Family Health Stress and Insomnia Symptoms Among Older Adults: The Moderating Role of Activity Engagement

Abstract

Insomnia symptoms arising from stress present significant health risks for older adults, yet few studies have examined (1) the association between family health-related stress and insomnia or (2) the moderating role of activity engagement. This study used data from the 2016 and 2018 Health and Retirement Study (N = 5565) to assess these relationships using linear regression models. The study focused on 4 insomnia symptoms and 15 activity items, adjusting for sociodemographic characteristics and health factors. Higher levels of family health stress were significantly associated with higher numbers of insomnia symptoms. The moderation analysis showed that engagement in social and hobby activities weakened this association, suggesting that certain activities serve a buffering role in reducing family health stress-related insomnia symptoms.

Keywords

stress sleep activity participation coping

Get full access to this article

View all access options for this article.

References

Brewster

G. S.

Riegel

Gehrman

P. R.

(2018). Insomnia in the older adult. Sleep medicine clinics, 13(1), 13–19. https://doi.org/10.1016/j.jsmc.2017.09.002

Chen

J. H.

Lauderdale

D. S.

Waite

L. J.

(2016). Social participation and older adults’ sleep. Social Science & Medicine, 149(1), 164–173. https://doi.org/10.1016/j.socscimed.2015.11.045

Das

(2013). Spousal loss and health in late life: Moving beyond emotional trauma. Journal of Aging and Health, 25(2), 221–242. https://doi.org/10.1177/0898264312464498

Denovan

Macaskill

(2016). Building resilience to stress through leisure activities: A qualitative analysis. Annals of Leisure Research, 20(4), 446–466. https://doi.org/10.1080/11745398.2016.1211943

Drake

C. L.

Pillai

Roth

(2014). Stress and sleep reactivity: A prospective investigation of the stress-diathesis model of insomnia. Sleep, 37(8), 1295–1304. https://doi.org/10.5665/sleep.3916

Dzierzewski

J. M.

Buman

M. P.

Giacobbi

P. R.

Jr. Roberts

B. L.

Aiken-Morgan

A. T.

Marsiske

McCrae

C. S.

(2014). Exercise and sleep in community-dwelling older adults: Evidence for a reciprocal relationship. Journal of Sleep Research, 23(1), 61–68. https://doi.org/10.1111/jsr.12078

Elsden

Fancourt

Mak

H. W.

(2022). Frequency of leisure activity engagement and health functioning over a 4-year period: A population-based study amongst middle- aged adults. BMC Public Health, 22(1), 1275. https://doi.org/10.1186/s12889-022-13670-3

Endeshaw

Y. W.

Yoo

(2016). Association between social and physical activities and insomnia symptoms among community-dwelling older adults. Journal of Aging and Health, 28(6), 1073–1089. https://doi.org/10.1177/0898264315618921

Epel

E. S.

Crosswell

A. D.

Mayer

S. E.

Prather

A. A.

Slavich

G. M.

Puterman

Mendes

W. B.

(2018). More than a feeling: A unified view of stress measurement for population science. Frontiers in Neuroendocrinology, 49(1), 146–169. https://doi.org/10.1016/j.yfrne.2018.03.001

10.

Felten-Barentsz

K. M.

van de Wetering-van Dongen

V. A.

Vloet

Koenders

Nijhuis- van der Sanden

M. W. G.

Hoogeboom

T. J.

(2021). Family participation during physical activity in the intensive care unit: A longitudinal qualitative study. Journal of Critical Care, 65(3), 42–48. https://doi.org/10.1016/j.jcrc.2021.05.004

11.

Fenton

A. T. H. R.

Keating

N. L.

Ornstein

K. A.

Kent

E. E.

Litzelman

Rowland

J. H.

Wright

A. A.

(2022). Comparing adult-child and spousal caregiver burden and potential contributors. Cancer, 128(10), 2015–2024. https://doi.org/10.1002/cncr.34164

12.

Fisher

G. G.

Ryan

L. H.

(2018). Overview of the health and retirement study and introduction to the special issue. Work, Aging and Retirement, 4(1), 1–9. https://doi.org/10.1093/workar/wax032

13.

Golics

C. J.

Basra

M. K.

Finlay

A. Y.

Salek

(2013). The impact of disease on family members: A critical aspect of medical care. Journal of the Royal Society of Medicine, 106(10), 399–407. https://doi.org/10.1177/0141076812472616

14.

Guo

X. R.

Cheng

T. Z.

Guo

(2024). The relationship between leisure activity participation and cognitive function among older Chinese adults: The differences across gender and age. Archives of public health = Archives belges de sante publique, 82(1), 201. https://doi.org/10.1186/s13690-024-01438-7

15.

Hahn

S. E.

Smith

C. S.

(1999). Daily hassles and chronic stressors: Conceptual and measurement issues. Stress Medicine, 15(2), 89–101. https://doi.org/10.1002/(SICI)1099-1700

16.

Hand

C. L.

Howrey

B. T.

(2019). Associations among neighborhood characteristics, mobility limitation, and social participation in late life. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 74(3), 546–555. https://doi.org/10.1093/geronb/gbw215

17.

Health and Retirement Study (HRS) . (2023). HRS 2006-2022 psychosocial and lifestyle questionnaire user guide. Institute for Social Research, University of Michigan.

18.

Holmes

A. M.

Deb

(2003). The effect of chronic illness on the psychological health of family members. The Journal of Mental Health Policy and Economics, 6(1), 13–22.

19.

Huang

Q. M.

Xie

J. H.

Chen

Yan

H. Y.

Gao

Z. H.

Gao

Kraus

V. B.

Mao

(2024). Association of insomnia symptoms and trajectories with the risk of functional disability: A prospective cohort study. BMC Geriatrics, 24(1), 492. https://doi.org/10.1186/s12877-024-05108-9

20.

Kalmbach

D. A.

Anderson

J. R.

Drake

C. L.

(2018). The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. Journal of Sleep Research, 27(6), Article e12710. https://doi.org/10.1111/jsr.12710

21.

Kaufmann

C. N.

Canham

S. L.

Mojtabai

Gum

A. M.

Dautovich

N. D.

Kohn

Spira

A. P.

(2013). Insomnia and health services utilization in middle-aged and older adults: Results from the Health and Retirement Study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 68(12), 1512–1517. https://doi.org/10.1093/gerona/glt050

22.

Kim

D. E.

Roberts

T. J.

Moon

(2021). Relationships among types of activity engagement and insomnia symptoms among older adults. BMC Geriatrics, 21(1), 87. https://doi.org/10.1186/s12877-021-02042-y

23.

Knutson

K. L.

(2013). Sociodemographic and cultural determinants of sleep deficiency: Implications for cardiometabolic disease risk. Social Science & Medicine, 79(1), 7–15. https://doi.org/10.1016/j.socscimed.2012.05.002

24.

Kuo

W. C.

Ersig

A. L.

Kunkul

Brown

R. L.

Oakley

L. D.

(2023). Linking chronic stress to insomnia symptoms in older adults: The role of stress co-occurrence during the pandemic. Research in Nursing & Health, 46(1), 68–79. https://doi.org/10.1002/nur.22278

25.

Lee

Y. S.

Putnam

Morrow-Howell

Inoue

Greenfield

J. C.

Chen

(2019). Consolidated measures of activity among older adults: Results of a three data set comparison. Journal of Gerontological Social Work, 62(5), 502–520. https://doi.org/10.1080/01634372.2019.1582123

26.

Leggett

Burgard

Zivin

(2016). The impact of sleep disturbance on the association between stressful life events and depressive symptoms. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 71(1), 118–128. https://doi.org/10.1093/geronb/gbv072

27.

Liu

(2021). Spouse and adult-child dementia caregivers in American families: Who are more stressed out? Journal of the American Medical Directors Association, 22(7), 1512–1517. https://doi.org/10.1016/j.jamda.2020.12.012

28.

MacLeod

Musich

Kraemer

Wicker

(2018). Practical non-pharmacological intervention approaches for sleep problems among older adults. Geriatric nursing (New York, N.Y.), 39(5), 506–512. https://doi.org/10.1016/j.gerinurse.2018.02.002

29.

Mak

H. W.

Noguchi

Bone

J. K.

Wels

Gao

Kondo

Saito

Fancourt

(2023). Hobby engagement and mental wellbeing among people aged 65 years and older in 16 countries. Nature Medicine, 29(9), 2233–2240. https://doi.org/10.1038/s41591-023-02506-1

30.

Marr

Vaportzis

Niechcial

M. A.

Dewar

Gow

A. J.

(2021). Measuring activity engagement in old age: An exploratory factor analysis. PLoS One, 16(12), Article e0260996. https://doi.org/10.1371/journal.pone.0260996

31.

Morese

Longobardi

(2022). The Impact of Physical Distancing in the Pandemic Situation: Considering the Role of Loneliness and Social Brain. Frontiers in Psychology, 13, 861329. https://doi.org/10.3389/fpsyg.2022.861329

32.

Morrow-Howell

Putnam

Lee

Y. S.

Greenfield

J. C.

Inoue

Chen

(2014). An investigation of activity profiles of older adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 69(5), 809–821. https://doi.org/10.1093/geronb/gbu002

33.

Nomaguchi

Milkie

M. A.

(2020). Parenthood and well-being: A decade in review. Journal of Marriage and Family, 82(1), 198–223. https://doi.org/10.1111/jomf.12646

34.

Pearlin

L. I.

(2010). The life course and the stress process: Some conceptual comparisons. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65B(2), 207–215. https://doi.org/10.1093/geronb/gbp106

35.

Pearlin

L. I.

Lieberman

M. A.

Menaghan

E. G.

Mullan

J. T.

(1981). The stress process. Journal of Health and Social Behavior, 22(4), 337–356.

36.

Pinquart

Sörensen

(2011). Spouses, adult children, and children-in-law as caregivers of older adults: A meta-analytic comparison. Psychology and Aging, 26(1), 1–14. https://doi.org/10.1037/a0021863

37.

Russell

Ogunbayo

O. J.

Newham

J. J.

Heslop-Marshall

Netts

Hanratty

Beyer

Kaner

(2018). Qualitative systematic review of barriers and facilitators to self- management of chronic obstructive pulmonary disease: Views of patients and healthcare professionals. NPJ Primary Care Respiratory Medicine, 28(1), 2. https://doi.org/10.1038/s41533-017-0069-z

38.

Seidel

A. J.

Yorgason

J. B.

Polenick

C. A.

Zarit

S. H.

Fingerman

K. L.

(2018). Are you sleeping? Dyadic associations of support, stress, and worries regarding adult children on sleep. The Gerontologist, 58(2), 341–352. https://doi.org/10.1093/geront/gnw149

39.

Simpson

Allegra

J. C.

Ezeamama

A. E.

Elkins

Miles

(2014). The impact of mid- and late-life loss on insomnia: Findings from the health and retirement study, 2010 cohort. Family & Community Health, 37(4), 317–326. https://doi.org/10.1097/FCH.0000000000000039

40.

Szabo

A. N.

Bangert

A. S.

Reuter-Lorenz

P. A.

Seidler

R. D.

(2013). Physical activity is related to timing performance in older adults. Neuropsychology, development, and cognition. Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition, 20(3), 356–369. https://doi.org/10.1080/13825585.2012.715625

41.

Tang

N. K. Y.

Saconi

Jansson-Fröjmark

Ong

J. C.

Carney

C. E.

(2023). Cognitive factors and processes in models of insomnia: A systematic review. Journal of Sleep Research, 32(6), Article e13923. https://doi.org/10.1111/jsr.13923

42.

Thomas

P. A.

Umberson

(2018). Do older parents’ relationships with their adult children affect cognitive limitations, and Does this differ for mothers and fathers? Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 73(6), 1133–1142. https://doi.org/10.1093/geronb/gbx009

43.

Troxel

W. M.

Matthews

K. A.

Bromberger

J. T.

Sutton-Tyrrell

(2003). Chronic stress burden, discrimination, and subclinical carotid artery disease in African American and Caucasian women. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 22(3), 300–309. https://doi.org/10.1037/0278-6133.22.3.300

44.

Wheaton

(1985). Models for the stress-buffering functions of coping resources. Journal of Health and Social Behavior, 26(4), 352–364. https://doi.org/10.2307/2136658

45.

Yang

Wang

Cui

Huang

Sheng

Shi

Huang

Lan

Huang

Y. N.

(2018). Association between insomnia and job stress: A meta-analysis. Sleep & breathing = Schlaf & Atmung, 22(4), 1221–1231. https://doi.org/10.1007/s11325-018-1682-y

46.

Zhang

Qing

Zhang

(2021). The impact of leisure activities on the mental health of older adults: The mediating effect of social support and perceived stress. Journal of Healthcare Engineering, 2021(1), Article 6264447. https://doi.org/10.1155/2021/6264447