Loneliness, social isolation, and sleep problems: Findings from a 10-year longitudinal study of Chinese middle-aged...

Social isolation, loneliness, and sleep problems have emerged as significant concerns in aging populations, yet longitudinal studies exploring their interconnections are limited. This study examined these relationships and performed subgroup analyses based on age and gender.

Data were derived from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, 2018, and 2020 waves; age ≥ 45 years, n = 7,622). The random intercept cross-lagged panel models (RI-CLPMs) were utilized to jointly examine the reciprocal effects between loneliness and sleep problems, as well as between social isolation and sleep problems in the total sample and within age and gender subgroups.

Our findings revealed a bidirectional association between loneliness and sleep problems: sleep problems predicted later loneliness, β = .032, 95% confidence interval (CI) [0.019, 0.046], to .041, 95% CI [0.024, 0.057], and vice versa (β = .030, 95% CI [0.017, 0.042], to .037, 95% CI [0.021, 0.053]). Age and sex moderated the relationship between social isolation and sleep problems. Subgroup analyses showed a bidirectional pattern in older adults, with social isolation predicting later sleep problems (β = .031, 95% CI [0.009, 0.053], to .037, 95% CI [0.010, 0.064]), and the reverse association also observed (β = .024, 95% CI [0.001, 0.046], to .027, 95% CI [0.002, 0.052]). Among females, a unidirectional effect emerged, where social isolation predicted subsequent sleep problems (β = .021, 95% CI [0.002, 0.040], to .026, 95% CI [0.003-0.050]).

Social isolation and loneliness exhibit distinct longitudinal relationships with sleep problems. Attention to loneliness and sleep problems should begin in middle age. Social isolation presents a greater threat to older adults and females, warranting further investigation in these populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).