Yang Shijun, Tan Wei, Yang Fan
Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Med Internet Res. 2025 Aug 6;27:e75328. doi: 10.2196/75328.
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 were cross-sectional, lacking longitudinal evidence to establish causality.
This study aims 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.
We analyzed data from the National Health and Aging Trends Study (NHATS) collected from 2011 to 2022, including a discovery sample of 5989 older adults and a validation sample of 3443. 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 used for cross-sectional and longitudinal analyses, respectively.
Cross-sectional analyses revealed a higher prevalence of sleep disorders among those with high digital isolation (discovery: 1452/2166, 67.03% vs 2259/3823, 59.06%; odds ratio [OR] 1.23, 95% CI 1.09-1.39; P<.001 and validation: 673/960, 70.10% vs 1524/2483, 61.38%; OR 1.22, 95% CI 1.02-1.47; P=.03). In longitudinal analyses, high digital isolation was associated with an increased risk of sleep disorders in the discovery (hazard ratio [HR] 1.21, 95% CI 1.05-1.38; P=.006) and pooled samples (HR 1.17, 95% CI 1.05-1.31; P=.005), but the association was not statistically significant in the validation sample after adjustment (HR 1.11, 95% CI 0.91-1.36; P=.30).
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 nonsignificant 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.
随着数字技术日益融入日常生活，老年人中的数字隔离现象愈发明显。这种隔离可能会限制获取健康信息和社会支持，从而可能导致睡眠质量下降。然而，大多数现有的关于数字隔离和睡眠障碍的研究都是横断面研究，缺乏纵向证据来确定因果关系。
本研究旨在采用横断面和纵向设计，调查老年人中数字隔离与睡眠障碍之间的关联，并评估数字隔离的特定组成部分对睡眠障碍风险的影响。
我们分析了2011年至2022年从国家健康与老龄化趋势研究（NHATS）收集的数据，包括一个由5989名老年人组成的发现样本和一个由3443名老年人组成的验证样本。通过手机、电脑、电子邮件和互联网的使用情况来衡量数字隔离，而睡眠障碍则根据入睡困难或维持睡眠困难以及使用助眠药物来确定。分别使用多变量逻辑回归和Cox比例风险模型进行横断面和纵向分析。
横断面分析显示，数字隔离程度高的人群中睡眠障碍的患病率更高（发现样本：1452/2166，67.03%对2259/3823，59.06%；优势比[OR]1.23，95%置信区间1.09 - 1.39；P <.001；验证样本：673/960，70.10%对1524/2483，61.38%；OR 1.22，95%置信区间1.02 - 1.47；P =.03）。在纵向分析中，发现样本（风险比[HR]1.21，95%置信区间1.05 - 1.38；P =.006）和合并样本（HR 1.17，95%置信区间1.05 - 1.31；P =.005）中，高数字隔离与睡眠障碍风险增加相关，但在调整后的验证样本中该关联无统计学意义（HR 1.11，95%置信区间0.91 - 1.36；P =.30）。
数字隔离与老年人的睡眠障碍显著相关，尤其是在横断面分析中，而纵向研究结果为这种关联提供了部分支持。在验证样本中观察到的无统计学意义的结果可能反映了样本异质性，并表明心理健康可能介导了这种关系。未来的干预措施应关注心理健康，以帮助减轻数字隔离对睡眠的负面影响。
