Predictors of Poor Sleep Quality among Vegetarians: Insights from a Study in Kuala Lumpur and Selangor, Malaysia
Abstract
This study aimed to examine the prevalence of poor sleep quality and its predictors among Malaysian vegetarians. The present cross-sectional study was conducted among 200 vegetarians in Malaysia. Data on socio-demographic characteristics, lifestyle behaviours, psychological distress and sleep quality were collected using a set of self-administered questionnaires. A three-day dietary recall was employed to examine the dietary intake of vegetarians. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality in vegetarians, with a score above five indicating poor sleep quality. A multiple logistic regression model was used to determine how socio-demographic characteristics, lifestyle behaviours (smoking, alcohol consumption and physical activity level), psychological distress (depression, anxiety, and stress) and specific dietary macronutrient intakes (carbohydrate, protein and fat) predicted poor sleep quality. The mean sleep duration was 6.0±1.4 hours among vegetarians. The mean PSQI score was 5.4±3.1, with 40.5% of vegetarians experiencing poor sleep quality. Multiple logistic regression found that vegetarians with depression (OR=4.56, 95% CI:1.62‒12.83) and stress (OR=3.07, 95% CI: 1.14‒8.31) had higher odds of poor sleep quality (p<0.05). About two in five (40.5%) vegetarians reported poor sleep quality with depression and stress as significant predictors. Effective sleep education programs are essential for improving sleep hygiene awareness. Psychological screening and mental health interventions for vegetarians with depression and stress are necessary to improve their sleep health.
Full text article
References
Allès B, Baudry J, Méjean C, Touvier M, Péneau S, Hercberg S, Kesse-Guyot E. 2017. Comparison of sociodemographic and nutritional characteristics between self-reported vegetarians, vegans, and meat-eaters from the NutriNet-Santé study. Nutr 9(9):1023–1041. https://doi.org/10.3390/nu9091023
Aye LM, Lee WH. 2024. Poor sleep quality and its associated factors among working adults during COVID-19 pandemic in Malaysia. Camb Prisms Glob Ment Health 11:e28. https://doi.org/10.1017/gmh.2024.23
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. 1989. The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Res 28(2):193–213. http://www.psychiatry.pitt.edu/node/8240
Chen K, Wen Y, Shu Z. 2024. Using genetic variations to reveal the complex relationships between vegetarianism and well-being, depressive symptoms and neuroticism. Front Nutr 11:1389000. https://doi.org/10.3389/fnut.2024.1389000
Ching YK, Chin YS, Appukutty M, Gan WY, Chan YM. 2020. Comparisons of conventional and novel anthropometric obesity indices to predict metabolic syndrome among vegetarians in Malaysia. Sci Rep 10(1):20861. https://doi.org/10.1038/s41598-020-78035-5
Ching YK, Chin YS, Appukutty M, Chan YM, Lim PY, Nasir KH. 2023. Interactions of genetic and macronutrient intake with abdominal obesity among middle-aged vegetarians in Malaysia. Asia Pac J Clin Nutr 32(1):168–182. https://doi.org/10.6133/apjcn.202303_32(1).0020
Dobersek U, Wy G, Adkins J, Altmeyer S, Krout K, Lavie CJ, Archer E. 2021. Meat and mental health: A systematic review of meat abstention and depression, anxiety, and related phenomena. Crit Rev Food Sci Nutr 61(4):622–635. https://doi.org/10.1080/10408398.2020.1741505
Dulawa SC, Janowsky DS. 2019. Cholinergic regulation of mood: From basic and clinical studies to emerging therapeutics. Mol Psychiatry 24(5):694–709. https://doi.org/10.1038/s41380-018-0219-x
Fang H, Tu S, Sheng J, Shao A. 2019. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med 23(4):2324–2332. https://doi.org/10.1111/jcmm.14170
Halonen R, Kuula L, Selin M, Suutari A, Antila M, Pesonen AK. 2024. REM sleep preserves affective response to social stress—experimental study. ENeuro 11(6):1–14. https://doi.org/10.1523/ENEURO.0453-23.2024
Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, Hazen N, Herman J, Katz ES, Kheirandish-Gozal L et al. 2015. National sleep foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health 1(1):40–43. https://doi.org/10.1016/j.sleh.2014.12.010
Iguacel I, Huybrechts I, Moreno LA, Michels N. 2021. Vegetarianism and veganism compared with mental health and cognitive outcomes: A systematic review and meta-analysis. Nutr Rev 79(4):361–381. https://doi.org/10.1093/nutrit/nuaa030
Kalmbach DA, Anderson JR, Drake CL. 2018. The impact of stress on sleep: pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. J Sleep Res 27(6):e12710. https://doi.org/10.1111/jsr.12710
Katagiri R, Asakura K, Kobayashi S, Suga H, Sasaki S, Sasak, Three-geneation Study of Woman on Diets and Health Study Group. 2014. Low intake of vegetables, high intake of confectionary, and unhealthy eating habits are associated with poor sleep quality among middle-aged female Japanese workers. J Occup Health 56:359–368.
Kautz A, Meng Y, Yeh KL, Peck R, Brunner J, Best M, Fernandez ID, Miller RK, Barrett ES, Groth SW, O'Connor TG et al. 2024. Dietary intake of nutrients involved in serotonin and melatonin synthesis and prenatal maternal sleep quality an affective symptoms. J Nutr Metab 2024(1):6611169. https://doi.org/10.1155/2024/6611169
Lee SY, Ju YJ, Lee JE, Kim YT, Hong SC, Choi YJ, Song MK, Kim HY. 2020. Factors associated with poor sleep quality in the Korean general population: Providing information from the Korean version of the Pittsburgh Sleep Quality Index. J Affect Disord 271:49–58. https://doi.org/10.1016/j.jad.2020.03.069
Neufingerl N, Eilander A. 2022. Nutrient intake and status in children and adolescents consuming plant-based diets compared to meat-eaters: A systematic review. Nutrients 15(20):4341. https://doi.org/10.3390/nu15204341
Park H, Suh B. 2019. Association between sleep quality and physical activity according to gender and shift work. J Sleep Res 29(6):e12924. https://doi.org/10.1111/jsr.12924
Riemann D, Dressle RJ, Benz F, Palagini L, Feige B. 2023. The psychoneurobiology of insomnia: Hyperarousal and REM sleep instability. Clin Transl Neurosci 7(4):30.https://doi.org/10.3390/ctn7040030
Soh BXP, Vignes M, Smith NW, von Hurst PR, McNabb WC. 2025. Evaluation of protein intake and protein quality in New Zealand vegans. Plos One 20(4):e0314889. https://doi.org/10.1371/journal.pone.0314889
Sutanto CN, Wang MX, Tan D, Kim JE. 2020. Association of sleep quality and macronutrient distribution: A systematic review and meta-regression. Nutr 12(1):126–147. https://doi.org/10.3390/nu12010126
Thompson KI, Chau M, Lorenzetti MS, Hill LD, Fins AI, Tartar JL. 2022. Acute sleep deprivation disrupts emotion, cognition, inflammation, and cortisol in young healthy adults. Front Behav Neurosci 16:945661. https://doi.org/10.3389/fnbeh.2022.945661
Tonon AC, Pilz LK, Markus RP, Hidalgo MP, Elisabetsky E. 2021. Melatonin and depression: A translational perspective from animal models to clinical studies. Front Psychiatry 12:638981. https://doi.org/10.3389/fpsyt.2021.638981
Tonstad S, Butler T, Yan R, Fraser GE. 2009. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 32(5):791–796. https://doi.org/10.2337/dc08-1886
Tucker Rm, Contreras DA, Carlson BR, Carter A, Drake CL. 2021. Sleep Education for Elders Program (SLEEP): Promising pilot results a virtual, intervention. Nat Sci Sleep 13:625–633. https://doi.org/10.2147/NSS.S304035
Wojcik JL, Aukema HM, Zahradka P, Taylor CG. 2016. Effects of high protein diets on metabolic syndrome parameters. Curr Opin Food Sci 8:43–49. https://doi.org/10.1016/j.cofs.2016.02.001
Wu W, Wang W, Dong Z, Xie Y, Gu Y, Zhang Y, Li M, Tan X. 2018. Sleep quality and its associated factors among low-income adults in a rural area of China: A population-based study. Int J Environ Res Public Health 15(9):2055–2073. https://doi.org/10.3390/ijerph15092055
Yap Y, Tung NYC, Shen L, Bei B, Phillips A, Wiley JF. 2024. Daily associations between salivary cortisol and electroencephalographic-assessed sleep: A 15-day intensive longitudinal study. Sleep 47(9):zsae087. https://doi.org/10.1093/sleep/zsae087
Yi G, Safdar B, Zhang Y, Li Y, Liu X. 2020. A study of the mechanism of small-molecule soybean-protein-derived peptide supplement to promote sleep in a mouse model. RSC Advances 10(19):11264–11273. https://doi.org/10.1039/d0ra00389a
Authors
The copyrights of manuscripts shall be assigned/transferred to Jurnal Gizi dan Pangan (Indonesian Journal of Nutrition and Food).
Article Details
How to Cite
