Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries

Louis Jacob, Lee Smith, Karel Kostev, Hans Oh, Razak M. Gyasi, Guillermo F. López Sánchez, Tae Jin Song, Mark A. Tully, Josep Maria Haro, Dong Keon Yon, Jae Il Shin, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007–2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged ≥18 years were analysed (mean [standard deviation] age 43.8 [14.4] years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio = 1.53, 95% confidence interval = 1.11–2.10) and severe food insecurity (odds ratio = 2.35, 95% confidence interval = 1.56–3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage = 43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.

Original languageEnglish
Article numbere13852
JournalJournal of Sleep Research
Volume32
Issue number4
DOIs
StatePublished - Aug 2023

Bibliographical note

Publisher Copyright:
© 2023 European Sleep Research Society.

Keywords

  • epidemiology
  • food insecurity
  • insomnia-related symptoms
  • low- and middle-income countries
  • sleep problems

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