(P19-043-23) Higher Adherence to a Mediterranean Diet and Dietary Approaches To Stop Hypertension (DASH) Is Associated With Lower Insomnia Risk in Older Women: Women’s Health Initiative

Objectives: Women experience significant age-related declines in sleep quality, reflected by an increase in insomnia among older women. Insomnia severity is positively correlated with a broad range of adverse health outcomes, highlighting the need to identify modifiable risk factors of insomnia. We have shown that diets with lower glycemic indices reduce the risk of insomnia in older women participating in the Women’s Health Initiative (WHI). However, the association of the Mediterranean and DASH diets with insomnia risk has not been studied in this population. We evaluated the associations between these healthful diet patterns and insomnia in the WHI.

Methods: Exposures included dietary scores (higher scores indicate better diet quality) for adherence to an alternate Mediterranean (aMed) and DASH at baseline, ascertained from a food frequency questionnaire. Outcomes were global score on the WHI Insomnia Rating Scale at baseline and year 3 follow-up; insomnia was defined as score ≥9. Independent samples t-tests compared diet quality scores between women with and without insomnia at baseline. Logistic regression models adjusted for energy intake, assessed prospective associations between baseline diet quality, segregated into quintiles, and insomnia incidence at year 3.

Results: At baseline, 31% of women (n=47,650) had insomnia. Baseline aMed and DASH scores were lower in women (n=153,599, age 63.2 ± 7.2 y) with vs. without insomnia aMed: 4.03 ± 1.76 vs. 4.14 ± 1.78; DASH: 24.13 ± 4.87 vs. 24.62 ± 4.89, both p< 0.0001). Of the women without insomnia at baseline, 17% developed insomnia at 3 y. In prospective analyses, the highest quintiles of aMed and DASH scores (reference bottom quintile) were associated with lower odds of insomnia (OR =0.87, 95%CI 0.83-0.91 and OR =0.88, 95%CI 0.84-0.92 respectively).

Conclusions: Healthful dietary patterns reduce the likelihood of developing insomnia among older women participating in the WHI.

Funding Sources: NHLBI