Food Insecurity is Associated with Objectively Measured Sleep Problems

ABSTRACT

Objective/Background: Food Insecurity (FI) can be a profound source of stress, which may increase the risk for sleep disturbance. This is the first study to examine the association between FI and objectively and subjectively measured sleep.

Participants: The sample included 785 adults living in two low-income neighborhoods (mean age = 56; 95% African American).

Methods: FI was measured using a validated 10-item survey that assesses conditions and behaviors that characterize households when they lack financial resources to meet basic food needs. Sleep duration, efficiency, wakefulness after sleep onset (WASO), and variability in sleep duration were measured via actigraphy. Sleep quality was assessed via sleep diary. Sleep outcomes were analyzed as a function of FI, adjusting for covariates. Psychological distress was tested as a potential mediator.

Results: Greater FI was associated with shorter actigraphy-assessed sleep duration (B = −2.44; SE = 1.24; i.e., 24 minutes shorter for the most as compared to least insecure group), poorer sleep efficiency (B = −.27; SE = .13); p’s < .05), and poorer subjective sleep quality (B = −.03; SE = .01; p < .01). Greater FI was also associated with greater likelihood of short (<7 hours; OR = 1.11; CI: 1.02–1.21) and long sleep (>9 hours; OR = 1.19; CI: 1.01–1.39), compared to the recommended sleep duration of 7–9 hours. Psychological distress partially mediated the association between FI and subjective sleep quality.

Conclusions: Addressing or mitigating food insecurity may present a novel opportunity for improving sleep health among low-income populations.

Acknowledgments

Funding was provided by the National Heart Lung Blood Institute (Grant No. R01 HL122460 and HL131531) and the National Cancer Institute (Grant No. R01CA164137). The authors express sincere appreciation and gratitude to La’Vette Wagner, study field coordinator, the data collection staff, our project coordinator, Jennifer Sloan, and our research assistant, Alvin Nugroho. The authors thank our community partners, including Hill House Association, Operation Better Block, and Homewood Children’s Village and most importantly, our participants, who make this work possible.

All authors contributed to and provided written feedback on the manuscript and approve of the manuscript in its final form. W.T and T.D. conceived and supervised the study. A.H. conducted the analyses. A.S.R. and B.G.D provided statistical expertise and contributed to measure selection. J.K. and M.B. processed all actigraphy data. D.J.B. and L.H. contributed expertise concerning social determinants of sleep and sleep measurement processing and selection.

Disclosure statement

Dr. Buysse has the following COIs to disclose in the past 12 months: Consultant for BeHealth, Emmi Solutions. Participated in CME program sponsored by CME Institute. Received licensing fees for the PSQI. These COIs are not relevant to the work herein.

None of the other authors have financial or non-financial conflicts of interest to disclose relevant to the work under review

Additional information

Funding

Funding was provided by the National Heart Lung Blood Institute (Grant No. R01 HL122460 and HL131531) and the National Cancer Institute (Grant No. R01CA164137).