Social Network and Risk of Poor Sleep Outcomes in Older Adults: Results from a Spanish Prospective Cohort Study

Figures & data

Table 1 Prospective Association Between Values of the Social Network Index (SNI) and Its Components in 2012, Changes in Nighttime Sleep Duration Between 2012 and 2015, and Risk of Short (<6 Hours) or Long (>9 Hours) Nighttime Sleep in 2015

Sleep Duration
	Mean Changes (95% CI) Between 2012 and 2015 (Minutes)		Odds Ratios (95% CI) for Short Nighttime Sleep in 2015		Odds Ratios (95% CI) for Long Nighttime Sleep in 2015
	Model 1^b	Model 2^c	Model 1^b	Model 2^c	Model 1^b	Model 2^c
n/Total	1444/1444^d		88/1196^d		104/1326^d
SNI (2012),^a quartiles
1st (0–1 items)	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
2nd (2 items)	0.37 (−9.39–10.1)	2.32 (−7.58–12.2)	1.61 (0.86–3.02)	1.54 (0.80–2.98)	1.35 (0.77–2.36)	1.35 (0.77–2.36)
3rd (3–4 items)	−4.39 (−14.7–5.89)	−2.70 (−13.19–7.79)	1.44 (0.73–2.85)	1.42 (0.70–2.89)	1.12 (0.60–2.10)	1.12 (0.60–2.10)
4th (5–8 items)	−13.06 (−23.17 - −2.95)	−13.04 (−23.41 - −2.67)	2.00 (1.07–3.70)	2.22 (1.16–4.27)	0.81 (0.43–1.50)	0.81 (0.43–1.50)
p-trend	0.01	0.02	0.04	0.02	0.52	0.52
Per 1-item increase	−3.24 (−5.58 - −0.91)	−3.16 (−5.56 - −0.75)	1.19 (1.03–1.38)	1.22 (1.05–1.42)	0.97 (0.84–1.11)	0.97 (0.84–1.11)
SNI items (2012)
Not being married	−7.02 (−15.88–1.83)	−6.29 (−15.33–2.74)	1.43 (0.83–2.45)	1.52 (0.86–2.68)	1.19 (0.73–1.94)	1.17 (0.70–1.96)
Living alone	−10.15 (−19.80 - −0.50)	−10.20 (−20.07 - −0.32)	1.44 (0.81–2.55)	1.51 (0.82–2.76)	1.06 (0.63–1.79)	1.05 (0.61–1.83)
No daily contact with family	−2.60 (−10.74–5.55)	−1.53 (−9.78–6.72)	0.90 (0.54–1.51)	0.88 (0.51–1.53)	0.58 (0.33–0.96)	0.61 (0.35–1.05)
No daily contact with friends	−1.76 (−9.02–5.68)	−3.12 (−10.70–4.47)	1.09 (0.69–1.72)	1.17 (0.72–1.89)	0.86 (0.56–1.32)	0.85 (0.54–1.33)
Spending ≥8 h/d alone	−13.01 (−22.96 - −3.05)	−12.52 (−22.62 - −2.40)	1.40 (0.78–2.51)	1.42 (0.77–2.61)	1.07 (0.62–1.86)	1.07 (0.62–1.86)
Lacking someone to go for a walk with	−7.60(−14.99 - −0.21)	−7.86 (−15.39 - −0.32)	1.80 (1.15–2.84)	1.83 (1.13–2.94)	1.13 (0.75–1.71)	1.12 (0.72–1.74)
No emotional support	−15.25 (−30.38 - −0.13)	−13.83 (−29.4–1.76)	1.63 (0.70–3.83)	1.88 (0.78–4.53)	0.93 (0.38–2.24)	1.09 (0.44–2.73)
No instrumental support	0.74 (−6.72–8.19)	1.81 (−5.77–9.39)	1.49 (0.93–2.41)	1.53 (0.93–2.53)	0.76 (0.52–1.22)	0.85 (0.54–1.32)

Notes: Data highlighted in bold show a statistically significant association. ^aThe SNI ranged from 0 to 8, with higher scores being indicative of worse social network. ^bModel 1 was adjusted for age (continuous), sex (male, female), education (≤ high school, high school, > high school), and baseline sleep duration (hours/night). ^cModel 2 additionally adjusted for baseline tobacco smoking (never-, former-, current-smoker), alcohol drinking (non-, ex-, moderate-, heavy-drinker), television viewing time (h/d), reading time (h/d), time listening to music (h/d), time on the computer (h/d), sex-specific tertiles of household and recreational physical activity (METs*h/wk), diet quality (sex-specific tertiles of the MEDAS score), caffeine consumption (mg/d), BMI (<25, 25–29.9, ≥30), number of symptoms of psychological distress (GHQ-12), depression (GDS-10), self-reported medical diagnosis of cardiovascular disease, diabetes, hypertension, lung disease, osteomuscular disease, and cancer, ≥2 falls in the previous year, and number of drug treatments. ^dResults for mean changes were conducted among the overall sample of 1444 older adults, results for the risk of short sleep among 1196 with no short sleep at baseline, and results for the risk of long sleep among 1414 with no long sleep at baseline.

Abbreviations: SNI, Social Network Index; 95% CI, 95% confidence interval; h, hours; d, days; METs*h/w, metabolic equivalents of tasks*hours/week; MEDAS, Mediterranean Diet Adherence Screener; BMI, body mass index; GHQ-12, 12-item general health questionnaire; GDS-10, Geriatric Depression Scale.

Table 2 Prospective Association Between Values of the Social Network Index (SNI) and Its Components in 2012, Changes in the Sleep Disturbance Scale Between 2012 and 2015, and Risk of Developing ≥4 Poor Sleep Disturbance Indicators in 2015

Sleep Quality
	Mean Changes (95% CI) in Number of Sleep Disturbance Indicators Between 2012 and 2015		Odds Ratios (95% CI) for ≥4 Sleep Disturbance Indicators in 2015
	Model 1^b	Model 2^c	Model 1^b	Model 2^c
n/Total	1444/1444^d		127/1200^d
SNI^a (2012), quartiles
1st (0–1 items)	Ref.	Ref.	Ref.	Ref.
2nd (2 items)	0.09 (−0.08–0.26)	0.09 (−0.08–0.26)	1.16 (0.67–2.00)	1.17 (0.65–2.10)
3rd (3–4 items)	0.14 (−0.04–0.32)	0.11 (−0.07–0.28)	1.61 (0.91–2.83)	1.76 (0.96–3.22)
4th (5–8 items)	0.14 (−0.03–0.33)	0.14 (−0.04–0.32)	1.43 (0.83–2.46)	1.48 (0.82–2.67)
p-trend	0.07	0.09	0.12	0.09
Per 1-item increase	0.04 (−0.00–0.08)	0.03 (−0.00–0.07)	1.12 (1.00–1.27)	1.13 (1.00–1.30)
SNI items (2012)
Not being married	0.10 (−0.06–0.25)	0.10 (−0.05–0.25)	1.25 (0.78–1.97)	1.22 (0.74–2.02)
Living alone	0.09 (−0.07–0.26)	0.08 (−0.09–0.24)	1.36 (0.86–2.22)	1.30 (0.76–2.22)
No daily contact with family	−0.01 (−0.15–0.12)	−0.00 (−0.15–0.13)	1.06 (0.86–1.66)	1.17 (0.73–1.88)
No daily contact with friends	0.06 (−0.06–0.19)	0.05 (−0.08–0.18)	1.06 (0.70–1.55)	1.06 (0.69–1.63)
Spending ≥8 h/d alone	0.07 (−0.10–0.24)	0.07 (−0.10–0.24)	1.26 (0.75–2.12)	1.27 (0.72–2.24)
Lacking someone to go for a walk with	0.06 (−0.06–0.19)	0.06 (−0.07–0.18)	1.30 (0.87–1.93)	1.20 (0.78–1.84)
No emotional support	0.11 (−0.15–0.36)	0.03 (−0.23–0.29)	2.19 (1.02–4.73)	1.99 (0.88–4.46)
No instrumental support	0.00 (−0.12–0.13)	−0.01 (−0.14–0.12)	1.15 (0.77–1.74)	1.30 (0.83–2.02)

Notes: Data highlighted in bold show a statistically significant association. ^aThe SNI ranged from 0 to 8, with higher scores being indicative of worse social network. ^bModel 1 was adjusted for age (continuous), sex (male, female), education (≤ high school, high school, > high school), baseline sleep duration (hours/night) and baseline number of sleep disturbance indicators. ^cModel 2 additionally adjusted for for baseline tobacco smoking (never-, former-, current-smoker), alcohol drinking (non-, ex-, moderate-, heavy-drinker), television viewing time (h/d), reading time (h/d), time listening to music (h/d), time on the computer (h/d), sex-specific tertiles of household and recreational physical activity (METs*h/wk), diet quality (sex-specific tertiles of the MEDAS score), caffeine consumption (mg/d), BMI (<25, 25–29.9, ≥30), number of symptoms of psychological distress (GHQ-12), depression (GDS-10), self-reported medical diagnosis of cardiovascular disease, diabetes, hypertension, lung disease, osteomuscular disease, and cancer, ≥2 falls in the previous year, and number of drug treatments. ^dResults for mean changes were conducted among the overall sample of 1444 older adults, results for the risk of developing ≥4 poor sleep disturbance indicators among 1200 with <4 indicators at baseline.

Abbreviations: SNI, Social Network Index; 95% CI, 95% confidence interval; h, hours; d, days; METs*h/w, metabolic equivalents of tasks*hours/week; MEDAS, Mediterranean Diet Adherence Screener; BMI, body mass index; GHQ-12, 12-item general health questionnaire; GDS-10, Geriatric Depression Scale.