Unclean cooking fuel use and sleep problems among adults 65 years and older from 6 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 6 low- and middle-income countries (China, Ghana, India, Mexico, Russia, and 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 14 585 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 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 (ie, >9 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. This article is part of a Special Collection on Cross-National Gerontology.

Keywords: household air pollution; low- and middle-income countries; older adults; sleep problems; unclean cooking fuel.