Probable insomnia is associated with future total energy intake and diet quality in men1–3

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Background:Insomnia is associated with several adverse health outcomes. Small clinical studies have suggested that an inferior nutrition status is a potential explanation, but to our knowledge, this possibility has not been examined in a large-scale, populationbased cohort study.Objective:We examined whether individuals with probable insomnia and individual insomnia symptoms had greater energy intake and a lower diet quality as assessed with the use of the Alternate Healthy Eating Index (AHEI) 2 y later.Design:A cohort study of 15,273 US men aged 58–93 y who were free of cancer, cardiovascular diseases, and diabetes and were participating in the Health Professionals Follow-Up Study reported information on insomnia symptoms in 2004. Dietary intake was assessed with the use of a food-frequency questionnaire in 2002 and 2006. We calculated the adjusted mean differences of total energy intake in 2006 and the AHEI-component scores and their 95% CIs between subjects with and without probable insomnia in 2004 and also across categories for each insomnia symptom while adjusting for related covariates.Results:After dietary intake in 2002, major chronic conditions, and other potential confounders were controlled for, men with probable insomnia had a mean higher consumption of 35.8 kcal/d (95% CI: 17.4, 54.1 kcal/d) and had lower scores in 3 individual AHEI components (trans fat, vegetables, and sodium), which denoted higher consumption of trans fat and sodium and lower intake of vegetables (P ≤ 0.01 for all). For individual insomnia symptoms, nonrestorative sleep and a difficulty maintaining sleep were associated with higher energy intake (P-trend ≤ 0.007 for both). A similar trend was observed in men who had difficulty initiating sleep (P-trend = 0.07). We also observed a significant association between the difficulty of initiating sleep and a lower AHEI score 2 y later (P-trend = 0.004).Conclusion:Probable insomnia is associated with higher intakes of total energy, trans fat, and sodium and lower intake of vegetables.

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