Journal article
Greater adherence to healthful dietary patterns is associated with lower insomnia risk in the Women's health initiative observational study
Sleep (New York, N.Y.), Vol.49(1), zsaf316
01/13/2026
DOI: 10.1093/sleep/zsaf316
PMCID: PMC12795745
PMID: 41065709
Abstract
Insomnia is highly prevalent among postmenopausal women and is associated with adverse health outcomes, highlighting the need to identify modifiable determinants of sleep. Diet and sleep are interrelated; however, few studies have evaluated longitudinal associations of complete dietary patterns with incident insomnia in postmenopausal women. This study evaluates prospective associations of established diet quality metrics with insomnia in the Women's Health Initiative Observational Study (WHI-OS).
The WHI-OS enrolled 93 676 postmenopausal women from across the US. Alternate Mediterranean (aMed) diet and Dietary Approaches to Stop Hypertension (DASH) diet quality scores were quantified from a Food Frequency Questionnaire at baseline and dichotomized scores using a data-driven approach. Insomnia was assessed at baseline and Year 3 using the WHI Insomnia Rating Scale. Multivariable logistic regression models adjusted for sociodemographic, lifestyle, and health factors evaluated associations of baseline diet quality with incident insomnia and longitudinal insomnia status (stable/new onset insomnia vs. stable absence/remission of insomnia).
Among women without insomnia at baseline (n = 50 644), good vs. poor diet quality at baseline was associated with lower risk for incident insomnia at 3-y follow-up (OR [95% CI], aMed: 0.925 [0.879-0.974], p=.003; DASH: 0.937 [0.891-0.985], p=.01]). In longitudinal analyses (n = 74 513), greater baseline adherence to aMed and DASH diets related to 6.3% (0.903-0.971) and 8.5% (0.883-0.948) lower odds, respectively, of having stable or new onset insomnia over 3 y (both p<.005).
Better diet quality predicts lower insomnia risk in postmenopausal women. Clinical trials are needed to determine whether strategies to enhance diet quality improve insomnia symptoms.
The Women's Health Initiative Observational Study is registered on Clinicaltrials.gov #NCT00000611: https://clinicaltrials.gov/study/NCT00000611.
Details
- Title: Subtitle
- Greater adherence to healthful dietary patterns is associated with lower insomnia risk in the Women's health initiative observational study
- Creators
- Faris M Zuraikat - Columbia University Irving Medical CenterBin Cheng - Columbia University Irving Medical CenterSanja Jelic - Columbia University Irving Medical CenterEsra Tasali - University of ChicagoElizabeth M Cespedes Feliciano - Kaiser PermanenteNazmus Saquib - Sulaiman Al Rajhi CollegesAladdin H Shadyab - University of California San DiegoTyler J Titcomb - University of Kansas Medical CenterLinda G Snetselaar - University of Kansas Medical CenterKathleen M Hayden - Wake Forest UniversityAshley H Sanderlin - North Carolina Agricultural and Technical State UniversityDoris P Molina-Henry - University of Southern CaliforniaErin S LeBlanc - Kaiser Permanente Center for Health ResearchMarie-Pierre St-Onge - Columbia University Irving Medical Center
- Resource Type
- Journal article
- Publication Details
- Sleep (New York, N.Y.), Vol.49(1), zsaf316
- DOI
- 10.1093/sleep/zsaf316
- PMID
- 41065709
- PMCID
- PMC12795745
- NLM abbreviation
- Sleep
- ISSN
- 1550-9109
- eISSN
- 1550-9109
- Publisher
- Oxford University Press
- Grant note
- National Heart, Lung, and Blood Institute (NHLBI): HHSN26820160000 NIH: R01 DK128154, R01 HL142648, R35 HL155670, R01 HL173190, R01 HL106041, R01 HL137234, NHLBI-WH-11-10
This manuscript is the result of funding in whole or in part by theNational Institutes of Health (NIH). It is subject to the NIH PublicAccess Policy.Through acceptance of this federal funding,NIH hasbeen given a right to make this manuscript publicly available inPubMed Central upon the Official Date of Publication, as definedby NIH.The Women's Health Initiative Program is funded by the National Heart, Lung, and Blood Institute (NHLBI): HHSN26820160000. The authors are supported by the following NIH Grants: R01 DK128154, R01 HL142648, R35 HL155670 (PI: MPSO); R01 HL173190(PI: FMZ); R01 HL106041, R01 HL137234 (SJ); NHLBI-WH-11-10(KMH).
- Language
- English
- Electronic publication date
- 10/09/2025
- Date published
- 01/13/2026
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9985015824202771
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