Negative Aging Stereotypes and Clinical Insomnia in Older U.S. Military Veterans

Abstract Background and Objectives Insomnia symptoms are more prevalent in older age and may be impacted by negative perceptions of aging; however, more research is needed. The present study characterizes the relationship between negative aging stereotypes and clinical insomnia symptoms in a nationally representative sample of older United States (U.S.) veterans. Research Design and Methods Data were analyzed from 3,000 U.S. veterans (aged 60-99) who participated in the National Health and Resilience in Veterans Study (NHRVS). Multivariable regression analyses were conducted to examine associations between negative aging stereotypes (assessed with the Expectations Regarding Aging Scale) and clinical insomnia (assessed with the Insomnia Severity Index). Results A total of 213 veterans (7.1%) screened positive for clinical insomnia and scored significantly higher on measures of negative emotional (p<.001), physical (p=.003), and cognitive (p=.013) aging stereotypes relative to veterans without clinical insomnia. Multivariable regression analyses revealed that, after adjusting for covariates, greater endorsement of negative stereotypes regarding emotional aging was associated with significantly greater odds of screening positive for clinical insomnia (OR=1.56, 95%CI=1.26-1.95, p<.001), sleep disturbance (OR=1.49, 95%CI=1.25-1.77, p<.001) and daytime dysfunction (OR=1.58, 95%CI=1.34-1.88, p<.001). Veterans who ‘somewhat’ and ‘fully’ endorsed these negative stereotypes were 3- and 6-times more likely to screen positive for clinical insomnia, respectively (probabilities=0.110 and 0.246 vs. 0.040). Discussion and Implications Negative aging stereotypes, particularly those related to emotional aging, are independently associated with clinical insomnia in older U.S. veterans. Efforts to modify these stereotypes in older veterans may help improve overall sleep quality.