Page 66 - JCBP-3-1

Journal of Clinical and
Basic Psychosomatics Protein and sleep problem

health, understanding factors that influence sleep quality 2. Methods
is of paramount importance. 4
2.1. Study population resources
Recent studies have revealed mechanisms by which a
high-protein diet may enhance sleep quality. For instance, This study utilized data from the NHANES conducted
a study published in Cell indicates that a protein-rich diet between 2005 and 2018, focusing on cycles where
can induce the secretion of a peptide that reduces sensory participants were assessed for sleep problems. Sleep
arousal, thereby promoting deep and restorative sleep. problems were evaluated with a single question: “Have
5
Dietary habits have emerged as a key factor influencing you ever told a doctor or other health professional that
sleep. Research suggests that high protein intake boosts you have trouble sleeping?” Of the 70,076 participants,
6-8
post-meal alertness and modulates rapid eye movement we excluded those under 18 years old (n = 31,748), as well
(REM) – non-REM sleep balance, impacting overall sleep as individuals with incomplete data on sleep problems
quality. 6,9,10 One possible mechanism is that protein-rich (n = 17), protein consumption data (n = 2,738), or weight
foods contain tryptophan, an amino acid that promotes (n = 321). Ultimately, 35,252 subjects were included in our
the production of sleep-regulating neurotransmitters analysis (Figure 1). The NHANES was approved by the
such as serotonin and melatonin. A systematic review National Center for Health Statistics Ethics Review Board,
and meta-regression found that better sleep is linked to and all participants provided written informed consent
higher protein energy intake, based on 15 cross-sectional before participating in the study.
studies and four randomized controlled trials (RCTs). 2.2. Covariate assessment
11
Furthermore, subjective sleep quality showed a positive
association with protein consumption in several studies. The study collected sociodemographic data, including
12
Further investigations, encompassing eight studies with information on participants’ age, gender, body mass index
diverse designs, yielded conflicting results regarding the (BMI), race, marital status, education level, smoking status
influence of protein consumption on subjective sleep (categorized as every day, some days, or not at all), alcohol
quality. While some studies reported significantly use (defined as having consumed at least 12 alcoholic
12
better sleep scores with high protein intake, others drinks), and physical activity (measured in minutes of
found no significant differences. Moreover, prospective sedentary activity). Protein consumption was assessed
cohort studies have failed to establish a clear association using 24-h dietary recall interviews.
between total protein intake and sleep quality. Despite
7,13
these findings, the overall evidence linking protein 2.3. Statistics
consumption to sleep outcomes remains inconclusive, All statistical analyses were performed using R version 4.2.1.
with conflicting results across studies. Moreover, most Initially, univariate analyses, including analysis of variance
research has focused on general dietary patterns rather for continuous variables and the Chi-square test for
than specifically examining the role of protein intake in categorical variables, were used to characterize the study
sleep health. 9,14 population. Logistic regression models were then applied
To address these gaps in the literature, the present to explore the relationship between protein consumption
study aims to investigate the association between protein (predictor variable) and sleep problems (dependent
consumption and sleep problems using data from the National variable), with the continuous protein consumption
Health and Nutrition Examination Survey (NHANES). By variable categorized into quartiles to examine potential
leveraging a large, nationally representative dataset, this non-linear relationships. Four models were utilized: (i) the
study seeks to provide a comprehensive understanding of the crude model without adjustments; (ii) model 1, adjusted
relationship between protein intakes and sleep outcomes. The for age and gender; (iii) model 2, further adjusted for race,
findings could inform public health initiatives designed to education, BMI, marital status, and total energy intake;
promote healthy dietary patterns for improved sleep health. and (iv) model 3 additionally adjusted for smoking status,
Moreover, elucidating the role of protein consumption in alcohol use, and sedentary activity. In addition, sensitivity
sleep outcomes may guide health-care providers in offering analyses were conducted using restricted cubic spline
dietary recommendations to individuals experiencing sleep (RCS) regression to visualize potential non-linear patterns
disturbances. Given the growing recognition of sleep’s between protein consumption and sleep problems. These
importance for overall health and well-being, investigating analyses were adjusted for covariates, including age, gender,
the dietary determinants of sleep quality is a critical step race, marital status, education, total energy intake, smoking
toward developing effective interventions to improve sleep status, alcohol use, and sedentary activity. Statistical
health and mitigate associated health risks. significance was determined by a two-sided P < 0.05.

Volume 3 Issue 1 (2025) 60 doi: 10.36922/jcbp.4148