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Loneliness is indirectly associated with sleep disturbances through anxiety symptoms, but not through substance use coping, in adults from Mississippi coastal communities.

In a cross-sectional study of 310 adults (mean age 50.47 years, 53.3% female), loneliness was initially associated with sleep disturbances, but this direct association became non-significant when anxiety and substance use coping were included. A significant indirect effect was found: loneliness increased anxiety, which in turn increased sleep disturbances. Higher community resilience and social support were associated with lower loneliness.

Last updated: Aug 29, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. The Relationship Between Loneliness and Sleep Disturbances: The Roles of Community Resilience, Social Support, Anxiety, and Substance Use Coping.

observational

Choi HW, Brazeal M, Lee J · International journal of environmental research and public health (2026)

Participants: N/A
Duration: N/A (cross-sectional)
Intervention: No intervention; observational study examining associations between loneliness, anxiety, substance use coping, community resilience, social support, and sleep disturbances.
Outcome: Sleep disturbances (measured via self-report instruments), anxiety symptoms (GAD-2), loneliness (UCLA 3-item), substance use coping (Brief COPE), community resilience (CART), social support (MSPSS).
Effect Size: N/A (no effect sizes reported in abstract)
Population: Adults (mean age 50.47 years, SD=17.57; 53.3% female) from households between Interstate 10 and the Gulf of Mexico coastline in three Mississippi counties (Hancock, Harrison, Jackson).

Result:

PubMed: 42652329DOI: 10.3390/ijerph23081014

Mechanism Graph

Loneliness is associated with increased anxiety symptoms.
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Increased anxiety symptoms are associated with higher sleep disturbances.
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Loneliness is not directly associated with sleep disturbances after controlling for anxiety and substance use coping.
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The indirect pathway through anxiety is significant, while the pathway through substance use coping is not.

Limitations

  • ⚠Cross-sectional design prevents causal inference.
  • ⚠Self-report measures may introduce response bias.
  • ⚠Sample limited to a specific geographic region (Mississippi coastal counties), limiting generalizability.
  • ⚠No effect sizes or confidence intervals reported in the abstract.

Frequently Asked Questions

Does loneliness directly cause sleep disturbances?▼

The study found that the direct association between loneliness and sleep disturbances was not significant after including anxiety and substance use coping, suggesting that anxiety mediates the relationship.

What role does anxiety play in the loneliness-sleep link?▼

Anxiety was a significant mediator: higher loneliness was associated with higher anxiety, which in turn was associated with more sleep disturbances.

Does substance use coping mediate the loneliness-sleep relationship?▼

No, the indirect effect through substance use coping was not statistically significant.

How do community resilience and social support relate to loneliness?▼

Higher levels of community resilience and social support were associated with lower levels of loneliness, suggesting they may be protective factors.

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References

  1. 1.Choi HW, Brazeal M, Lee J. "The Relationship Between Loneliness and Sleep Disturbances: The Roles of Community Resilience, Social Support, Anxiety, and Substance Use Coping.." International journal of environmental research and public health, 2026. PMID: 42652329 DOI: 10.3390/ijerph23081014
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.