More sleep problems at baseline were associated with lower psychological well-being nine years later, with a significant adjusted association in females (B=-1.63, p<0.001) but not males (p=0.257).
Cohort (n=574)
Do sleep problems predict worse psychological well-being 9 years later, and does sex moderate this association in middle-aged and older adults?
Sleep problems have lasting negative effects on psychological well-being over nine years, with stronger impacts among females.
Effect estimate: Adjusted B=-1.20
p-value: p=<0.001
Abstract Introduction Sleep problems are related to worse psychological well-being (PWB). Additionally, females have been shown to have greater sleep problems than males. However, less is known about the interplay between sleep problems and sex in relation to PWB. This study investigates the prospective association between sleep problems and PWB in middle-aged and older adults and whether sex moderates this association. Methods Data came from 574 middle-aged and older adults who participated in the Midlife in the United States study at two time points (T1: 2005-2006, T2: 2013-2017, Mage at T1=51.7, females=316). Participants responded via telephone to the Pittsburgh Sleep Quality Index (PSQI) and a 42-item PWB questionnaire (range=42-294; higher scores indicate better PWB). We used linear regressions to examine the prospective association between PSQI (T1) and PWB (T2), adjusting for sociodemographic and health covariates, including age, sex, education, current working status (working, not working, retired), partnered status (living with a partner or not), number of illnesses, and T1 PWB. We tested for moderation by including interaction terms between PSQI and sex. Results More sleep problems at T1 related to lower PWB at T2 (unadjusted: B=-2.71, SE=0.38, p 0.001; adjusted: B=-1.20, SE=0.30, p 0.001). Moderation analyses showed that the association between sleep problems and PWB differed by sex (overall interaction: unadjusted: F=27.51, p 0.001; adjusted: F=11.59, p 0.001). Specifically, in the unadjusted model, more sleep problems at T1 related to lower PWB at T2 more strongly for females (B=-3.23, SE=0.45, p 0.001) than for males (B=-2.00, SE=0.50, p 0.001). After adjusting for covariates, the association remained significant for females (B=-1.63, SE=0.34, p 0.001) but not for males (B=-0.44, SE=0.39, p=0.257). Conclusion This study found that sleep problems have lasting negative effects on PWB over nine years, with stronger impacts among females. Our findings suggest that sleep problems are a key long-term risk factor for poorer well-being. Developing early, sex-specific sleep interventions may enhance psychological well-being. Future research should incorporate sex-specific metabolic biomarkers to better understand the mechanisms underlying sex-based differences. Support (if any) N/A
Hamada et al. (2026) conducted a cohort in Sleep problems (n=574). Sleep problems was evaluated on Psychological well-being (PWB) at T2 (Adjusted B=-1.20, p=<0.001). More sleep problems at baseline were associated with lower psychological well-being nine years later, with a significant adjusted association in females (B=-1.63, p<0.001) but not males (p=0.257).