Mediterranean diet pattern and sleep duration and insomnia symptoms in the Multi-Ethnic Study of Atherosclerosis

Cecilia Castro-Diehl, Alexis C. Wood, Susan Redline, Michelle Reid, Dayna A. Johnson, Janice E. Maras, David R. Jacobs, Steven Shea, Allison Crawford, Marie Pierre St-Onge

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60 Scopus citations


Sleep duration and sleep quality are important predictors of risk for cardiovascular disease (CVD). One potential link between sleep health and CVD is through lifestyle factors such as diet. To clarify the association between diet and sleep, we assessed the associations of sleep duration and insomnia symptoms with current Mediterranean-style diet (aMed) and with historical changes in aMed score. Actigraphy-measured sleep duration and self-reported insomnia symptoms categorized as insomnia with short sleep (<6 hr/night), insomnia without short sleep, no insomnia with short sleep, and no insomnia or short sleep were obtained from 2068 individuals who also had dietary intake data. A 10-point aMed score, derived from a self-report food frequency questionnaire, was collected concurrently with the sleep assessment and 10 years before. Compared with individuals who currently reported a low aMed score, those with a moderate-high aMed score were more likely to sleep 6-7 vs. <6 hr/night (p < 0.01) and less likely to report insomnia symptoms occurring with short sleep (vs. no insomnia or short sleep alone; p < 0.05). An increase in aMed score over the preceding 10 years was not associated with sleep duration or insomnia symptoms. However, compared with those with decreasing aMed score, individuals with an unchanging score reported fewer insomnia symptoms (p = 0.01). These results suggest that a Mediterranean-style diet is associated with adequate sleep duration, less insomnia symptoms, and less likely to have insomnia accompanied by short sleep. Further research should identify possible mediators through which diet may promote adequate sleep duration and reduce the risk of insomnia.

Original languageEnglish (US)
Issue number11
StatePublished - Nov 1 2018

Bibliographical note

Funding Information:
This work was supported by R01 HL098433 (PI: Susan Redline) and R01 HL 119945 (PI: M-P St-Onge). MESA was supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040 and UL1-TR-001079 from NCRR. Dr. St-Onge is funded from AHA Go Red Strategically Focused Research Network (16SFRN27950012) and National Heart, Lung and Blood Institute (R01 HL128226). Dr. Cecilia Castro-Diehl is supported by the T32 Training Program in Cardiovascular Epidemiology NIH number 5T32HL125232. The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at Conflict of interest statement. None declared.

Publisher Copyright:
© Sleep Research Society 2018. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved.


  • Mediterranean-style diet
  • sleep duration insomnia


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