Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 1, 2025
Open Peer Review Period: Apr 1, 2025 - May 27, 2025
Date Accepted: Jun 4, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Association Between Digital Isolation and Sleep Disorders in Older Adults: A Cross-Sectional and Longitudinal Study Using NHATS Data
ABSTRACT
Background:
As digital technology becomes increasingly embedded in daily life, digital isolation among older adults has become more pronounced. This isolation may restrict access to health information and social support, potentially leading to poorer sleep quality. However, most existing studies on digital isolation and sleep disorders are cross-sectional, lacking longitudinal evidence to establish causality.
Objective:
This study aimed to investigate the association between digital isolation and sleep disorders in older adults using both cross-sectional and longitudinal designs, and to assess the impact of specific components of digital isolation on the risk of sleep disorders.
Methods:
We analyzed data from the National Health and Aging Trends Study (NHATS) collected from 2011 to 2022, including a discovery sample of 5,989 older adults and a validation sample of 3,443. Digital isolation was measured by the use of mobile phones, computers, email, and the internet, while sleep disorders were identified based on difficulties initiating or maintaining sleep and the use of sleep medication. Multivariable logistic regression and Cox proportional hazards models were employed for cross-sectional and longitudinal analyses, respectively.
Results:
Cross-sectional analyses revealed a higher prevalence of sleep disorders among those with high digital isolation (discovery: 67.03% vs. 59.06%, OR = 1.23, P < 0.001; validation: 70.10% vs. 61.38%, OR = 1.22, P = 0.033). In longitudinal analyses, high digital isolation was associated with an increased risk of sleep disorders in the discovery (HR = 1.21, P = 0.006) and pooled samples (HR = 1.17, P = 0.005), but the association was not statistically significant in the validation sample after adjustment (HR = 1.11, P = 0.298).
Conclusions:
Digital isolation is significantly associated with sleep disorders among older adults, particularly in cross-sectional analyses, while longitudinal findings provide partial support for this association. The non-significant result observed in the validation sample may reflect sample heterogeneity, and suggests that mental health may mediate this relationship. Future interventions should address mental health to help mitigate the negative impact of digital isolation on sleep.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.