Mediterranean Dietary Patterns Related to Sleep Duration and Sleep-Related Problems Among Adolescents: The EHDLA Study

Purpose: The aim of the present study was to examine the association of adherence to the Mediterranean Diet (MD) and its specific components with both sleep duration and sleep-related disorders in a sample of adolescents from the (Region of Murcia, Spain).

Methods: This cross-sectional study included a sample of 847 Spanish adolescents (55.3% girls) aged 12-17 years. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for Children and Teenagers. Sleep duration was reported by adolescents for weekdays and weekend days separately. The BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) screening was used to evaluate issues related to sleep, which include difficulties at bedtime, excessive drowsiness during the day, waking up frequently during the night, irregularity, length of sleep, and breathing issues while sleeping.

Results: Adolescents who presented a high adherence to the MD were more likely to meet the sleep recommendations (OR = 1.52, 95% CI 1.12-2.06, = 0.008) and less likely to report at least one sleep-related problem (OR = 0.56, 95% CI 0.43-0.72, < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, waist circumference, energy intake, physical activity, and sedentary behavior, indicating a significant association of adherence to the MD with sleep outcomes (meeting sleep recommendations: OR = 1.40, 95% CI 1.00-1.96, = 0.050; sleep-related problems: OR = 0.68, 95% CI 0.50-0.92, = 0.012).

Conclusions: Adolescents with high adherence to the MD were more likely to report optimal sleep duration and fewer sleep-related problems. This association was more clearly observed for specific MD components, such as fruits, pulses, fish, having breakfast, dairies, sweets, and baked goods/pastries.