JMIR Publications

ABSTRACT

Background:

Sleep problems are prevalent among middle-aged and older adults, exerting a bidirectional influence on their physical and mental health. The growing prevalence of internet use has shown potential benefits for physical and mental well-being in this population. However, the relationship between internet use and sleep outcomes remains insufficiently explored.

Objective:

This study investigates the association between internet use (both usage and frequency) and sleep quality and sleep duration among middle-aged and elderly Chinese individuals, and examines gender and age group differences in these relationships.

Methods:

A longitudinal analysis was conducted using the China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018. Sleep quality was assessed using the sleep-related item from the Centre for Epidemiologic Studies Depression Scale (CES-D), categorized as "good" (<1 day; reference group), "fair" (1-4 days), or "poor" (5-7 days). Sleep duration was classified as short (<6 hours), medium (6-9 hours; reference group), or long (>9 hours). Logistic regression models were employed to examine the associations between Internet use and usage frequency in 2015 and the likelihood of experiencing different sleep quality and sleep duration outcomes in 2018.

Results:

The baseline analysis included 18460 participants aged 45 years and older. Among them, 1272 (6.9%) reported using internet, 8825 (48.1%) experienced fair or poor sleep, and 6750 (37.2%) had an abnormal sleep schedule. Participants using the internet, particularly almost daily, had a lower likelihood of poor sleep quality and abnormal sleep durations compared to non-internet users. In the longitudinal analysis, internet users had a significantly reduced risk of poor sleep quality (OR = 0.72, 95% CI: 0.58–0.90) and long sleep duration (OR = 0.53, 95% CI: 0.30–0.92) compared to those non-users. Similar patterns were observed among participants using the internet almost daily (poor sleep quality: OR = 0.74, 95% CI: 0.58–0.95; long sleep duration: OR = 0.49, 95% CI: 0.25–0.96). Subgroup analyses revealed that males had better internet usage and sleep outcomes than females. However, among females, internet use was linked to a more pronounced reduction in the likelihood of sleep problems compared to non-users.

Conclusions:

This study suggests that internet users among middle-aged and older adults are less likely to experience poor sleep quality and abnormal sleep duration, particularly with almost daily internet use, compared to non-users. For those with infrequent internet use, a moderate increase in usage frequency, without excessive engagement, may help mitigate sleep problems.  Clinical Trial: CHARLS was approved by the Biomedical Ethics Review Committee of Peking University (IRB00001052–11015)