Insufficient marine omega-3 intake, particularly DHA and EPA, is a modifiable risk factor for sleep impairment in older adults with diabetes.
Key Findings
Results
Sleep-impaired older adults with T2DM had significantly lower DHA intake compared to those without sleep impairment.
Mean DHA intake was 284.5 mg/d in the sleep-impaired group versus 884.8 mg/d in the non-impaired group (P < .001).
Study included 193 hospitalized participants divided into sleep impairment (PSQI ≥ 5) and without sleep impairment (PSQI < 5) groups.
Dietary intake was assessed via a validated 14-item food frequency questionnaire incorporating local food profiles.
Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).
Results
Sleep-impaired older adults with T2DM had significantly lower EPA intake compared to those without sleep impairment.
Mean EPA intake was 134.7 mg/d in the sleep-impaired group versus 405.2 mg/d in the non-impaired group (P < .001).
The difference in EPA intake between groups was statistically significant at P < .001.
Both DHA and EPA are marine-derived omega-3 fatty acids assessed through habitual (non-supplemental) dietary intake patterns.
Results
DHA intake below a threshold of 583.1 mg/d was associated with a 2.81-fold increased risk of sleep impairment in adjusted models.
OR = 2.81 (95% CI: 1.61–4.92, P = .006) for DHA intake < 583.1 mg/d.
This association was found in adjusted logistic regression models.
The threshold of 583.1 mg/d was used as the cutoff for low versus adequate DHA intake.
Results
EPA intake below a threshold of 269.3 mg/d was associated with a 1.99-fold higher risk of sleep impairment in adjusted models.
OR = 1.99 (95% CI: 1.05–3.75, P = .012) for EPA intake < 269.3 mg/d.
This association was found in adjusted logistic regression models.
The threshold of 269.3 mg/d was used as the cutoff for low versus adequate EPA intake.
Results
Total polyunsaturated fatty acid (PUFA) intake and linoleic acid (omega-6) intake showed no significant association with sleep impairment risk.
Total PUFA: OR = 1.62, P = .182 (not statistically significant).
Linoleic acid intake: OR = 1.79, P = .842 (not statistically significant).
These findings suggest the association with sleep impairment is specific to marine omega-3 fatty acids (DHA and EPA) rather than omega-6 or total PUFA intake.
Methods
The study design was a hospital-based case-control analysis focused on habitual dietary intake rather than supplemental fatty acid intake in older adults with T2DM.
193 hospitalized participants were included in the analysis.
The study specifically addressed gaps in research on habitual (non-supplemental) intake patterns.
Participants were older adults with type 2 diabetes mellitus (T2DM), described as a high-risk population for sleep disturbances.
Dietary intake was assessed via a validated 14-item food frequency questionnaire incorporating local food profiles.
What This Means
This research examined whether the amount of omega-3 and omega-6 fatty acids that older people with type 2 diabetes eat in their regular diet is linked to how well they sleep. The study looked at 193 hospitalized patients and compared those who had poor sleep (measured by a standard questionnaire called the Pittsburgh Sleep Quality Index) to those who slept well. Researchers specifically focused on DHA and EPA — two omega-3 fatty acids found mainly in fish and seafood — as well as linoleic acid, a common omega-6 fatty acid found in vegetable oils.
The study found that people with poor sleep were eating dramatically less DHA and EPA than those who slept well. Specifically, poor sleepers consumed about one-third the amount of DHA and EPA compared to good sleepers. When the researchers accounted for other factors, people eating below certain thresholds of DHA (583.1 mg/day) or EPA (269.3 mg/day) had roughly 2–3 times the risk of having poor sleep. In contrast, total fat intake from polyunsaturated fatty acids and omega-6 fatty acids showed no meaningful link to sleep quality.
This research suggests that getting enough marine omega-3 fatty acids — the kind found primarily in fish — through regular diet may be important for sleep quality in older people with diabetes, a group already at high risk for sleep problems. The findings highlight DHA and EPA specifically, rather than omega-6 fats or total unsaturated fats, as the dietary components associated with sleep. Because dietary habits are changeable, this points to a potentially modifiable factor in managing sleep health in this population, though the case-control design means the study shows association rather than causation.
Wang L, Shen Y, Xu M, Cao T. (2026). The relationship between intake of dietary omega-3 and omega-6 fatty acids and sleep quality in older adults with diabetes: A hospital-based analysis.. Medicine. https://doi.org/10.1097/MD.0000000000047670