Unclean cooking fuel use and sleep problems among adults aged 65 years and older from six countries

Abstract

We investigated the association between unclean cooking fuel use and sleep problems in a nationally representative sample of adults aged ≥65 years from six low- and middle-income countries (China, Ghana, India, Mexico, Russia, South Africa). Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Outcomes related to sleep included self-reported nocturnal sleep problems, lethargy, poor sleep quality, and sleep duration. Multivariable logistic regression analysis was conducted. Data on 14585 individuals aged ≥65 years were analyzed [mean (SD) age 72.6 (11.5) years; 55.0% females]. After adjustment for potential confounders, unclean cooking fuel use was associated with a significant 1.51 (95%CI=1.03-2.22) times higher odds for nocturnal sleep problems, while it was also associated with 1.64 (95%CI=1.20-2.26) times higher odds for long sleep duration (i.e., >9 h vs. >6 to 9 h) but not with other sleep-related outcomes. These findings suggest that the implementation of the United Nations Sustainable Development Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all, may also have a positive impact on sleep problems, as well as a plethora of other health and environmental impacts.</p