New Study Finds The Regularity Of Daily Routines Is Linked To Health

A new study published in the Journal of Behavioral Medicine looked at behavioral-social rhythms and insomnia symptoms and the associations with pain, body mass index, and depressive symptoms among older adults.

“Our study looked at what researchers call ‘behavioral-social rhythms’ or basically how consistent people are in the timing of everyday activities like getting out of bed, having their first conversation of the day, starting their daily work or duties, eating dinner, and going to sleep,” study author Enjoin Tracy told us. “The idea is that doing these things at roughly the same time each day acts like a set of signals that keep the body’s internal clock running smoothly, which in turn may support better health.”

Tracy is Assistant Professor in the Department of Human Development and Family Science at the University of Missouri.

The research team focused on older adults because this is a stage of life when two things often show up together: sleep problems like insomnia, and health challenges like chronic pain, weight gain, and low mood. Yet most sleep research pays attention to the night, meaning how long or how well someone sleeps. 

“We wanted to step back and look at rhythms from a full 24-hour perspective, because our bodies run on a 24-hour clock, and it is not only what happens at night that matters but also the timing and consistency of everything we do across the whole day,” Tracy told us. “We wanted to fill that gap. Specifically, we set out to answer three questions. First, do older adults who have insomnia differ from good sleepers when it comes to the regularity of their daily routines, their pain, their body weight, and their mood? Second, is having a more regular daily routine actually linked to less pain, lower body weight, and fewer depressive symptoms? And third, does insomnia change that picture; in other words, does a steady routine matter more, less, or the same for people who struggle with sleep compared to those who don’t? What we were really hoping to find out was whether something as simple and within reach as the timing of everyday activities could be tied to how older adults feel, both physically and emotionally.”

The research team held a theory grounded in a well-established idea called social zeitgeber theory. Zeitgeber is German for ‘time-giver’, and the theory holds that everyday social routines, like waking, eating, working, and interacting with others, act as external cues that keep our internal body clock in step with the 24-hour day. When those routines get thrown off, the internal clock can drift out of alignment, and that misalignment has been linked to problems like depression. 

“Up to now, this theory has mostly been tested in the world of mental health, since it is the foundation for a well-known treatment for mood disorders,” Tracy told us. “One thing we were curious about was whether the same logic extends to physical health, so we deliberately looked beyond mood to include pain and body weight. Building on that, we expected that older adults with insomnia would have more irregular daily routines than people who sleep well, and that the combination of insomnia plus an irregular routine would be especially hard on health, a kind of double burden. We also predicted that people with less consistent routines would report more pain, carry more weight, and have more depressive symptoms.”

Insomnia is common in later life. A large share of older adults struggle with falling asleep, staying asleep, or waking too early, and it travels together with problems like chronic pain, weight gain, and low mood. For years, most of the attention, both in research and in public health messaging, has centered on how many hours people sleep. 

“Sleep duration absolutely matters, but over time researchers have come to understand that it is not the only factor that shapes our health,” Tracy told us. “Our circadian rhythms, or internal body clocks, are critically important too. Our bodies run on a roughly 24-hour clock that regulates far more than sleep, including hormone release, metabolism, mood, and even how sensitive we are to pain.

That is exactly what drew me to behavioral-social rhythms as a concept, because it captures both sides of the story at once. It reflects the importance of sleep and of circadian functioning together, by measuring the timing and consistency not only of when we sleep, but also of the daily activities that anchor our internal clock, like when we eat, work, and socialize. I have long been interested in this other side of the clock, meaning what people do all day and when they do it. In my earlier work I studied people whose schedules had been turned upside down for years, like retired night-shift workers, and that convinced me that the timing of daily life deserves as much attention as sleep itself.”

The timing of daily activities is also something people can actually change, without medication or expensive treatment, which Tracy told us, makes it appealing on two fronts. It is both an accessible thing to study and a potential target for treatment. 

“If regular routines really do support health, then helping people build and keep those routines could become a practical, low-cost strategy that clinicians add to care for improving well-being in later life,” Tracy told us. “There was also a real gap in the literature. Very little work had examined whether the regularity of these daily routines relates to pain in older adults, even though pain and depression are so common and so closely intertwined in this age group.”

To these their theory, the researchers worked with 67 adults aged 60 and older. Thirty-seven had diagnosed insomnia and 30 were good sleepers. For one full week, each person kept a daily diary recording what time they did five key activities: getting out of bed, having their first interaction with another person, starting work or other daily duties, eating dinner, and going to bed. 

“From those diaries we calculated a regularity score,” Tracy told us. “Someone who did those activities at nearly the same time every day scored high, and someone whose timing bounced around scored low. Participants also completed standard questionnaires about pain and depressive symptoms, and we measured their height and weight in the lab. Then we used statistical models to test whether routine regularity was connected to each health outcome, and whether insomnia changed those connections.”

The study results showed that older adults with insomnia and good sleepers turned out to be essentially identical in how regular their daily routines were, and their body weight was similar too. The insomnia group did report more pain and more depressive symptoms than the good sleepers, which lines up with what previous research has shown.

Results also showed that the regularity of daily routines was clearly linked to health. Older adults with more consistent daily rhythms had lower body mass index, less physical pain, and fewer depressive symptoms. Behavioral-social rhythms were the key predictor of better health across all three outcomes.

Results also showed that insomnia did not change these relationships. The benefits tied to a regular routine showed up whether or not a person had insomnia. This pattern held for everyone in the sample rather than in only one group.

“We had assumed that insomnia would go hand in hand with a disorganized daily schedule, and it didn’t,” Tracy told us. “Many people with insomnia keep quite orderly days even when their nights are difficult, which was a genuine surprise. I found it encouraging for a specific reason: our main finding was that a regular daily routine is linked to better health regardless of whether someone has insomnia.”

Tracy elaborated that if people who struggle with sleep are already able to maintain steady routines, then this health-supporting habit is genuinely within their reach, and they do not have to wait until their sleep problems are solved to benefit from it. The connection between steady routines and less pain also stood out to the researchers, because pain has rarely been examined in this line of research. Social zeitgeber theory grew up mostly in mental health, so finding that routine regularity tracked with a physical outcome like pain was a meaningful extension. The links with weight and mood were more in line with what the researchers anticipated.

“To me, the most important implication is that the regularity of daily routines was associated with better health regardless of insomnia symptoms,” Tracy told us. “In other words, the benefit held whether or not a person struggled with sleep. Sleep itself is of course very important for health, but a steady daily rhythm appeared to matter on its own. In our sample, older adults who kept more regular daily rhythms, waking, eating, working, and socializing at consistent times, reported less physical pain and fewer depressive symptoms. One likely reason is that regular daily activities help support the body’s circadian rhythm, or internal clock, which plays an important role in mood, metabolism, and pain regulation. In practical terms, keeping a steady daily rhythm may be a simple, free, and accessible part of healthy aging, and you do not have to be a perfect sleeper to benefit.”

Tracy believes it also points to something clinicians could build into care, since therapies that help people anchor the timing of their days already exist and may be worth applying more broadly in older populations. 

Categories: Anxiety , Depression , Health | Tags: anxiety, depression, health