Castro-Diehl · Sleep 2018 · observational cohort study · n=2068

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

Level 3 - non-randomized controlled study

Observational cohort study evaluating cross-sectional and historical dietary data with sleep outcomes.

PubMed 30137563 · doi:10.1093/sleep/zsy158 · record verified 2026-08-26

What was done

Researchers evaluated 2068 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) to examine associations between a Mediterranean-style diet (aMed, measured via a food frequency questionnaire) and sleep outcomes. Sleep duration was measured objectively using actigraphy, and insomnia symptoms were categorized by self-report and sleep duration. The study assessed both concurrent diet scores and 10-year historical changes in diet.

What was found

Participants with moderate-to-high concurrent aMed scores were significantly more likely to sleep 6-7 hours versus <6 hours per night (p < 0.01) and less likely to report insomnia symptoms occurring with short sleep (p < 0.05) compared to those with low scores. Longitudinal 10-year increases in aMed score were not associated with sleep duration or insomnia, though maintaining an unchanging score was associated with fewer insomnia symptoms compared to a decreasing score (p <= 0.01). Numerical effect estimates and confidence intervals were not provided in the abstract.

Why it matters

This study provides evidence linking adherence to a Mediterranean dietary pattern with objectively measured adequate sleep duration and lower risk of insomnia with short sleep in a diverse population.

Limits

The observational design cannot establish causality. Dietary intake was self-reported and subject to recall bias, longitudinal increases in diet quality showed no direct association, and specific effect sizes were omitted from the abstract.