(LB02-28-24) Conversations About Tea and Sleep in Midlife Women From Mexico City: A Mixed-Methods Ethnographic Approach

Objectives: Increasing evidence shows that diet quality may be beneficial for sleep among women. However, only some studies have examined the knowledge, attitudes, and perceived norms surrounding the diet-sleep connection among midlife adult women. Within a sample of midlife women, we undertook a mixed-methods ethnographic approach, combining conversations about sleep with questionnaire- and actigraphy-based sleep and food frequency questionnaire (FFQ) data to learn what midlife women from Mexico City think about diet and sleep.

Methods: We conducted in-depth ethnographic interviews with a purposive, ethnographic sample of 30 women from the Mexico City-based ELEMENT cohort. The data from these interviews, including ethnographer fieldnotes and transcripts, were analyzed using thematic analysis. Subsequently, guided by the insights from the ethnographic interviews, we conducted post hoc epidemiological analyses of tea consumption and sleep using FFQ and actigraphy, respectively, in the larger cohort (n=406).

Results: The mean (SD) age of the ethnographic sample was 50.0 (9.0) years. From ethnographic interviews, some themes that emerged related to the diet-sleep connection included not eating before bed and using lettuce to promote sleep. The top noted theme was the use of herbal tea to improve sleep; most women (29/30) discussed herbal teas, characterizing them as a “natural remedy” to facilitate sleep. In post hoc analyses, linear regression estimates revealed a positive association, such that each additional serving of tea without sugar was related to a 14.4-minute increase in weekday nightly sleep duration [β = 14.4 (95% CI: 2.4, 26.4; P=0.01).

Conclusions: Findings underscore the value of combining qualitative and quantitative data to unveil societal/cultural-specific practices, specifically the consumption of herbal teas, that promote better sleep among midlife women in Mexico City. This study sheds light on dietary practices that have not previously been the focus of epidemiological investigations.

Funding Sources: This work was supported by the National Institutes of Health [grant numbers: R24 ES028502, and R24 ES028502 Supplement, K01 HL151673, R01 ES032330, T32 HL161270] and the University of Michigan (M-Cubed and Institute of Research on Women and Gender (IRWG) pilot grants).