Alcohol Consumption and Physical Inactivity Mediate the Link Between Sleep Disturbance and Psychological Wellbeing in Older Adults: A 10-Year Follow-Up From the English Longitudinal Study of Ageing

Importance: The level of optimal sleep often decreases with age, yet the mechanisms explaining the links with psychological wellbeing and other outcomes remain poorly understood. Very few studies (none in the United Kingdom) explored these associations in large, well-characterised groups of community-dwelling individuals. Objective: To investigate the mediating role of various lifestyle behaviours in the relationship between sleep and subsequent psychological wellbeing. Design: A longitudinal analysis of the English Longitudinal Study of Ageing spanning over 10 years from wave 4 (2008-09) to wave 9 (2018-19), and mediating factors investigated at wave 5 (2010-11). Setting: English population-based sample. Participants: The sample was comprised of 4,110 men and women aged 50 years living in England. Exposures: Sleep duration, sleep disturbance (insomnia, difficulty falling asleep) and covariates were assessed at wave 4. Outcomes: Lifestyle behaviours (alcohol, smoking, physical inactivity, and low fruit & vegetable consumption) were assessed at wave 5. Depressive symptoms, quality of life, and life satisfaction were measured with well-established scales at wave 9. Results: During a 10-year follow up, compared with optimal baseline sleep (7-8 hours), short sleep (