@article {11802,
	title = {Sleep disturbance and pain in U.S. adults over 50: Evidence for reciprocal, longitudinal effects},
	journal = {Sleep Medicine},
	volume = {86},
	year = {2021},
	pages = {32-39},
	abstract = {ObjectiveTo examine the relationship between sleep disturbance and pain over a 14-year period.MethodsThis study used data from the 2002-2016 waves of the Health and Retirement Study (HRS), an observational study of U.S. adults over age 50 (n=17,756). Sleep disturbance was measured via four items (assessing difficulty falling asleep, staying asleep, and waking up too early as well as restedness) and pain via two items assessing the presence and degree of pain. Analyses consisted of path analysis; more specifically, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine how pain and sleep disturbance predict one another over two-year intervals after accounting for the trait-like nature of both factors.ResultsThere was evidence of reciprocal effects between sleep disturbance and pain across some, but not all, intervals. Moreover, the latent variables representing the trait-like nature of sleep disturbance and pain both showed significant variance (p <.001), indicating stable differences between persons in sleep and pain. These trait-like characteristics were strongly associated (β=.51, p <.001). The findings remained after adjusting the model for baseline age, self-reported health, partner status, depression, years of education, and sex.ConclusionSleep disturbance and pain are stable experiences. Moreover, there was some evidence that sleep disturbance and pain are bidirectionally linked across time among adults over 50, whereby across some intervals deviations in one{\textquoteright}s typical level of sleep disturbance predicted corresponding deviations in one{\textquoteright}s typical level of pain and vice versa. Clinically, this comorbidity and potential longitudinal bidirectionality underscore the importance of evidence-based interventions that target both sleep and pain among older individuals. Further studies should replicate these findings by collecting validated and/or objective sleep and pain measures on a more frequent basis.},
	keywords = {pain, path analysis, RI-CLPM, Sleep},
	isbn = {1389-9457},
	doi = {10.1016/j.sleep.2021.08.006},
	author = {Sarah C. Griffin and Ravyts, Scott G. and Bourchtein, Elizaveta and Ulmer, Christi S. and Leggett, Melanie K. and Joseph M. Dzierzewski and Patrick S Calhoun}
}
@article {10794,
	title = {Sleep Disturbance Mediates the Association Between Loneliness and Health in Older Americans},
	journal = {International Journal of Behavioral Medicine},
	year = {2020},
	abstract = {Background
As the research documenting loneliness as a risk factor for morbidity and mortality continues to grow, it becomes increasingly critical to understand the mechanics of this relationship. This study assessed whether sleep disturbance mediates the relationship between loneliness and health.

Method
Data came from the 2006, 2010, and 2014 waves of the Health and Retirement Study, a longitudinal study of older Americans; participants >= 65 who completed the Psychosocial and Lifestyle Questionnaire in 2006 were included (n = 5067). Measures include the Hughes loneliness scales, a modified version of the Jenkins sleep scale, and self-reported health. Cross-lagged mediation models (i.e., path analysis) were used to model the relationships between loneliness, sleep disturbance, and self-reported health over the 8-year span.

Results
Loneliness predicted subsequent sleep disturbance, which in turn predicted subsequent self-reported health. Moreover, there was evidence of both direct and indirect effects (via sleep disturbance) of loneliness on self-reported health. These effects remained after controlling for demographics, isolation, and depression.

Conclusion
Sleep disturbance partially mediates the relationship between loneliness and self-reported health over 8 years. These findings are not attributable to isolation or depression. Further research is necessary to develop and assess a more comprehensive model of how loneliness shapes health. This study indicates that targeting sleep disturbance may mitigate the health risks of loneliness in older Americans.},
	keywords = {Aging, health, Loneliness, Older Adults, Sleep},
	isbn = {1532-7558},
	doi = {10.1007/s12529-020-09897-2},
	author = {Sarah C. Griffin and Samantha N Mladen and Williams, Allison Baylor and Dautovich, Natalie D. and Lageman, Sarah K. and Joseph M. Dzierzewski and Paul B. Perrin and Bruce D. Rybarczyk}
}
@article {11138,
	title = {Reciprocal Effects Between Loneliness and Sleep Disturbance in Older Americans.},
	journal = {Journal of Aging and Health},
	year = {2019},
	abstract = {<p> To model the relationship between loneliness and sleep disturbance over time. : Data came from the Health and Retirement Study (2006, 2010, 2014 waves; age >= 65 years;  = 5,067). Loneliness was measured via the Hughes Loneliness Scale and sleep disturbance via a four-item scale assessing sleep and restedness. Cross-lagged panel modeling (path analysis) was used to jointly examine reciprocal effects between loneliness and sleep disturbance. : Higher loneliness correlated with higher sleep disturbance at baseline. There was evidence of reciprocal effects between loneliness and sleep across timepoints. These associations overall remained when accounting for demographics, objective isolation, and depression. : Although causality cannot be established, the findings indicate that the relationship between loneliness and sleep disturbance is bidirectional. This requires revision to the current theory on sleep disturbance as a mechanism for the relationship between loneliness and health and indicates that effective treatment of sleep disturbance may reduce loneliness.</p>},
	keywords = {health, insomnia, Loneliness, Older Adults, Sleep},
	issn = {1552-6887},
	doi = {10.1177/0898264319894486},
	author = {Sarah C. Griffin and Williams, Allison Baylor and Samantha N Mladen and Paul B. Perrin and Joseph M. Dzierzewski and Bruce D. Rybarczyk}
}
