Exploring the relationship between sleep quality and loneliness among older adults in Indonesian long-term care facilities

Purpose This study aims to explore the relationship between sleep quality and loneliness among older adults residing in Indonesian long-term care facilities, with the objective of informing targeted non-pharmacological interventions for mental health and sleep hygiene in institutionalized elderly care. Design/methodology/approach A cross-sectional correlational study was conducted among 72 older adults (aged ≥ 60 years) across government-run nursing homes (Panti Sosial Tresna Werdha) in Indonesia. Sleep quality was assessed using a single-item sleep quality scale (SQS), and loneliness was measured using a single-item loneliness scale. Spearman’s rank correlation, Fisher’s Exact Test and Kruskal–Wallis H-test were used for data analysis. Findings A statistically significant moderate positive correlation was found between poorer sleep quality and higher loneliness levels (r = 0.351, p = 0.003). Participants with severe loneliness exhibited significantly worse sleep quality (mean SQS = 4.93, SD = 1.82) compared to those who were not lonely (mean SQS = 7.15, SD = 1.92; p = 0.002). Overall, 72.2% of participants experienced moderate-to-severe loneliness, while 47.2% reported fair sleep quality and 12.5% poor sleep quality. The association between sleep quality categories and loneliness categories was significant (Fisher’s Exact Test p 0.001; Cramer’s V = 0.362). Research limitations/implications The cross-sectional design precludes causal inferences, and the use of single-item measures may limit psychometric precision. Future longitudinal and intervention studies are warranted to establish temporal directionality and evaluate integrated sleep and social engagement programmes in Indonesian long-term care settings. Practical implications The findings suggest that routine screening for both sleep quality and loneliness using brief single-item measures should be integrated into nursing home care protocols. Non-pharmacological interventions addressing sleep hygiene and social connectedness simultaneously may offer synergistic benefits for institutionalized older adults in resource-limited settings. Originality/value This is the first study to examine the sleep quality–loneliness relationship among institutionalized older adults in Indonesia, extending prior research on loneliness and depression in similar settings by identifying sleep as an additional modifiable correlate of psychosocial wellbeing in resource-limited long-term care environments.