Abstract
This hospital-based study aimed to investigate the relationship between dietary omega-3 (DHA, EPA) and omega-6 (linoleic acid) fatty acid intake and sleep quality in older adults with type 2 diabetes mellitus (T2DM), addressing gaps in research on habitual (non-supplemental) intake patterns and their associations with sleep disturbances in this high-risk population. A case-control study included 193 hospitalized participants, divided into with sleep impairment (Pittsburgh Sleep Quality Index, 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 PSQI. Logistic regression models evaluated associations between fatty acid intake thresholds and sleep impairment risk. Sleep-impaired individuals exhibited significantly lower marine ω-3 intake: DHA (284.5 vs 884.8 mg/d, P <.001) and EPA (134.7 vs 405.2 mg/d, P <.001). Adjusted models revealed consistent associations: DHA intake <583.1 mg/d increased sleep impairment risk by 2.81-fold (95% CI:1.61-4.92, P = .006), while EPA <269.3 mg/d conferred 1.99-fold higher risk (95% CI:1.05-3.75, P = .012). Total polyunsaturated fatty acid (PUFA) (OR = 1.62, P = .182) and linoleic acid intake (OR = 1.79, P = .842) showed no significant associations. Insufficient marine ω-3 intake, particularly DHA and EPA, is a modifiable risk factor for sleep impairment in older adults with diabetes.