Association between anxiety and sleep disorders in older adults: evidence from the 2020 health and retirement study

Background Sleep disorders and anxiety are both common in older adults and are closely related to health and wellbeing. However, evidence from large population-based samples remains limited, particularly regarding the potential roles of self-rated health and life satisfaction in this association. Objective To examine the prevalence of anxiety symptoms and sleep disorders in older adults and to investigate the association between anxiety and sleep disorders using data from the 2020 Health and Retirement Study. Methods This cross-sectional study used data from the 2020 Health and Retirement Study. A total of 3,436 participants aged 60 years and older who completed the psychosocial questionnaire were included. Chi-square tests, multivariable logistic regression, and mediation analyses were performed to examine the association between anxiety and sleep disorders. Results Among the participants, 19.6% had sleep disorders and 12.8% had anxiety symptoms. In the multivariable logistic regression analysis, anxiety was significantly associated with higher odds of sleep disorders (OR = 2.113, 95% CI: 1.677–2.664). Mediation analysis indicated that self-rated health and life satisfaction were statistically significant indirect pathways in this association. The indirect effect through self-rated health was 0.04, accounting for 21.95% of the total association, and the indirect effect through life satisfaction was 0.03, accounting for 17.04%. Conclusion In this sample of older adults, anxiety was significantly associated with sleep disorders. Self-rated health and life satisfaction may partly account for this association. Because of the cross-sectional design, the findings should be interpreted as associations rather than causal relationships.