Diet Quality and Sleep Characteristics in Midlife: The Bogalusa Heart Study

OBJECTIVES: The objective of this study was to determine the cross-sectional relationship between diet quality and multiple sleep outcomes in the Bogalusa Heart Study (BHS). METHODS: This cross-sectional study included 824 midlife participants of the 2013–2016 BHS visit (mean age 48 years, 30% Black). Diet was assessed with a validated food frequency questionnaire and dietary patterns (Alternate Healthy Eating Index [AHEI] 2010, Healthy Eating Index 2015, and Alternate Mediterranean). Insomnia risk, sleep apnea risk, and healthy sleep pattern scores were measured with validated questionnaires. Generalized estimating equations with a logit link function were used to estimate the odds ratio (OR) of high risk of insomnia, sleep apnea, and having a healthy sleep pattern across quintiles (Q) and per standard deviation (SD) increase in dietary pattern scores controlling for body mass index (BMI), socioeconomic status, and other potential confounders. Interactions by race, sex, and education were explored. RESULTS: Higher diet quality as measured by AHEI 2010 was associated with decreased odds of being high risk for sleep apnea after controlling for demographic, socioeconomic, health, and lifestyle factors (OR [95% confidence interval (CI)] Q5 vs. Q1: 0.38 [0.22, 0.65], per SD increase: 0.80 [0.67, 0.95], p-trend: 0.003). This association was stronger among women compared to men (OR [95% CI] per SD increase women: 0.69 [0.55, 0.86], men: 1.01 [0.74, 1.39], p-interaction = 0.01) and in those with higher education compared to those with less education (OR [95% CI] per SD increase high education: 0.67 [0.51, 0.87], low education: 0.94 [0.74, 1.20], p-interaction = 0.03). There were no associations among other dietary patterns or for insomnia risk or healthy sleep pattern in fully adjusted models. CONCLUSIONS: Higher diet quality is associated with decreased odds of sleep apnea risk in a biracial cohort from a semi-rural, low-income community in the southeastern United States. If confirmed in prospective studies, these results have public health implications for the prevention of chronic disease. FUNDING SOURCES: National Heart, Lung, And Blood Institute of the National Institutes of Health.