Social distancing and trouble sleeping during COVID-19 pandemic among older adults in Europe: Mediating and moderating effects

Purpose: We examined the association between social distancing and trouble sleeping during the COVID-19 outbreak in adults 65+, and underlying potential mechanisms. Methods: We used data from the extensive Survey of Health, Aging, and Retirement in Europe (SHARE). Logistic regression analysis tested the direct and indirect associations between social distancing and trouble sleeping during the pandemic, the mediation effect of depression, and the moderating-mediation effects of perceived economic status and employment status. Findings: Social distancing was associated with a higher probability of sleeping problems, partially mediated by depression and moderated by employment status and perceived economic status. Depression had a greater effect on trouble sleeping among those unemployed and those who perceived their economic status as difficult or partially difficult. Conclusion: COVID-19 policy of lockdowns and physical distancing has negative consequences on sleeping and the development of depressive symptoms among older adults. Clinical and policy relevance: Clinicians should be aware of sleep problems in older adults during the pandemic and after, and try to reduce depressive symptoms. Policymakers should determine future policies and regulations that encourage employment among older adults and improve their economic resilience during pandemics.