Unclean cooking fuel use and sleep problems among adults aged 65 years and older from six countries

We investigated the association between unclean cooking fuel use and sleep problems in a nationally representative sample of adults aged ≥65 years from six low- and middle-income countries (China, Ghana, India, Mexico, Russia, South Africa). Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Outcomes related to sleep included self-reported nocturnal sleep problems, lethargy, poor sleep quality, and sleep duration. Multivariable logistic regression analysis was conducted. Data on 14585 individuals aged ≥65 years were analyzed [mean (SD) age 72.6 (11.5) years; 55.0% females]. After adjustment for potential confounders, unclean cooking fuel use was associated with a significant 1.51 (95%CI=1.03-2.22) times higher odds for nocturnal sleep problems, while it was also associated with 1.64 (95%CI=1.20-2.26) times higher odds for long sleep duration (i.e., >9 h vs. >6 to 9 h) but not with other sleep-related outcomes. These findings suggest that the implementation of the United Nations Sustainable Development Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all, may also have a positive impact on sleep problems, as well as a plethora of other health and environmental impacts.