Loneliness as a Mediator in the Association Between Food Insecurity and Multiple Sleep Problems: Evidence From the 2021/22 UK Household Longitudinal Study

Abstract

Purpose: This study examines whether loneliness mediates the association between food insecurity and multiple sleep problems. Design: Quantitative, cross-sectional. Setting: Data were drawn from the 2021/22 wave of the UK Household Longitudinal Study, which—for the first time in the main survey—included a validated measure of food insecurity. Subjects: The analytic sample included 21,650 individuals aged 18 and older. Measures: Sleep problems were assessed across six dimensions using items from the Pittsburgh Sleep Quality Index. Loneliness was measured using the UCLA three-Item Loneliness Scale. Food insecurity was assessed using the Food Insecurity Experience Scale. Sociodemographic variables were included as covariates. Analysis: Ordinary Least Squares and logistic regression models were used to examine associations between food insecurity and sleep outcomes. The Karlson-Holm-Breen method was employed to assess mediation by loneliness. Results: Individuals experiencing food insecurity reported worse outcomes across all sleep problems compared to those without food insecurity (from b = .154, P < .001 for greater daytime dysfunction to b = .470, P < .001 for longer sleep latency; OR = 2.531, P < .001 for short sleep duration). Loneliness mediated all associations, explaining between 14.75% and 27.24% of the total effect. Conclusion: Public health interventions that address both food insecurity and loneliness may help improve sleep health.