Abstract MP05: Night-to-night Variability In Sleep Duration Is Associated With Higher Energy Intake And Poorer Diet Quality In The Multi-Ethnic Study Of Atherosclerosis
Authors: Zuraikat Faris M , Makarem Nour , Cheng Bin , Huang Tianyi , Aggarwal Brooke A , Jelic Sanja , Shea Steven J , Redline Susan , St-Onge Marie-Pierre 
Published: May 2021

Introduction:
Variability in sleep patterns is an emerging risk factor for metabolic and cardiovascular diseases (CVD). Poor diet likely contributes to these relations, given the intricate link between sleep and diet, both of which are important determinants of cardiometabolic health. However, associations of irregular sleep with energy intake and consumption of a Mediterranean diet pattern, key markers of diet quantity and quality predictive of CVD risk, have not been evaluated.

Hypothesis:
Greater night-to-night variability in sleep duration will be associated with higher energy intake and poorer diet quality, defined as lower alternate Mediterranean (aMed) diet scores (range: 0-9).

Methods:
This was a cross-sectional analysis of 2,007 men and women (age: 68.6±9.2 y, 61% racial/ethnic minority) from the Multi-Ethnic Study of Atherosclerosis Sleep Ancillary Study. The standard deviation (SD) of sleep duration, derived from 1-wk of wrist actigraphy, was used as a measure of sleep duration variability. Diet, including daily energy intake, aMed score, and consumption of aMed components, was ascertained from a food frequency questionnaire. Multivariable linear regression models adjusted for age, race/ethnicity, sex, study site, marital status, and education, evaluated associations of sleep duration variability with diet. Sensitivity analyses, also adjusted for sociodemographic factors, were conducted to evaluate relations of weekday sleep duration SD, a potentially more representative measure of habitual sleep, with diet.

Results:
Mean sleep duration variability was 84±48 min. Greater sleep duration variability was associated with higher energy intake and lower aMed score; each 30-min increase in sleep duration SD related to 23±11 more kcal/d (P=0.04) and 0.06±0.02 lower aMed score (P=0.02). Higher sleep duration SD (per 30 min increase) was also associated with lower intakes of whole grains (β=-0.01±0.01, P<0.05), nuts/seeds (β=-0.01±0.01, P=0.02), and monounsaturated to saturated fat ratio (β=-0.02±0.01, P=0.02). Results of sensitivity analyses showed that each 30-min increase in weekday sleep duration SD was associated with 28±11 kcal higher energy intake (P=0.01) and 0.06±0.02 lower aMed score (P=0.02) as well as 0.02±0.01 and 0.01±0.01 fewer servings (per 1000 kcal) of whole grains and seeds/nuts, respectively (P<0.01).

Conclusions:
We provide novel initial evidence that irregular sleep duration, particularly during weekdays, may contribute to overconsumption and poor diet quality. Further investigation into a possible mechanistic role of diet in the association of sleep variability with cardiometabolic disease risk is warranted. Longitudinal or experimental data are needed to elucidate a potential complex interplay between sleep duration variability, diet, and other health and lifestyle factors, including physical activity, obesity, and depression.