Associations Between Different Sources of Carbohydrates and Added Sugars Intake With Subjective Sleep Quality in...

Recent studies have reported that the quality of carbohydrates affects sleep. The present study aimed to evaluate the associations between various carbohydrate sources and added sugar intake with the prevalence of poor sleep quality (PSQ) in patients undergoing hemodialysis (HD).

Dietary intake was assessed using a validated food frequency questionnaire from December 2021 to January 2022. The daily intake of dietary carbohydrates was categorized into 3 groups, with the lowest tertile serving as the reference category. Sleep quality among patients was calculated using the Pittsburgh Sleep Quality Index standard questionnaire. A multivariable logistic regression model and restricted cubic spline analyses were conducted to evaluate the aforementioned relationship.

After adjustment for potential confounders, the highest level of carbohydrates derived from pickled products (odds ratio [OR]_{tertile 3 (T3) to tertile 1 (T1)} = 1.53, 95% confidence interval [CI] = 1.00-2.35) and sweet foods (OR_{T3 to T1} = 1.68, 95% CI = 1.02-2.76) as well as added sugar intake (OR_{T3 to T1} = 1.67, 95% CI = 1.00-2.83) were positively associated with the prevalence of PSQ compared to the reference group. Meanwhile, the linear trends were also obvious (P < .05). Similarly, the prevalence of PSQ in patients on HD increased by 31% (OR = 1.31, 95% CI = 1.01-1.71) for each standard deviation increment in added sugar intake. The dose-response curve indicated that the prevalence of PSQ increased linearly with the intake of carbohydrates from pickled products, sweet foods, and added sugars (all P_nonlinear >.05). In addition, the intake of carbohydrates from fresh eggs was positively associated with the prevalence of PSQ in male patients (P < .05).

A higher intake of carbohydrates from pickled products and sweet foods, as well as added sugars, was positively associated with PSQ in individuals receiving HD. These findings support the potential importance of reducing carbohydrate intake to improve sleep quality.