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 June 06, 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as odds ratios (OR) and 95% confidence intervals (CI). Subjects: 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=1.45; 95% CI:1.24-1.70, I 2 =95, P<0.001, n=7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR=1.31; 95% CI: 1.16-1.48, I 2 =0%, P<0.001, n=5), moderate (OR=1.49; 95% CI: 1.32-1.68, I 2 =0%, P<0.001, n=5), and severe (OR=1.89; 95% CI: 1.63-2.20, I 2 =0%, P<0.001, n=5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR=1.39; 95% CI: 1.05-1.83, I 2 =91%, P=0.002, n=3) and trouble staying asleep (OR=1.91; 95% CI: 1.37-2.67, I 2 =89%, P<0.001, n=3). Moreover, FI was associated with the odds of shorter (OR=1.14; 95% CI:1.07-1.21, I 2 =0%, P<0.001, n=4) and longer sleep duration (OR=1.14; 95% CI:1.03-1.26, I 2 =0%, P=0.010, 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.