Prevalence and predictors of insomnia and its treatment-seeking among older adults in India.

Abstract

Background: Insomnia is a serious health problem among older adults and, if untreated, is linked to a high morbidity rate and decreased quality of life. There is limited empirical evidence on Insomnia and its treatment-seeking exclusively among older adults (60 plus years) using representative data in India. This study assesses the prevalence and predictors of Insomnia and its treatment-seeking among older adults.

Methods: Data gathered through the nationally-representative Longitudinal Ageing Study in India (LASI); Wave 1 (2017-18) was used for the analysis. Specifically, information from older adults aged 60 and above for whom complete information on insomnia was available (n- 31,464) was considered for the analysis. Binary logistic regression was used to check the adjusted effects of insomnia's socio-demographic and economic predictors and its treatment-seeking status. Stata was used for the data analysis with a 5% significance level.

Results: 37% of older adults had insomnia. Increasing age, female gender, living without a spouse, illiteracy, chronic health conditions, nutritionally underweight, physically inactive status, lack of exposure to mass media, Hindu religion, non-tribal status, and rural residence were significantly associated with insomnia. 3% of older adults sought treatment for insomnia. Not seeking treatment for insomnia was associated with male gender, exposure to mass media, physical activity, lack of chronic health issues, tribal status, living in a rural area, and being economically disadvantaged.

Conclusions: A sizable number of older adults have insomnia, and the prevalence varies by their socioeconomic, demographic, and health status. Many modifiable risk factors like low education, chronic health conditions, smoking, being underweight, physical inactivity, and lack of exposure to mass media are identified. Treatment-seeking for Insomnia is further inadequate, enhancing the older adult's vulnerability to various morbidities. Policy and program intervention to raise awareness about insomnia, including early identification and pharmacological and non-pharmacological treatment, will ensure better health and welfare of older adults. Estimations are based on self-report questionnaires; therefore, the possibility of recall bias and under-reporting cannot be ignored. Moreover, the estimation of insomnia may vary depending on various clinical definitions. However, a large sample size from a recent nationally representative survey with a robust sampling design is the strength of this study.