Associations Between Sleep Health and Diet Quality and Dietary Intake During Pregnancy: Evidence From Two Australian...

Poor sleep and suboptimal diet are common during pregnancy and contribute to adverse maternal and infant outcomes. While sleep-diet associations are documented in general populations, evidence in pregnancy is scarce. This study investigated associations between sleep quality and duration and diet quality and dietary intake among Australian pregnant women. Data from two Australian pregnancy cohorts (Newcastle1000 and ORIGINS; n = 1070) were collected at 18-20 weeks gestation (2017-2024). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), and dietary intake and diet quality using the Australian Eating Survey and Australian Recommended Food Score (ARFS). Generalised linear models examined associations between sleep quality (continuous PSQI score) and sleep duration (< 7 h, 7-9 h, > 9 h) and dietary variables, adjusting for age, income, pre-pregnancy BMI, mental health, physical activity, and cohort. Participants were aged 32.3 ± 4.3 years; with a pre-pregnancy BMI of 25.9 ± 5.7 kg/m² and 95.3% were English-speaking. Most participants reported poor sleep quality (72.9%; PSQI global score 6.4 ± 2.8) and suboptimal diet quality (ARFS 35.5 ± 8.9). Poor sleep quality was associated with higher saturated fat intake (Exp(β) = 1.004, 95% CI: 1.000,1.008, p = 0.046). Short sleep duration (< 7 h) was associated with lower diet quality (β = -2.60, 95% CI: -3.95, -1.25, p < 0.001) and lower fibre intake (Exp(β) = 0.945, 95% CI: 0.900,0.992, p = 0.022). No other significant associations were observed in adjusted models. Poor sleep quality and short sleep duration were associated with less favourable dietary patterns during pregnancy. This highlights the need for further research to inform integrated interventions that consider sleep quality and duration alongside strategies to support healthier eating patterns and improve maternal and infant health outcomes.