title: Social and emotional loneliness and self-reported difficulty initiating and maintaining sleep (DIMS) in a sample of Norwegian university students.
abstract: Social and emotional loneliness negatively impact several areas of health, including sleep. However, few comprehensive population-based studies have evaluated this relationship. Over 12,000 students aged 21-35 years who participated in the student survey for higher education in Norway (the SHoT study) were assessed. Loneliness was assessed using the Social and Emotional Loneliness Scale. Difficulty initiating and maintaining sleep (DIMS) was assessed by a single-item subjective response on the depression scale of the Hopkins Symptoms Checklist (HSCL-25). Social loneliness was associated with more serious DIMS (unadjusted proportional odds-ratio [OR] = 2.69, 95% CI = 2.46-2.95). This association was attenuated following adjustment for anxiety (adjusted OR = 1.92, 95% CI = 1.75-2.10) and depression (adjusted OR = 1.48, 95% CI = 1.34-1.63), however was not substantially altered when all demographics and psychological distress were accounted for (fully adjusted OR = 1.46, 95% CI = 1.30-1.63). Emotional loneliness was also associated with more serious DIMS (unadjusted proportional OR = 2.33, 95% CI = 2.12-2.57). Adjustment for anxiety (adjusted OR = 1.96, 95% CI = 1.78-2.15) and depression (adjusted OR = 1.64, 95% CI = 1.48-1.80) attenuated, but did not extinguish this relationship in the fully adjusted model (adjusted OR = 1.22, 95% CI = 1.09-1.31). Mediation analyses revealed that the social loneliness-DIMS association was fully attributed to psychological distress, while the emotional loneliness-DIMS association was only partially mediated, and a direct association was still observed. Associations between social and emotional loneliness and subjective DIMS were embedded in a larger pattern of psychological distress. Mitigating underlying feelings of loneliness may reduce potentially deleterious effects on sleep health and psychological wellbeing in young adults.
authors.affiliation: Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia.
authors.forename: Amie C
authors.initials: AC
authors.lastname: Hayley
authors.affiliation: Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia.
authors.forename: Luke A
authors.initials: LA
authors.lastname: Downey
authors.affiliation: Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia.
authors.forename: Con
authors.initials: C
authors.lastname: Stough
authors.affiliation: Department of Public Mental Health, Domain for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.|Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.|Department of Psychiatry, Helse Fonna HF, Haugesund, Norway.
authors.forename: Børge
authors.initials: B
authors.lastname: Sivertsen
authors.affiliation: Department of Public Mental Health, Domain for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.|Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Knapstad
authors.affiliation: Department of Public Mental Health, Domain for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.|Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
authors.forename: Simon
authors.initials: S
authors.lastname: Øverland
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008132:Loneliness; D008297:Male; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000523:psychology*; D012934:Social Isolation; D013315:Stress, Psychological / Q000150:complications; D055815:Young Adult
keywords: Emotional; adult; loneliness; psychopathology; sleep disturbance; social; student