Food insecurity is associated with the sleep quality and quantity in adults: a systematic review and meta-analysis

Objective:We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (>= 18 years). Design:The current study represented a systematic review and meta-analysis of observational studies. Setting:Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI. Participants:Data from ten eligible observational studies, including 83 764 participants, were included. Results:FI was associated with an increased risk of poor sleep quality (OR = 1 center dot 45; 95 % CI (1 center dot 24, 1 center dot 70), I-2 = 95, P < 0 center dot 001, n 7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1 center dot 31; 95 % CI (1 center dot 16, 1 center dot 48), I-2 = 0 %, P < 0 center dot 001, n 5), moderate (OR = 1 center dot 49; 95 % CI (1 center dot 32, 1 center dot 68), I-2 = 0 %, P < 0 center dot 001, n 5) and severe (OR = 1 center dot 89; 95 % CI (1 center dot 63, 2 center dot 20), I-2 = 0 %, P < 0 center dot 001, n 5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1 center dot 39; 95 % CI (1 center dot 05, 1 center dot 83), I-2 = 91 %, P = 0 center dot 002, n 3) and trouble staying asleep (OR = 1 center dot 91; 95 % CI (1 center dot 37, 2 center dot 67), I-2 = 89 %, P < 0 center dot 001, n 3). Moreover, FI was associated with the odds of shorter (OR = 1 center dot 14; 95 % CI (1 center dot 07, 1 center dot 21), I-2 = 0 %, P < 0 center dot 001, n 4) and longer sleep duration (OR = 1 center dot 14; 95 % CI (1 center dot 03, 1 center dot 26), I-2 = 0 %, P = 0 center dot 010, n 4). Conclusions:Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.