Food Insecurity Is Associated with Short and Long Sleep Duration and Circadian Misalignment Among US Adults in the 2017–18 National Health and Nutrition Examination Survey

Abstract

Food insecurity is a leading public health issue associated with negative health consequences. Poor sleep and circadian misalignment, the discrepancy between the natural circadian rhythm and the cycle imposed by the social clock, may contribute to these health problems. This study examined relationships between food insecurity and sleep and circadian characteristics, including sleep duration and circadian misalignment, characterized by social jetlag and later midpoint of sleep (MPS), in a nationally representative sample of adults. Data were from the 2017–18 National Health and Nutrition Examination Survey (NHANES), which included 5410 adults ≥18 years old with household food security and usual weekday and weekend sleep and wake times. Self-reported sleep measures were used to calculate MPS (median sleep and wake time) and social jetlag (difference between weekend and weekday MPS). MPS and social jetlag were classified into 3 categories based on the 25th and 75th percentiles. Self-reported sleep duration was classified as short (<7 hours), adequate (7–9 hours), and long (>9 hours). Multinominal logistic regression models were conducted between household food security and sleep variables, adjusting for sociodemographic characteristics and accounting for complex survey weights. In the analytic sample, 14.3% had low and 8.9% had very low food security. The average MPS was 2:46 AM ± 2.1 hours on weekdays and 3:34 AM ± 1.8 hours on weekends. The average sleep duration was 7.6 hours on weekdays and 8.3 hours on weekends. Greater food insecurity was associated with higher social jetlag in a dose-response manner (p-trend = 0.01). Compared to food-secure adults, adults with very low food security had later weekday MPS (OR 1.37, 95% CI 1.10–1.72) and weekend MPS (OR 1.55, 95% CI 1.24–1.95). In contrast, low food security was related to early weekday MPS (OR 1.23, 95% CI 1.00–1.50). Low and very low food security were each associated with short weekday (OR 1.34, 95% CI 1.08–1.66 and OR 1.22, 95% CI 1.03–1.45) and weekend (OR 1.39, 95% CI 1.11–1.75 and OR 1.42, 95% CI 1.17–1.73) sleep duration. Low and very low food security were also related to long weekday sleep duration. Greater severity of food insecurity was related to multiple markers of circadian misalignment and with short and excessive sleep duration. University of Michigan.