Food insecurity and sleep health by race/ethnicity in the United States

Food insecurity, poised to increase with burgeoning concerns related to climate change, may influence sleep, yet few studies examined the food security-sleep association among racially/ethnically diverse populations with multiple sleep dimensions. We determined overall and racial/ethnic-specific associations between food security and sleep health. Using National Health Interview Survey data, we categorised food security as very low, low, marginal and high. Sleep duration was categorised as very short, short, recommended and long. Sleep disturbances included trouble falling/staying asleep, insomnia symptoms, waking up feeling unrested and using sleep medication (all >= 3 d/times in the previous week). Adjusting for socio-demographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95 % confidence intervals (95 % CIs) for sleep dimensions by food security. Among 177 435 participants, the mean age of 47 center dot 2 +/- 0 center dot 1 years, 52 center dot 0 % were women, and 68 center dot 4 % were non-Hispanic (NH)-White. A higher percent of NH-Black (7 center dot 9 %) and Hispanic/Latinx (5 center dot 1 %) lived in very low food security households than NH-White (3 center dot 1 %) participants. Very low v. high food security was associated with a higher prevalence of very short (PR = 2 center dot 61 [95 % CI 2 center dot 44-2 center dot 80]) sleep duration as well as trouble falling asleep (PR = 2 center dot 21 [95 % CI 2 center dot 12-2 center dot 30]). Very low v. high food security was associated with a higher prevalence of very short sleep duration among Asian (PR = 3 center dot 64 [95 % CI 2 center dot 67-4 center dot 97]) and NH-White (PR = 2 center dot 73 [95 % CI 2 center dot 50-2 center dot 99]) participants compared with NH-Black (PR = 2 center dot 03 [95 % CI 1 center dot 80-2 center dot 31]) and Hispanic/Latinx (PR = 2 center dot 65 [95 % CI 2 center dot 30-3 center dot 07]) participants. Food insecurity was associated with poorer sleep in a racially/ethnically diverse US sample.