Recent lifestyle change impacts sleep and circadian rhythms among the Indigenous peoples of Peninsular Malaysia

ABSTRACT Sleep disorders are rising globally, but their lifestyle causes remain unclear. We recorded sleep-wake patterns via actigraphy from 1036 Orang Asli adults across 12 communities in Peninsular Malaysia undergoing market integration, marked by changes in permanent infrastructure (electricity and housing), digital technologies (smartphones), and labor practices (i.e., wage labor). We evaluated associations with sleep timing (onset, offset and regularity), quality (nighttime awakenings and waking after sleep onset) and quantity (sleep duration), while accounting for age and sex. Delayed and destabilized sleep timing was observed in communities with powerline access, also resulting in shorter sleep duration; paradoxically, it also improved sleep quality, suggesting increased homeostatic pressure. Age and sex were strong and consistent predictors of sleep variation: older adults had earlier, shorter, and more consistent, consolidated sleep patterns. Men displayed later and shorter sleep patterns than women, likely reflecting gendered divisions of labor among the Orang Asli. Despite averaging relatively few hours slept (6 hrs), Orang Asli exhibited relatively efficient sleep, potentially challenging the notion that longer sleep is universally beneficial. These findings underscore the complex interplay of biology, ecology, and culture in shaping sleep and circadian rhythms. Significance A comprehensive cross-sectional study of sleep across a pronounced lifestyle gradient among Malaysia’s Indigenous Orang Asli populations reveals new insights into the drivers of human sleep and circadian rhythms. Lifestyle changes with market integration, particularly access to electricity, resulted in delayed bedtime and shortened sleep duration, yet enhanced sleep consolidation. Consistent with cross-cultural evidence, aging resulted in earlier bedtimes, earlier rising times, and less sleep. Our findings contribute to debates about the adaptability of human circadian rhythms and challenge universal models of optimal sleep duration.