Unclean Cooking Fuels Linked to Sleep Disturbances in Older Adults in Six LMICs

Overview

This study analyzed data from 14,585 adults aged 65 and above across six low- and middle-income countries, finding that use of unclean cooking fuels is associated with increased odds of nocturnal sleep problems and long sleep duration. The findings highlight a significant public health concern linking household air pollution to sleep disturbances in older populations.

Background

Sleep problems are prevalent among older adults, especially in low- and middle-income countries (LMICs), where aging populations are rapidly increasing. Poor sleep quality is linked to adverse health outcomes including cardiovascular disease and mortality. Unclean cooking fuels, such as kerosene and biomass, are widely used in LMICs and produce household air pollution that may disrupt sleep through respiratory and neurobehavioral pathways. Prior research on this association is limited and mostly confined to China, underscoring the need for broader multinational studies.

Data Highlights

Key Findings

• Use of unclean cooking fuels is associated with a 51% higher odds of nocturnal sleep problems in adults aged 65 and older.
• Unclean fuel use is linked to a 64% higher odds of long sleep duration (>9 hours) compared to normal sleep duration (6-9 hours).
• No significant associations were found between unclean fuel use and lethargy or poor sleep quality.
• The study included nationally representative samples from six LMICs, enhancing generalizability beyond previous China-only studies.
• Exposure to particulate matter and respiratory inflammation from unclean fuel combustion are plausible mechanisms affecting sleep.

Clinical Implications

Clinicians should consider environmental factors such as household air pollution from unclean cooking fuels when evaluating sleep disturbances in older adults, particularly in LMIC settings. Interventions promoting access to clean, modern cooking fuels may help reduce sleep problems and improve overall health in aging populations. These findings support broader public health efforts aligned with the United Nations Sustainable Development Goal 7 to provide sustainable energy solutions.

Conclusion

This multinational study demonstrates that unclean cooking fuel use is significantly associated with certain sleep disturbances among older adults in LMICs. Addressing household air pollution may be a valuable strategy to improve sleep health and reduce related morbidity in this vulnerable population.

References

1. WHO Study on global AGEing and adult health (SAGE) -- Data source
2. United Nations Sustainable Development Goal 7 -- Affordable and clean energy
3. Systematic review on sleep problems in LMICs -- Prevalence and impact