisson regression models were conducted to examine the association of social isolation and/or loneliness with sleep quality at follow-up after adjusting for multiple confounding variables.


Univariate analysis showed that sleep quality was inversely associated with both social isolation and loneliness. After demographic, health, cognitive factors, and depressive symptoms were controlled in multivariable analysis, social isolation at the baseline still predicted poor sleep quality 6 years later (incident rate ratio, IRR 1.14; 95% CI 1.04–1.24; p < 0.01), while the association between loneliness and sleep quality was no longer significant (IRR 1.08; 95% CI 0.94–1.23; p = 0.27). The results were unchanged when participants who had poor sleep quality at the baseline were excluded from the analysis.


These findings confirm an adverse effect of social isolation on the sleep quality of older adults, but indicate that this effect is independent of loneliness. Social isolation and loneliness seem to have distinct pathways in affecting the sleep quality of older adults.

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The authors thank the SEBAS research group for collecting the data and making it available to researchers.

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Correspondence to Po-Wen Ku or Li-Jung Chen.

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All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Yu, B., Steptoe, A., Niu, K. et al. Prospective associations of social isolation and loneliness with poor sleep quality in older adults. Qual Life Res 27, 683–691 (2018).

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  • Sleep quality
  • Social isolation
  • Loneliness
  • Older adults