Clinical Scorecard: Association of Unclean Cooking Fuels with Sleep Disturbances in Older Adults Aged 65 and Above Across Six Countries
At a Glance
Category
Detail
Condition
Sleep disturbances including nocturnal sleep problems and altered sleep duration
Key Mechanisms
Exposure to household air pollution from unclean cooking fuels leading to neurobehavioral and respiratory effects impacting sleep
Target Population
Older adults aged 65 years and above in low- and middle-income countries
Care Setting
Community-based settings in low- and middle-income countries
Key Highlights
Use of unclean cooking fuels (kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, shrubs/grass) is associated with increased odds of nocturnal sleep problems and long sleep duration (>9 hours) in older adults.
Sleep problems are prevalent and increasing in older adults in LMICs, with significant health consequences including cardiovascular disease and premature mortality.
Implementation of sustainable energy policies (UN SDG 7) may reduce sleep disturbances and improve health outcomes by reducing exposure to household air pollution.
Guideline-Based Recommendations
Diagnosis
Assess sleep quality and duration in older adults, especially those exposed to unclean cooking fuels.
Include evaluation of household fuel type as part of environmental risk assessment for sleep disturbances.
Management
Promote transition to clean, affordable, and sustainable cooking fuels to reduce exposure to household air pollution.
Address comorbid medical and psychiatric conditions contributing to sleep problems in older adults.
Monitoring & Follow-up
Monitor sleep patterns and respiratory symptoms in older adults using unclean cooking fuels.
Track changes in sleep outcomes following interventions to improve household air quality.
Risks
Prolonged exposure to unclean cooking fuels increases risk of nocturnal sleep problems and abnormal sleep duration.
Sleep disturbances linked to unclean fuel use may contribute to higher risk of cardiovascular diseases, cancers, and premature mortality.
Patient & Prescribing Data
Older adults aged 65 and above residing in LMICs using unclean cooking fuels
Reducing exposure to unclean cooking fuels may improve sleep quality and duration; interventions should consider environmental and social factors influencing fuel use.
Clinical Best Practices
Incorporate environmental exposure history including cooking fuel type in geriatric sleep assessments.
Advocate for public health policies supporting access to clean cooking fuels in LMICs.
Educate patients and caregivers about the impact of household air pollution on sleep and overall health.
Consider multidisciplinary approaches addressing both medical and environmental contributors to sleep disturbances.
by Lee Smith, Guillermo F López Sánchez, Masoud Rahmati, Pinar Soysal, Mark A Tully, Yvonne Barnett, Laurie Butler, Dong Keon Yon, Soeun Kim, Helen Keyes, Nicola Veronese, Hans Oh, Karel Kostev, Louis Jacob, Jae Il Shin, Ai Koyanagi
