Associations Between Midlife Insomnia Symptoms and Earlier Retirement

Abstract

Background: Insomnia symptoms are prevalent and associated with impaired health and well-being. However, scant research has investigated whether midlife insomnia symptoms are also associated with earlier retirement, thereby contributing to additional economic consequences.

Participants and methods: We analyzed data from a community-based sample of 1635 Wisconsin State employees (51.6% women) that were collected from 1988 until 2014. Study participants were asked about insomnia symptoms (difficulty getting to sleep, difficulty getting back to sleep, repeated nocturnal awakenings, and early morning awakenings) in midlife, with prospective follow-up questions about the specific reasons for retirement between 2010 and 2014. Using Cox proportional hazards models, we investigated longitudinal associations between insomnia symptom measures (ie, each individual insomnia symptom, any insomnia symptom, and number of insomnia symptoms) and rates of retirement. We also investigated reasons for retirement and the potentially mediating role of depression.

Results: For most of our insomnia measures, after adjusting for confounding variables, we did not find that insomnia symptoms at age 50 years were predictive of earlier overall retirement. One exception is that early morning awakening at age 50 years is associated with an increased rate of overall retirement (hazard ratio, 1.22; 95% confidence interval, 1.04-1.43). With regard to reason for retirement, we found that all measures of insomnia were associated with increased rates of retirement due to poor health/disability. For example, the presence of at least one insomnia symptom was associated with a hazard ratio of 1.38 (95% confidence interval, 1.13-1.68). We also found evidence that depressive symptoms mediate the association between insomnia symptoms and retirement due to poor health/disability.

Discussion: Our study finds an association between insomnia symptoms in midlife and retirement due to poor health/disability, whereas there is less compelling evidence between insomnia symptoms and retirement due to other reasons. Future research on insomnia should consider how earlier retirement affects the social and economic consequences of insomnia.

Keywords: Disability; Health; Insomnia; Insomnia symptoms; Retirement; Sleep; Wisconsin Sleep Cohort.