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Yuan Z, Wang Y, Du Z, Lin S, Zeng J, Sun X, Zhang Y, Deng X, Sun Y, Wei J, Zhang M, Sun J, Gu J, Zhang W, Hao Y. Association of long-term exposure to PM 2.5 and its chemical components with the reduced quality of sleep. Sleep Med 2024; 121:251-257. [PMID: 39024779 DOI: 10.1016/j.sleep.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/22/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
Poor sleep quality is a widespread concern. While the influence of particle exposure on sleep disturbances has received considerable attention, research exploring other dimensions of sleep quality and the chemical components of the particles remains limited. We employed a marginal structural model to explore the association of long-term exposure to PM2.5 and its chemical components with poor sleep quality. The odds ratio (95 % CI) for poor sleep quality was 1.335 (1.292-1.378), 1.097 (1.080-1.113), 1.137 (1.100-1.174), 1.197 (1.156-1.240), and 1.124 (1.107-1.140) per IQR increase in the concentration of PM2.5, SO42-, NO3-, NH4+, and BC, respectively. The score (and 95 % CI) of sleep latency, use of sleep medication, habitual sleep efficiency, subjective sleep quality, and daytime dysfunction were affected by PM2.5, with an increase of 0.059 (0.050-0.069), 0.054 (0.049-0.059), 0.011 (0.008-0.014), 0.011 (0.005-0.018), and 0.026 (0.018-0.034) per IQR increase in PM2.5 concentrations, respectively. This study supports the association of long-term exposure to PM2.5 and its chemical components with poor sleep quality.
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Affiliation(s)
- Zhupei Yuan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Jincai Zeng
- Department of Preventive Health, Dongguan People's Hospital, Dongguan, China
| | - Xurui Sun
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinlei Deng
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Yongqing Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, 20740, USA
| | - Man Zhang
- Department of nosocomial infection management, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jie Sun
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China.
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Ng M, Gerstorf D, Conroy DE, Pincus AL, Ram N. Affective Sensitivity to Air Pollution (ASAP): Person-specific associations between daily air pollution and affective states. PLoS One 2024; 19:e0307430. [PMID: 39110667 PMCID: PMC11305556 DOI: 10.1371/journal.pone.0307430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 07/04/2024] [Indexed: 08/10/2024] Open
Abstract
Individuals' sensitivity to climate hazards is a central component of their vulnerability to climate change. In this paper, we introduce and outline the utility of a new intraindividual variability construct, affective sensitivity to air pollution (ASAP)-defined as the extent to which an individual's affective states fluctuate in accordance with daily changes in air quality. As such, ASAP pushes beyond examination of differences in individuals' exposures to air pollution to examination of differences in individuals' sensitivities to air pollution. Building on known associations between air pollution exposure and adverse mental health outcomes, we empirically illustrate how application of Bayesian multilevel models to intensive repeated measures data obtained in an experience sampling study (N = 150) over one year can be used to examine whether and how individuals' daily affective states fluctuate with the daily concentrations of outdoor air pollution in their county. Results indicate construct viability, as we found substantial interindividual differences in ASAP for both affect arousal and affect valence. This suggests that repeated measures of individuals' day-to-day affect provides a new way of measuring their sensitivity to climate change. In addition to contributing to discourse around climate vulnerability, the intraindividual variability construct and methodology proposed here can help better integrate affect and mental health in climate adaptation policies, plans, and programs.
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Affiliation(s)
- Michelle Ng
- Department of Communication, Stanford University, Palo Alto, California, United States of America
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Palo Alto, California, United States of America
| | - Denis Gerstorf
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
- German Socio-Economic Panel (SOEP) at German Institute for Economic Research (DIW), Berlin, Germany
| | - David E. Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Aaron L. Pincus
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Nilàm Ram
- Department of Communication, Stanford University, Palo Alto, California, United States of America
- Department of Psychology, Stanford University, Palo Alto, California, United States of America
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Wang J, Gueye-Ndiaye S, Castro-Diehl C, Bhaskar S, Li L, Tully M, Rueschman M, Owens J, Gold DR, Chen J, Phipatanakul W, Adamkiewicz G, Redline S. Associations between indoor fine particulate matter (PM 2.5) and sleep-disordered breathing in an urban sample of school-aged children. Sleep Health 2024:S2352-7218(24)00133-5. [PMID: 39095254 DOI: 10.1016/j.sleh.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/12/2024] [Accepted: 06/25/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES Environmental risk factors may contribute to sleep-disordered breathing. We investigated the association between indoor particulate matter ≤2.5µm in aerodynamic diameter (PM2.5) and sleep-disordered breathing in children in an urban US community. METHODS The sample consisted of children aged 6-12years living in predominantly low-income neighborhoods in Boston, Massachusetts. Indoor PM2.5 was measured in participants' main living areas for 7days using the Environmental Multipollutant Monitoring Assembly device. High indoor PM2.5 exposure was defined as greater than the sample weekly average 80th percentile level (≥15.6 μg/m3). Sleep-disordered breathing was defined as an Apnea-Hypopnea-Index (AHI) or Oxygen-Desaturation-Index (ODI) (≥3% desaturation) of ≥5 events/hour. Habitual loud snoring was defined as caregiver-report of loud snoring (most or all the time each week) over the past 4weeks. We examined the associations of PM2.5 with sleep-disordered breathing or snoring using logistic regression adjusting for potential confounders. RESULTS The sample included 260 children (mean age 9.6years; 41% female), with 32% (n = 76) classified as having sleep-disordered breathing. In a logistic regression model adjusted for socioeconomics and seasonality, children exposed to high indoor PM2.5 levels (n = 53) had a 3.53-fold increased odds for sleep-disordered breathing (95%CI: 1.57, 8.11, p = .002) compared to those with lower indoor PM2.5. This association persisted after additional adjustments for physical activity, outdoor PM2.5, environmental tobacco smoke, and health characteristics. Similar associations were observed for snoring and indoor PM2.5. CONCLUSIONS: Children with higher indoor PM2.5 exposure had greater odds of sleep-disordered breathing and habitual loud snoring, suggesting that indoor air quality contributes to sleep disparities.
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Affiliation(s)
- Jing Wang
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Seyni Gueye-Ndiaye
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Pulmonary and Sleep Medicine, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Cecilia Castro-Diehl
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Sanjana Bhaskar
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Le Li
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Meg Tully
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Judith Owens
- Division of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Diane R Gold
- Harvard Medical School, Boston, Massachusetts, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jarvis Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Massachusetts, USA; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
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Zhang W, Chen B, Yoda Y, Shima M, Zhao C, Ji X, Wang J, Liao S, Jiang S, Li L, Chen Y, Guo X, Deng F. Ambient ultrafine particles exacerbate oxygen desaturation during sleep in patients with chronic obstructive pulmonary disease: New insights into the effect spectrum of ultrafine particles on susceptible populations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 947:174519. [PMID: 38972410 DOI: 10.1016/j.scitotenv.2024.174519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/09/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
The health effects of ultrafine particles (UFPs) are of growing global concern, but the epidemiological evidence remains limited. Sleep-disordered breathing (SDB) characterized by hypoxemia is a prevalent condition linked to many debilitating chronic diseases. However, the role of UFPs in the development of SDB is lacking. Therefore, this prospective panel study was performed to specifically investigate the association of short-term exposure to UFPs with SDB parameters in patients with chronic obstructive pulmonary disease (COPD). Ninety-one COPD patients completed 226 clinical visits in Beijing, China. Personal exposure to ambient UFPs of 0-7 days was estimated based on infiltration factor and time-activity pattern. Real-time monitoring of sleep oxygen saturation, spirometry, respiratory questionnaires and airway inflammation detection were performed at each clinical visit. Generalized estimating equation was used to estimate the effects of UFPs. Exposure to UFPs was significantly associated with increased oxygen desaturation index (ODI) and percent of the time with oxygen saturation below 90 % (T90), with estimates of 21.50 % (95%CI: 6.38 %, 38.76 %) and 18.75 % (95%CI: 2.83 %, 37.14 %), respectively, per 3442 particles/cm3 increment of UFPs at lag 0-3 h. Particularly, UFPs' exposure within 0-7 days was positively associated with the concentration of alveolar nitric oxide (CaNO), and alveolar eosinophilic inflammation measured by CaNO exceeding 5 ppb was associated with 29.63 % and 33.48 % increases in ODI and T90, respectively. In addition, amplified effects on oxygen desaturation were observed in current smokers. Notably, individuals with better lung function and activity tolerance were more affected by ambient UFPs due to longer time spent outdoors. To our knowledge, this is the first study to link UFPs to hypoxemia during sleep and uncover the key role of alveolar eosinophilic inflammation. Our findings provide new insights into the effect spectrum of UFPs and potential environmental and behavioral intervention strategies to protect susceptible populations.
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Affiliation(s)
- Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Baiqi Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yoshiko Yoda
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Masayuki Shima
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Chen Zhao
- Community Health Service Center, Huayuan Road, Haidian District, Beijing 100088, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Junyi Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Sha Liao
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Simin Jiang
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yahong Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
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Wang H, Li J, Liu Q, Zhang Y, Wang Y, Li H, Sun L, Hu B, Zhang D, Liang C, Lei J, Wang P, Sheng J, Tao F, Chen G, Yang L. Physical activity attenuates the association of long-term exposure to nitrogen dioxide with sleep quality and its dimensions in Chinese rural older adults. J Affect Disord 2024; 349:187-196. [PMID: 38199389 DOI: 10.1016/j.jad.2024.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Joint impacts of air pollution and physical activity (PA) on sleep quality remain unaddressed. We aimed to investigate whether PA attenuates the association of long-term exposure to nitrogen dioxide (NO2) with sleep quality and its dimensions in older adults. METHODS This study included 3408 Chinese rural older adults. Annual NO2 was estimated using the Space-Time Extra-Trees model. PA was assessed by International Physical Activity Questionnaire. Sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI) scale. Linear regression models were used to assess the associations of long-term NO2 exposure and PA with sleep quality and its dimensions, and interaction plots were used to depict the attenuating effect of PA on associations of NO2 with sleep quality and its dimensions. RESULTS Three-year (3-y) average NO2 (per 0.64-μg/m3 increment) was positively associated with global PSQI (β = 0.41, 95 % CI: 0.23, 0.59), sleep duration (β = 0.16, 95 % CI: 0.11, 0.21), and habitual sleep efficiency (β = 0.22, 95 % CI: 0.17, 0.27), while PA was negatively associated with global PSQI (β = -0.33, 95 % CI: -0.46, -0.20) and five domains of PSQI other than sleep duration and sleep disturbances. The associations of NO2 with global PSQI, sleep duration, and habitual sleep efficiency were attenuated with increased PA (Pinteraction were 0.037, 0.020, and 0.079, respectively). CONCLUSIONS PA attenuates the adverse impacts of long-term NO2 exposure on sleep quality, especially on sleep duration, and habitual sleep efficiency, in Chinese rural elderly people. Participating in PA should be encouraged in this population, and continued efforts are still needed to reduce air pollution.
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Affiliation(s)
- Hongli Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Center for Big Data and Population Health of IHM, Hefei 230032, Anhui, China
| | - Junzhe Li
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Center for Big Data and Population Health of IHM, Hefei 230032, Anhui, China
| | - Qiang Liu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Center for Big Data and Population Health of IHM, Hefei 230032, Anhui, China
| | - Yan Zhang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Huaibiao Li
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Dongmei Zhang
- School of Health Services Management, Anhui Medical University, Hefei 230032, Anhui, China
| | - Chunmei Liang
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Jingyuan Lei
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Panpan Wang
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Jie Sheng
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Fangbiao Tao
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, Anhui, China
| | - Guimei Chen
- School of Health Services Management, Anhui Medical University, Hefei 230032, Anhui, China
| | - Linsheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Center for Big Data and Population Health of IHM, Hefei 230032, Anhui, China.
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Liu J, Ji X, Rovit E, Pitt S, Lipman T. Childhood sleep: assessments, risk factors, and potential mechanisms. World J Pediatr 2024; 20:105-121. [PMID: 36441394 PMCID: PMC9702880 DOI: 10.1007/s12519-022-00628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep problem is a highly prevalent health issue among pediatric populations across the world. In this review, we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children. Potential biological, psychosocial, and environmental mechanisms as well as research gaps in the literature are also discussed. DATA SOURCES A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info. Both relevant data based and systematic reviews are included. RESULTS This paper summarizes many risk factors for childhood sleep problems, including biological (e.g., genetics, gender, age and puberty, prenatal factors, postnatal factors); nutritional (e.g., macronutrients, micronutrients, omega-3 fatty acids, obesity); environmental (e.g., heavy metals, noise, light, air pollution); interpersonal (e.g., family, exposure to violence, screen media use, physical injury); and community/socioeconomic variables (e.g., racial/ethnicity and cultural factors, neighborhood conditions and socioeconomic status, school factors, public health disasters/emergencies), to better understand the development of sleep problems in children. CONCLUSIONS Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological, environmental, and psychosocial risk factors and contributors. A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.
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Affiliation(s)
- Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, 19716, USA
| | - Elizabeth Rovit
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Susannah Pitt
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18510, USA
| | - Terri Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
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He Y, Liu WT, Lin S, Li Z, Qiu H, Yim SHL, Chuang HC, Ho KF. The joint association of ambient air pollution and different sleep posture with mild obstructive sleep apnea: A study conducted at Taipei Sleep Center. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166531. [PMID: 37633386 DOI: 10.1016/j.scitotenv.2023.166531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Growing evidence suggests the detrimental impact of supine position and air pollution on obstructive sleep apnea (OSA), as well as the potential benefits of nonsupine positions. However, their interaction effects on OSA remain unclear. OBJECTIVES To evaluate the interaction effects of air pollution (NO2/PM2.5) and sleep position on OSA on additive and multiplicative scales. METHODS This study included 3330 individuals. Personal exposure to air pollution was assessed using a spatiotemporal model. OSA was diagnosed through polysomnography. The associations of supine and nonsupine positions and air pollutants with mild-OSA and their interaction effects on mild-OSA. were explored through generalized logistic regression. RESULTS Supine position and high NO2 level independently increased the risk of mild-OSA, while PM2.5 was not associated with mild-OSA. Significant interactions were observed between supine position and NO2 at different lag periods (0-7 days, 0-1 year, and 0-2 years) (P = 0.042, 0.013, and 0.010, respectively). The relative excess risks due to interactions on the additive scale for 1-week, 1-year, and 2-year NO2 exposure and supine position were 0.63 (95 % CI: 0.10-1.16), 0.56 (95 % CI: 0.13-0.99), and 0.64 (95 % CI: 0.18-1.10); the corresponding odds ratios for interactions on the multiplicative scale were 1.45 (95 % CI: 1.01-2.07), 1.55 (95 % CI: 1.09-2.22), and 1.60 (95 % CI: 1.12-2.28). The positive interactions persisted in men and participants with obesity. No interaction was observed between nonsupine position and NO2 levels; nevertheless, significant interactions were noted on both the negative additive and multiplicative scales in men. CONCLUSION Prolonged supine sleep significantly increased the risk of mild-OSA, particularly in men and individuals with obesity. Although the benefits of nonsupine position are considerably less than the risks of NO2 exposure, avoiding prolonged supine sleep may reduce the risk of mild-OSA caused by high levels of NO2 in men.
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Affiliation(s)
- Yansu He
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Wen-Te Liu
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shangyang Lin
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Zhiyuan Li
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
| | - Hong Qiu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Steve Hung Lam Yim
- The Asian School of the Environment, Nanyang Technological University, Singapore
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kin Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China.
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Smith MG, Basner M. Environmental stressors, sleep, and a visit from St. Nicholas. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad048. [PMID: 38046223 PMCID: PMC10691440 DOI: 10.1093/sleepadvances/zpad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Affiliation(s)
- Michael G Smith
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
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Hussain R, Graham U, Elder A, Nedergaard M. Air pollution, glymphatic impairment, and Alzheimer's disease. Trends Neurosci 2023; 46:901-911. [PMID: 37777345 DOI: 10.1016/j.tins.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/12/2023] [Accepted: 08/29/2023] [Indexed: 10/02/2023]
Abstract
Epidemiological evidence demonstrates a link between air pollution exposure and the onset and progression of cognitive impairment and Alzheimer's disease (AD). However, current understanding of the underlying pathophysiological mechanisms is limited. This opinion article examines the hypothesis that air pollution-induced impairment of glymphatic clearance represents a crucial etiological event in the development of AD. Exposure to airborne particulate matter (PM) leads to systemic inflammation and neuroinflammation, increased metal load, respiratory and cardiovascular dysfunction, and sleep abnormalities. All these factors are known to reduce the efficiency of glymphatic clearance. Rescuing glymphatic function by restricting the impact of causative agents, and improving sleep and cardiovascular system health, may increase the efficiency of waste metabolite clearance and subsequently slow the progression of AD. In sum, we introduce air pollution-mediated glymphatic impairment as an important mechanistic factor to be considered when interpreting the etiology and progression of AD as well as its responsiveness to therapeutic interventions.
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Affiliation(s)
- Rashad Hussain
- Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14642, USA.
| | | | - Alison Elder
- Department of Environmental Medicine, University of Rochester, Rochester, NY 14642, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14642, USA; Center for Translational Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark.
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Tsai TY, Lo LW, Lin WL, Chou YH, Cheng WH, Liu SH, Yang CCH, Kuo TBJ, Chen SA. Neural mechanism facilitating PM2.5-related cardiac arrhythmias through cardiovascular autonomic and calcium dysregulation in a rat model. Sci Rep 2023; 13:16016. [PMID: 37749136 PMCID: PMC10520066 DOI: 10.1038/s41598-023-41148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/22/2023] [Indexed: 09/27/2023] Open
Abstract
Particulate matter < 2.5 μm (PM2.5) exposure is associated with increased arrhythmia events and cardiovascular mortality, but the detailed mechanism remained elusive. In the current study, we aimed to investigate the autonomic alterations in a rodent model after acute exposure to PM2.5. Twelve male WKY rats were randomized to control and PM2.5 groups. All were treated with 2 exposures of oropharyngeal aerosol inhalations (1 μg PM2.5 per gram of body weight in 100 μL normal saline for the PM2.5 group) separately by 7 days. Polysomnography and electrocardiography were surgically installed 7 days before oropharyngeal inhalation and monitored for 7 days after each inhalation. Physiologic monitors were used to define active waking (AW), quiet sleep (QS), and paradoxical sleep (PS). Autonomic regulations were measured by heart rate variability (HRV). The protein expression of ventricular tissue of the 2 groups was compared at the end of the experiment. In sleep pattern analysis, QS interruption of the PM2.5 group was significantly higher than the control group (0.52 ± 0.13 events/min, 0.35 ± 0.10 events/min, p = 0.002). In HRV analysis, the LF/HF was significantly higher for the PM2.5 group than the control group (1.15 ± 0.16, 0.64± 0.30, p = 0.003), largely driven by LF/HF increase during the QS phase. Ionic channel protein expression from Western blots showed that the PM2.5 group had significantly lower L-type calcium channel and higher SERCA2 and rectifier potassium channel expressions than the control group, respectively. Our results showed that acute PM2.5 exposure leads to interruption of QS, sympathetic activation, and recruitment of compensatory calcium handling proteins. The autonomic and calcium dysregulations developed after PM 2.5 exposure may explain the risk of sleep disturbance and sleep-related arrhythmia.
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Affiliation(s)
- Tsung-Ying Tsai
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Wei Lo
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.
- Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wei-Lun Lin
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Biomedical Science, Mackay Medical College, New Taipei city, Taiwan
| | - Yu-Hui Chou
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Han Cheng
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
| | - Shin-Hui Liu
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Tsoutun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Shih-Ann Chen
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan
- National Chung Hsing University, Taichung, Taiwan
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Zhou F, Liu F, Wu T, Zhang K, Pan M, Wang X, Chen Z, Tong J, Yan Y, Xiang H. Exposures to ambient air pollutants increase prevalence of sleep disorder in adults: Evidence from Wuhan Chronic Disease Cohort Study (WCDCS). ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115226. [PMID: 37441944 DOI: 10.1016/j.ecoenv.2023.115226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Sleep disorder contributes to memory dysfunction and chronic diseases. Clear evidence of environment disturbance, such as residential noise, are associated with an increased risk of sleep disorder. However, not enough studies have been conducted on association between residential air pollutants and sleep disorder. We sought to determine whether exposures to residential air pollutants associated with risk of sleep disorder among adults. METHODS Using the dataset of the Wuhan Chronic Disease Cohort Study (WCDCS), we investigated the prevalence of sleep disorder and five sleep disorder symptoms in the study. The data of air pollutants (including PM10, PM2.5, NO2, SO2 and O3) were obtained from 10 air quality monitoring stations in Wuhan. We utilized logistic regression model to evaluate the associations of five types of air pollutants with odds ratio (OR) of sleep disorder and symptoms. The potential moderating effects of socio-demographic factors in the associations were explored using the interaction effects model. RESULTS Of the study participants, 52.1 % had sleep disorder. Exposures to higher concentrations of air pollutants were associated with increased prevalence of sleep disorder. For example, per interquartile range (IQR) increases in concentrations of PM10, PM2.5 or SO2 corresponded to the increase of sleep disorder increased prevalence at 14.7 % (adjusted odds ratio (aOR) = 1.147, 95 %CI:1.062, 1.240), 8.9 % (aOR = 1.089, 95 %CI: 1.003, 1.182) and 15.8 % (aOR = 1.158, 95 %CI: 1.065, 1.260). For symptoms specific analyses, significant linkages of PM10, PM2.5, SO2 with difficulty in falling asleep, wake up after falling asleep and early awaken were observed. Moderating effects of age and place of residence on the linkages of PM10 with increased prevalence of sleep disorder were identified. CONCLUSION Higher level of air pollution exposure could increase the prevalence of sleep disorder. Middle-aged and elderly population, as well as the rural residents are more likely to suffer from sleep disorder.
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Affiliation(s)
- Feng Zhou
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Feifei Liu
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Tingting Wu
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Ke Zhang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Mengnan Pan
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Xiangxiang Wang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Zhongyang Chen
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Jiahui Tong
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Yaqiong Yan
- Wuhan Center for Disease Control and Prevention, 288# Machang Road, Wuhan, China.
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
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12
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Chang JL, Goldberg AN, Alt JA, Alzoubaidi M, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera JE, Bartley BL, Billings ME, Boon MS, Bosschieter P, Braverman I, Brodie K, Cabrera-Muffly C, Caesar R, Cahali MB, Cai Y, Cao M, Capasso R, Caples SM, Chahine LM, Chang CP, Chang KW, Chaudhary N, Cheong CSJ, Chowdhuri S, Cistulli PA, Claman D, Collen J, Coughlin KC, Creamer J, Davis EM, Dupuy-McCauley KL, Durr ML, Dutt M, Ali ME, Elkassabany NM, Epstein LJ, Fiala JA, Freedman N, Gill K, Boyd Gillespie M, Golisch L, Gooneratne N, Gottlieb DJ, Green KK, Gulati A, Gurubhagavatula I, Hayward N, Hoff PT, Hoffmann OM, Holfinger SJ, Hsia J, Huntley C, Huoh KC, Huyett P, Inala S, Ishman SL, Jella TK, Jobanputra AM, Johnson AP, Junna MR, Kado JT, Kaffenberger TM, Kapur VK, Kezirian EJ, Khan M, Kirsch DB, Kominsky A, Kryger M, Krystal AD, Kushida CA, Kuzniar TJ, Lam DJ, Lettieri CJ, Lim DC, Lin HC, Liu SY, MacKay SG, Magalang UJ, Malhotra A, Mansukhani MP, Maurer JT, May AM, Mitchell RB, Mokhlesi B, Mullins AE, Nada EM, Naik S, Nokes B, Olson MD, Pack AI, Pang EB, Pang KP, Patil SP, Van de Perck E, Piccirillo JF, Pien GW, Piper AJ, Plawecki A, Quigg M, Ravesloot MJ, Redline S, Rotenberg BW, Ryden A, Sarmiento KF, Sbeih F, Schell AE, Schmickl CN, Schotland HM, Schwab RJ, Seo J, Shah N, Shelgikar AV, Shochat I, Soose RJ, Steele TO, Stephens E, Stepnowsky C, Strohl KP, Sutherland K, Suurna MV, Thaler E, Thapa S, Vanderveken OM, de Vries N, Weaver EM, Weir ID, Wolfe LF, Tucker Woodson B, Won CH, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu JL, Zeidler M, Rosen IM. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol 2023; 13:1061-1482. [PMID: 36068685 PMCID: PMC10359192 DOI: 10.1002/alr.23079] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
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Affiliation(s)
- Jolie L. Chang
- University of California, San Francisco, California, USA
| | | | | | | | - Liza Ashbrook
- University of California, San Francisco, California, USA
| | | | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Maurits S. Boon
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Pien Bosschieter
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Itzhak Braverman
- Hillel Yaffe Medical Center, Hadera Technion, Faculty of Medicine, Hadera, Israel
| | - Kara Brodie
- University of California, San Francisco, California, USA
| | | | - Ray Caesar
- Stone Oak Orthodontics, San Antonio, Texas, USA
| | | | - Yi Cai
- University of California, San Francisco, California, USA
| | | | | | | | | | | | | | | | | | - Susmita Chowdhuri
- Wayne State University and John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Peter A. Cistulli
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Claman
- University of California, San Francisco, California, USA
| | - Jacob Collen
- Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Eric M. Davis
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Mohan Dutt
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mazen El Ali
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Kirat Gill
- Stanford University, Palo Alto, California, USA
| | | | - Lea Golisch
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | | | | | - Arushi Gulati
- University of California, San Francisco, California, USA
| | | | | | - Paul T. Hoff
- University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver M.G. Hoffmann
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | - Jennifer Hsia
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Colin Huntley
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Sanjana Inala
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | | | | | | | | | - Meena Khan
- Ohio State University, Columbus, Ohio, USA
| | | | - Alan Kominsky
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Meir Kryger
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Derek J. Lam
- Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | | | | | - Atul Malhotra
- University of California, San Diego, California, USA
| | | | - Joachim T. Maurer
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Anna M. May
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Ron B. Mitchell
- University of Texas, Southwestern and Children’s Medical Center Dallas, Texas, USA
| | | | | | | | | | - Brandon Nokes
- University of California, San Diego, California, USA
| | | | - Allan I. Pack
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | | | - Mark Quigg
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Armand Ryden
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | | | - Firas Sbeih
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | | | | | | | | | - Jiyeon Seo
- University of California, Los Angeles, California, USA
| | - Neomi Shah
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Ryan J. Soose
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Erika Stephens
- University of California, San Francisco, California, USA
| | | | | | | | | | - Erica Thaler
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sritika Thapa
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Nico de Vries
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Ian D. Weir
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Josie Xu
- University of Toronto, Ontario, Canada
| | | | | | | | | | | | - Ilene M. Rosen
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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13
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Han L, Wang Q. Urinary polycyclic aromatic hydrocarbon metabolites were associated with short sleep duration and self-reported trouble sleeping in US adults: data from NHANES 2005-2016 study population. Front Public Health 2023; 11:1190948. [PMID: 37427274 PMCID: PMC10325832 DOI: 10.3389/fpubh.2023.1190948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background The aim of the current study was to investigate the link between human exposure to PAHs with short sleep duration (SSD) and self-reported trouble sleeping. Methods A total of 9,754 participants and 9,777 participants obtained from NHANES 2005-2016 were included in this cross-sectional study about SSD and self-reported trouble sleeping, respectively. The association between urinary PAHs metabolites with the prevalence of SSD and self-reported trouble sleeping by the weighted multivariate logistic regression model, restricted cubic spline (RCS) curves, and weighted quantile sum (WQS) regression. Results After adjusting for all covariates, 1-hydroxynapthalene, 2-hydroxynapthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxyphenanthrene demonstrated positive associations with SSD prevalence. Besides, 1-hydroxynapthalene, 2-hydroxynapthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxyphenanthrene exhibited positive associations with the prevalence of self-reported trouble sleeping following the adjustment for all covariates. RCS curves confirmed the non-linear associations between 1-hydroxynapthalene, 2-hydroxynapthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, and 1-hydroxyphenanthrene with the prevalence of SSD, and 1-hydroxynapthalene, 3-hydroxyfluorene, and 2-hydroxyfluorene with the prevalence of self-reported trouble sleeping. The WQS results showed that mixed exposure to PAH metabolites had a significant positive association with the prevalence of SSD (OR: 1.087, 95% CI: 1.026, 1.152, p = 0.004) and self-reported trouble sleeping (OR: 1.190, 95% CI: 1.108, 1.278, p < 0.001). Conclusion Urinary concentrations of PAH metabolites exhibited a close association with the prevalence of SSD and self-reported trouble sleeping in US adults. More emphasis should be placed on the importance of environmental effects on sleep health.
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He F, Yanosky JD, Bixler EO, Fernandez-Mendoza J, Chinchilli VM, Al-Shaar L, Vgontzas AN, Liao D. Short-term and intermediate-term fine particulate air pollution are synergistically associated with habitual sleep variability in adolescents - A cross-sectional study. ENVIRONMENTAL RESEARCH 2023; 227:115726. [PMID: 36958382 PMCID: PMC10164704 DOI: 10.1016/j.envres.2023.115726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Both air pollution and poor sleep have been associated with increased risk of cardiovascular diseases. However, the association between air pollution and sleep health, especially among adolescents, is rarely investigated. METHODS To investigate the association between fine particulate (PM2.5) air pollution and habitual sleep patterns, we analyzed data obtained from 246 adolescents who participated in the Penn State Child Cohort follow-up examination. We collected their individual-level 24-h (short-term) PM2.5 concentration by using a portable monitor. We estimated their residential-level PM2.5 concentration during the 60-day period prior to the examination (intermediate-term) using a kriging approach. Actigraphy was used to measure participants' sleep durations for seven consecutive nights. Habitual sleep duration (HSD) and sleep variability (HSV) were calculated as the mean and SD of the seven-night sleep duration. Multivariable-adjusted linear regression models were used to assess the association between PM2.5 exposures and HSD/HSV. An interaction between short-term and intermediate-term PM2.5 was created to explore their synergistic associations with HSD/HSV. RESULTS Elevated short-term and intermediate-term PM2.5 exposure were significantly (p < 0.05) associated with higher HSV, but not HSD. Specifically, the mean (95% CI) increase in HSV associated with 1 SD higher 24-h (26.3 μg/m3) and 60-day average (2.2 μg/m3) PM2.5 were 14.6 (9.4, 14.8) and 4.9 (0.5, 9.2) minutes, respectively. In addition, there was a synergistic interaction (p = 0.08) between short-term and intermediate-term PM2.5 exposure on HSV, indicative that the association between intermediate-term PM2.5 and HSV became stronger as short-term PM2.5 increases, and vice versa. CONCLUSION Short-term individual-level and intermediate-term residential-level PM2.5 exposures are adversely and synergistically associated with increased sleep variability, an indicator of instability of sleep quantity, in adolescents. Through such an association with sleep pattern, PM2.5 air pollution may increase long-term cardiometabolic risks.
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Affiliation(s)
- Fan He
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Jeff D Yanosky
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Vernon M Chinchilli
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Laila Al-Shaar
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Tsai CY, Huang HT, Liu M, Cheng WH, Hsu WH, Kuan YC, Majumdar A, Lee KY, Feng PH, Tseng CH, Chen KY, Kang JH, Lee HC, Wu CJ, Liu WT. Associations between air pollution, intracellular-to-extracellular water distribution, and obstructive sleep apnea manifestations. Front Public Health 2023; 11:1175203. [PMID: 37397706 PMCID: PMC10310528 DOI: 10.3389/fpubh.2023.1175203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Background Exposure to air pollution may be a risk factor for obstructive sleep apnea (OSA) because air pollution may alter body water distribution and aggravate OSA manifestations. Objectives This study aimed to investigate the mediating effects of air pollution on the exacerbation of OSA severity through body water distribution. Methods This retrospective study analyzed body composition and polysomnographic data collected from a sleep center in Northern Taiwan. Air pollution exposure was estimated using an adjusted nearest method, registered residential addresses, and data from the databases of government air quality motioning stations. Next, regression models were employed to determine the associations between estimated air pollution exposure levels (exposure for 1, 3, 6, and 12 months), OSA manifestations (sleep-disordered breathing indices and respiratory event duration), and body fluid parameters (total body water and body water distribution). The association between air pollution and OSA risk was determined. Results Significant associations between OSA manifestations and short-term (1 month) exposure to PM2.5 and PM10 were identified. Similarly, significant associations were identified among total body water and body water distribution (intracellular-to-extracellular body water distribution), short-term (1 month) exposure to PM2.5 and PM10, and medium-term (3 months) exposure to PM10. Body water distribution might be a mediator that aggravates OSA manifestations, and short-term exposure to PM2.5 and PM10 may be a risk factor for OSA. Conclusion Because exposure to PM2.5 and PM10 may be a risk factor for OSA that exacerbates OSA manifestations and exposure to particulate pollutants may affect OSA manifestations or alter body water distribution to affect OSA manifestations, mitigating exposure to particulate pollutants may improve OSA manifestations and reduce the risk of OSA. Furthermore, this study elucidated the potential mechanisms underlying the relationship between air pollution, body fluid parameters, and OSA severity.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Huei-Tyng Huang
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Ming Liu
- Department of Biology, University of Oxford, Oxfordshire, United Kingdom
| | - Wun-Hao Cheng
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Respiratory Therapy, Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Chien-Hua Tseng
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Jiunn-Horng Kang
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Wen-Te Liu
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
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Basner M, Smith MG, Jones CW, Ecker AJ, Howard K, Schneller V, Cordoza M, Kaizi-Lutu M, Park-Chavar S, Stahn AC, Dinges DF, Shou H, Mitchell JA, Bhatnagar A, Smith T, Smith AE, Stopforth CK, Yeager R, Keith RJ. Associations of bedroom PM 2.5, CO 2, temperature, humidity, and noise with sleep: An observational actigraphy study. Sleep Health 2023; 9:253-263. [PMID: 37076419 PMCID: PMC10293115 DOI: 10.1016/j.sleh.2023.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE Climate change and urbanization increasingly cause extreme conditions hazardous to health. The bedroom environment plays a key role for high-quality sleep. Studies objectively assessing multiple descriptors of the bedroom environment as well as sleep are scarce. METHODS Particulate matter with a particle size <2.5 µm (PM2.5), temperature, humidity, carbon dioxide (CO2), barometric pressure, and noise levels were continuously measured for 14 consecutive days in the bedroom of 62 participants (62.9% female, mean ± SD age: 47.7 ± 13.2 years) who wore a wrist actigraph and completed daily morning surveys and sleep logs. RESULTS In a hierarchical mixed effect model that included all environmental variables and adjusted for elapsed sleep time and multiple demographic and behavioral variables, sleep efficiency calculated for consecutive 1-hour periods decreased in a dose-dependent manner with increasing levels of PM2.5, temperature, CO2, and noise. Sleep efficiency in the highest exposure quintiles was 3.2% (PM2.5, p < .05), 3.4% (temperature, p < .05), 4.0% (CO2, p < .01), and 4.7% (noise, p < .0001) lower compared to the lowest exposure quintiles (all p-values adjusted for multiple testing). Barometric pressure and humidity were not associated with sleep efficiency. Bedroom humidity was associated with subjectively assessed sleepiness and poor sleep quality (both p < .05), but otherwise environmental variables were not statistically significantly associated with actigraphically assessed total sleep time and wake after sleep onset or with subjectively assessed sleep onset latency, sleep quality, and sleepiness. Assessments of bedroom comfort suggest subjective habituation irrespective of exposure levels. CONCLUSIONS These findings add to a growing body of evidence highlighting the importance of the bedroom environment-beyond the mattress-for high-quality sleep.
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Affiliation(s)
- Mathias Basner
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
| | - Michael G Smith
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher W Jones
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Adrian J Ecker
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kia Howard
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Victoria Schneller
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Makayla Cordoza
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Marc Kaizi-Lutu
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sierra Park-Chavar
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alexander C Stahn
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David F Dinges
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Haochang Shou
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jonathan A Mitchell
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Ted Smith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Allison E Smith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Cameron K Stopforth
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Ray Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
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Bozigar M, Huang T, Redline S, Hart JE, Grady ST, Nguyen DD, James P, Nicholas B, Levy JI, Laden F, Peters JL. Associations between Aircraft Noise Exposure and Self-Reported Sleep Duration and Quality in the United States-Based Prospective Nurses' Health Study Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47010. [PMID: 37058435 PMCID: PMC10104165 DOI: 10.1289/ehp10959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Sleep disruption is linked with chronic disease, and aircraft noise can disrupt sleep. However, there are few investigations of aircraft noise and sleep in large cohorts. OBJECTIVES We examined associations between aircraft noise and self-reported sleep duration and quality in the Nurses' Health Study, a large prospective cohort. METHODS Aircraft nighttime equivalent sound levels (Lnight) and day-night average sound levels (DNL) were modeled around 90 U.S. airports from 1995 to 2015 in 5-y intervals using the Aviation Environmental Design Tool and linked to geocoded participant residential addresses. Lnight exposure was dichotomized at the lowest modeled level of 45 A-weighted decibels [dB(A)] and at multiple cut points for DNL. Multiple categories of both metrics were compared with < 45 dB(A). Self-reported short sleep duration (< 7 h/24-h day) was ascertained in 2000, 2002, 2008, 2012, and 2014, and poor sleep quality (frequent trouble falling/staying asleep) was ascertained in 2000. We analyzed repeated sleep duration measures using generalized estimating equations and sleep quality by conditional logistic regression. We adjusted for participant-level demographics, behaviors, comorbidities, and environmental exposures (greenness and light at night) and examined effect modification. RESULTS In 35,226 female nurses averaging 66.1 years of age at baseline, prevalence of short sleep duration and poor sleep quality were 29.6% and 13.1%, respectively. In multivariable models, exposure to Lnight ≥ 45 dB(A) was associated with 23% [95% confidence interval (CI): 7%, 40%] greater odds of short sleep duration but was not associated with poor sleep quality (9% lower odds; 95% CI: - 30 % , 19%). Increasing categories of Lnight and DNL ≥ 45 dB(A) suggested an exposure-response relationship for short sleep duration. We observed higher magnitude associations among participants living in the West, near major cargo airports, and near water-adjacent airports and among those reporting no hearing loss. DISCUSSION Aircraft noise was associated with short sleep duration in female nurses, modified by individual and airport characteristics. https://doi.org/10.1289/EHP10959.
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Affiliation(s)
- Matthew Bozigar
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Redline
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Stephanie T. Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Daniel D. Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Bradley Nicholas
- Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, Massachusetts, USA
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Zhou P, Ma J, Li X, Zhao Y, Yu K, Su R, Zhou R, Wang H, Wang G. The long-term and short-term effects of ambient air pollutants on sleep characteristics in the Chinese population: big data analysis from real world by sleep records of consumer wearable devices. BMC Med 2023; 21:83. [PMID: 36882820 PMCID: PMC9993685 DOI: 10.1186/s12916-023-02801-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Several studies on long-term air pollution exposure and sleep have reported inconsistent results. Large-scale studies on short-term air pollution exposures and sleep have not been conducted. We investigated the associations of long- and short-term exposure to ambient air pollutants with sleep in a Chinese population based on over 1 million nights of sleep data from consumer wearable devices. Air pollution data including particulate matter (PM2.5, PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) were collected from the Ministry of Ecology and Environment. Short-term exposure was defined as a moving average of the exposure level for different lag days from Lag0 to Lag0-6. A 365-day moving average of air pollution was regarded as long-term exposure. Sleep data were recorded using wearable devices from 2017 to 2019. The mixed-effects model was used to evaluate the associations. We observed that sleep parameters were associated with long-term exposure to all air pollutants. Higher levels of air pollutant concentrations were associated with longer total sleep and light sleep duration, shorter deep sleep duration, and decreases in wake after sleep onset (WASO), with stronger associations of exposures to NO2 and CO [a 1-interquartile range (IQR) increased NO2 (10.3 μg/m3) was associated with 8.7 min (95% CI: 8.08 to 9.32) longer sleep duration, a 1-IQR increased CO (0.3 mg/m3) was associated with 5.0 min (95% CI: - 5.13 to - 4.89) shorter deep sleep duration, 7.7 min (95% CI: 7.46 to 7.85) longer light sleep duration, and 0.5% (95% CI: - 0.5 to - 0.4%) lower proportion of WASO duration to total sleep]. The cumulative effect of short-term exposure on Lag0-6 is similar to long-term exposure but relatively less. Subgroup analyses indicated generally greater effects on individuals who were female, younger (< 45 years), slept longer (≥ 7 h), and during cold seasons, but the pattern of effects was mixed. We supplemented two additional types of stratified analyses to reduce repeated measures of outcomes and exposures while accounting for individual variation. The results were consistent with the overall results, proving the robustness of the overall results. In summary, both short- and long-term exposure to air pollution affect sleep, and the effects are comparable. Although people tend to have prolonged total sleep duration with increasing air pollutant concentrations, their sleep quality might remain poor because of the reduction in deep sleep.
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Affiliation(s)
- Peining Zhou
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jing Ma
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Xueying Li
- Department of Medical Statistics, Peking University First Hospital, Beijing, China
| | - Yixue Zhao
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Kunyao Yu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Rui Su
- Zepp Health Corp., Hefei, China
| | - Rui Zhou
- Bigdata and Cloud Platform BU, Zepp Health Corp., Hefei, China
| | | | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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Cai J, Shen Y, Zhao Y, Meng X, Niu Y, Chen R, Quan G, Li H, Groeger JA, Du W, Hua J, Kan H. Early-Life Exposure to PM 2.5 and Sleep Disturbances in Preschoolers from 551 Cities of China. Am J Respir Crit Care Med 2023; 207:602-612. [PMID: 36170612 DOI: 10.1164/rccm.202204-0740oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Air pollution has been linked with sleep disturbance in adults, but the association in children remains unclear. Objectives: To examine the associations of prenatal and postnatal exposure to fine particulate matter (particulate matter ⩽2.5 μm in aerodynamic diameter; PM2.5) with sleep quality and sleep disturbances among children in 551 Chinese cities. Methods: A total of 1,15,023 children aged 3-7 years from the Chinese National Cohort of Motor Development were included. Sleep quality was measured using the Children's Sleep Habits Questionnaire (CSHQ). PM2.5 exposure was estimated using a satellite-based model. Generalized additive mixed models with Gaussian and binomial distributions were used to examine the associations of PM2.5 exposure with CSHQ scores and risk of sleep disturbance, respectively, adjusting for demographic characteristics and temporal trends. Measurements and Main Results: Early-life PM2.5 exposure was associated with higher total CSHQ score, and the association was stronger for exposure at age 0-3 years (change of CSHQ score per interquartile range increase of PM2.5 = 0.46; 95% confidence interval [CI], 0.29-0.63) than during pregnancy (0.22; 95% CI, 0.12-0.32). The associations were more evident in sleep-disordered breathing and daytime sleepiness. Postnatal PM2.5 exposure was associated with increased risk of sleep disturbance (adjusted odds ratio for per-interquartile range increase of PM2.5 exposure at age 0-3 years, 1.10; 95% CI, 1.04-1.15), but no associations were found for prenatal exposure. Children who were exclusively breastfed for <6 months and had neonatal ICU admission may be more vulnerable to sleep disturbance related to PM2.5 exposure. Conclusions: PM2.5 exposure can impair sleep quality in preschool children.
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Affiliation(s)
- Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Yang Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Yan Zhao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Guangbin Quan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; and
| | - John A Groeger
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Wenchong Du
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Jing Hua
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
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20
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Bai KJ, Liu WT, Lin YC, He Y, Lee YL, Wu D, Chang TY, Chang LT, Lai CY, Tsai CY, Chung KF, Ho KF, Chuang KJ, Chuang HC. Ambient relative humidity-dependent obstructive sleep apnea severity in cold season: A case-control study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 861:160586. [PMID: 36455744 DOI: 10.1016/j.scitotenv.2022.160586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/04/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The objective of this study was to examine associations of daily averages and daily variations in ambient relative humidity (RH), temperature, and PM2.5 on the obstructive sleep apnea (OSA) severity. METHODS A case-control study was conducted to retrospectively recruit 8628 subjects in a sleep center between January 2015 and December 2021, including 1307 control (apnea-hypopnea index (AHI) < 5 events/h), 3661 mild-to-moderate OSA (AHI of 5-30 events/h), and 3597 severe OSA subjects (AHI > 30 events/h). A logistic regression was used to examine the odds ratio (OR) of outcome variables (daily mean or difference in RH, temperature, and PM2.5 for 1, 7, and 30 days) with OSA severity (by the groups). Two-factor logistic regression models were conducted to examine the OR of RH with the daily mean or difference in temperature or PM2.5 with OSA severity. An exposure-response relationship analysis was conducted to examine the outcome variables with OSA severity in all, cold and warm seasons. RESULTS We observed associations of mean PM2.5 and RH with respective increases of 0.04-0.08 and 0.01-0.03 events/h for the AHI in OSA patients. An increase in the daily difference of 1 % RH increased the AHI by 0.02-0.03 events/h in OSA patients. A daily PM2.5 decrease of 1 μg/m3 reduced the AHI by 0.03 events/h, whereas a daily decrease in the RH of 1 % reduced the AHI by 0.03-0.04 events/h. The two-factor model confirmed the most robust associations of ambient RH with AHI in OSA patients. The exposure-response relationship in temperature and RH showed obviously seasonal patterns with OSA severity. CONCLUSION Short-term ambient variations in RH and PM2.5 were associated with changes in the AHI in OSA patients, especially RH in cold season. Reducing exposure to high ambient RH and PM2.5 levels may have protective effects on the AHI in OSA patients.
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Affiliation(s)
- Kuan-Jen Bai
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yuan-Chien Lin
- Department of Civil Engineering, National Central University, Taoyuan City, Taiwan.
| | - Yansu He
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Dean Wu
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.
| | - Li-Te Chang
- Department of Environmental Engineering and Science, Feng Chia University, Taichung, Taiwan.
| | - Chun-Yeh Lai
- Department of Civil Engineering, National Central University, Taoyuan City, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK.
| | - Kin-Fai Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Key Laboratory of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China.
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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Zhang Y, Ke L, Ma X, Di Q. Impact of ground-level ozone exposure on sleep quality and electroencephalogram patterns at different time scales. ENVIRONMENTAL RESEARCH 2023; 218:115025. [PMID: 36502906 DOI: 10.1016/j.envres.2022.115025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/15/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Ozone exposure is associated with various adverse health outcomes, but its impact on sleep quality is uncertain. Here we assessed the causal effect of long-term (yearly and monthly) exposure to ozone on nocturnal workday sleep time in a national representative sample from the China Family Panel Study, using a difference-in-differences approach. We further followed ninety healthy Chinese young adults four times in four seasons from September 2020 to June 2021, measured their daily sleep architecture using accelerometers, ascertained daily ozone exposure, recorded 5-min eye-closed resting-state electroencephalogram (EEG) signals at the last day of each one-week-long measurement session, and explored the effect of ozone exposure on objectively-measured sleep architecture. In the national sample, we found that every 1 interquartile range (IQR) μg/m3 increase in yearly and monthly ozone exposure was causally associated with 7.31 (p = 0.0039) and 4.19 (p = 0.040) minutes decline in nocturnal workday sleep time; the dose-response curve represented a quasi-linear pattern with no safety threshold, and plateaued at higher concentrations. In the small-scale study with objectively-measured sleep architecture, we found that every 1 IQR μg/m3 increase in the weekly ozone exposure was associated with 5.33 min decrease in night-time total sleep time (p = 0.031), 1.63 percentage points decrease in sleep efficiency (p < 0.001), 1.99 min increase in sleep latency (p = 0.0070), and 5.34 min increase in wake after sleep onset time (p = 0.0016) in a quasi-linear pattern. Notably, we found the accumulating trend of ozone exposure on sleep quality during both the short-term and long-term periods. We also found that short-term ozone exposure was associated with altered EEG patterns, mediated by sleep quality. This study indicates that long-term and short-term ozone exposures have negative and accumulating impacts on sleep quality and might impair brain functioning. More hidden health burdens of ozone are worth exploring.
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Affiliation(s)
- Yao Zhang
- Soochow College, Soochow University, Suzhou, 215006, China; Division of Sports Science & Physical Education, Tsinghua University, Beijing, 100084, China.
| | - Limei Ke
- School of Medicine, Tsinghua University, Beijing, 100084, China.
| | - Xindong Ma
- Division of Sports Science & Physical Education, Tsinghua University, Beijing, 100084, China; IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China.
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China; Institute for Healthy China, Tsinghua University, Beijing, 100084, China.
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22
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Liao W, Liu X, Kang N, Song Y, Wang L, Yuchi Y, Huo W, Mao Z, Hou J, Wang C. Associations of cooking fuel types and daily cooking duration with sleep quality in rural adults: Effect modification of kitchen ventilation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158827. [PMID: 36122709 DOI: 10.1016/j.scitotenv.2022.158827] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Associations of combined different cooking fuel types and cooking duration with sleep quality were scarcely reported. This study aimed to explore the associations of exposure to household air pollution (HAP) from different cooking fuel types and cooking duration with sleep quality and examine the effect modification of kitchen ventilation on these associations. METHODS A total of 28,135 eligible participants were obtained from the Henan rural cohort study. Sleep quality was assessed by the Pittsburgh sleep quality index (PSQI), and participants with a PSQI score > 5 were identified as having poor sleep quality. A questionnaire was used to collect the cooking fuel types, cooking frequency, cooking duration, and kitchen ventilation. The average daily cooking duration was calculated as the cooking frequency per week multiplied by the cooking duration for each meal divided by 7. RESULTS Both domestic fuel use and cooking duration were positively related to poor sleep quality. The solid fuel users with a cooking duration ≥1.5 h/day had a higher prevalence of poor sleep quality (OR: 1.390, 95% CI: 1.233, 1.567), relative to those who never cooked. Notably, the estimated OR and 95% CI for poor sleep quality of clean fuel users with a cooking duration <1.5 h/day plus mechanical or natural ventilation versus those who never cooked was 1.05 (0.933, 1.187) or 1.306 (1.163, 1.466) and these associations were modified by kitchen ventilation. CONCLUSION Positive associations of combined different cooking fuel types and cooking duration with the prevalence of poor sleep quality were attenuated by kitchen ventilation, implying that installing mechanical ventilation may be an effective measure to improve sleep quality in low- and middle-income countries. These results need to be confirmed by future studies, which measure HAP more accurately using personal monitoring devices or behavior diaries.
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Affiliation(s)
- Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yu Song
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lulu Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Wang S, Xiong H, Wang L, Pei G, Lao M, Xu Y, Liu L, Luo S, Zhang Y, Ou Q. Association between residential greenness and obstructive sleep apnoea among adults in Southern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158414. [PMID: 36055505 DOI: 10.1016/j.scitotenv.2022.158414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/29/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND No previous study has explored the association of residential greenness with obstructive sleep apnoea (OSA) indexes. OBJECTIVE To investigate the association of exposure to residential greenness with OSA indexes in adults in Guangdong Province, Southern China. METHODS From January 1, 2005 to December 31, 2015, a total of 3925 participants were recruited from the Sleep Center of Guangdong Provincial People's Hospital. Apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were measured by polysomnography or home sleep test (HST). Participants' daytime sleepiness scores were evaluated using The Epworth Sleeping Scale (ESS). The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were used to assess residential greenness levels. Generalized linear regression models were used to assess the associations of residential greenness with OSA indexes after adjusting for multiple covariates. RESULTS The mean (standard deviation) age of the participants was 63.3 (14.4) years. In adjusted models, an interquartile range (IQR) increase in 3-year average NDVI was significantly associated with 9.8 % (95 % confidence interval [95 % CI]: 17.5 %, 2.1 %); 14.5 % (95 % CI: 24.5 %, 4.4 %) and 6.9 % (95 % CI: 13.7 %, 0.0 %) decreases in AHI, ODI and ESS scores, respectively. Furthermore, an IQR increase in 3-year average EVI was significantly associated with 7.8 % (95 % CI: 13.7 %, 1.9 %); 10.8 % (95 % CI: 18.3 %, 3.2 %) and 7.2 % (95 % CI: 12.5 %, 2.0 %) declines in AHI, ODI and ESS scores, respectively. Significant associations were only observed among males, adults aged ≥65 years old, and in the warm season. CONCLUSIONS Our study indicates that higher residential greenness was significantly associated with lower OSA indexes in adult population in South China, especially in males, in the elderly, and in the warm season.
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Affiliation(s)
- Suhan Wang
- Medical Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hailin Xiong
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China; Departments of Medical Oncology, Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Longlong Wang
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Guo Pei
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Linjiong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Siqi Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China.
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Al-Ajlouni YA, Al Ta'ani O, Shamaileh G, Mushasha R, Makarem N, Duncan DT. Effects of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations: a systematic review of the literature. BMJ Open 2022; 12:e066964. [PMID: 36600378 PMCID: PMC9729847 DOI: 10.1136/bmjopen-2022-066964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study sought to conduct a systematic review of the literature on the impact of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations, understudied geographic regions including with regards to sleep health. SETTING A systematic literature search of studies published from inception to 27 March 2022 was conducted on multiple databases using developed keywords. PARTICIPANTS Studies were included if they (1) investigated one or more aspects/dimensions of sleep health as an outcome (eg, sleep duration, sleep quality, sleep problems); (2) measured the impact of a COVID-19 pandemic-related domain (eg, impact of quarantine, work from home, lifestyle changes); (3) focused on at least one MENA region population; (4) were peer-reviewed; (5) included ≥100 participants; (6) were written in English and (7) had full-text article publicly available. PRIMARY AND SECONDARY OUTCOMES MEASURED Primary outcomes were sleep duration, sleep quality and sleep problems. RESULTS In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 164 studies were included for data extraction. The Newcastle-Ottawa scale for cross-sectional studies was used to assess the quality of the studies. Overall, the COVID-19 pandemic significantly impacted sleep duration, sleep quality and presence and severity of sleep disorders in MENA populations, including adults, children, students, healthcare workers and people with chronic illnesses. The directionality and strength of associations, as well as the determinants of sleep health, varied by subpopulations. CONCLUSIONS Longitudinal studies are needed to understand the longer-term impact of the COVID-19 pandemic on the sleep health of MENA populations. Sleep health interventions and policy measures should be tailored to the need of each subpopulation. PROSPERO REGISTRATION NUMBER CRD42022321128.
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Affiliation(s)
- Yazan A Al-Ajlouni
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Omar Al Ta'ani
- University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Ghaith Shamaileh
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | - Nour Makarem
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
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Tran HM, Chen TT, Lu YH, Tsai FJ, Chen KY, Ho SC, Wu CD, Wu SM, Lee YL, Chung KF, Kuo HP, Lee KY, Chuang HC. Climate-mediated air pollution associated with COPD severity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 843:156969. [PMID: 35760178 DOI: 10.1016/j.scitotenv.2022.156969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
Air pollution has been reported to be associated with chronic obstructive pulmonary disease (COPD). Our study aim was to examine the mediating effects of air pollution on climate-associated health outcomes of COPD patients. A cross-sectional study of 117 COPD patients was conducted in a hospital in Taiwan. We measured the lung function, 6-min walking distance, oxygen desaturation, white blood cell count, and percent emphysema (low attenuation area, LAA) and linked these to 0-1-, 0-3-, and 0-5-year lags of individual-level exposure to relative humidity (RH), temperature, and air pollution. Linear regression models were conducted to examine associations of temperature, RH, and air pollution with severity of health outcomes. A mediation analysis was conducted to examine the mediating effects of air pollution on the associations of RH and temperature with health outcomes. We observed that a 1 % increase in the RH was associated with increases in forced expiratory volume in 1 s (FEV1), eosinophils, and lymphocytes, and a decrease in the total-lobe LAA. A 1 °C increase in temperature was associated with decreases in oxygen desaturation, and right-, left-, and upper-lobe LAA values. Also, a 1 μg/m3 increase in PM2.5 was associated with a decrease in the FEV1 and an increase in oxygen desaturation. A 1 μg/m3 increases in PM10 and PM2.5 was associated with increases in the total-, right-, left, upper-, and lower-lobe (PM2.5 only) LAA. A one part per billion increase in NO2 was associated with a decrease in the FEV1 and an increase in the upper-lobe LAA. Next, we found that NO2 fully mediated the association between RH and FEV1. We found PM2.5 fully mediated associations of temperature with oxygen saturation and total-, right-, left-, and upper-lobe LAA. In conclusion, climate-mediated air pollution increased the risk of decreasing FEV1 and oxygen saturation and increasing emphysema severity among COPD patients. Climate change-related air pollution is an important public health issue, especially with regards to respiratory disease.
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Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yueh-Hsun Lu
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK.
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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26
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Zhang C, Zhang B, Ling Z, Xiao Y, Li S, Yu Y, Zou B, Chen X, Shen M. Long-term exposure to ambient black carbon is associated with sleep disturbance in college students. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156066. [PMID: 35605861 DOI: 10.1016/j.scitotenv.2022.156066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence suggests an association of air pollution with sleep quality. However, there is limited knowledge regarding the effect of black carbon, a key component of ambient particulate matter, on sleep. OBJECTIVES To investigate the association of long-term exposure to black carbon and sleep quality in a group of college students. METHODS A retrospective cohort study was conducted in five universities in different regions of China. The concentrations of black carbon and other environment factors were defined as the averages during the 6 years prior to the recruitment. Averagely daily dose of black carbon exposure was estimated according to the respiratory rate. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) with a cutoff >5 indicating sleep disturbance. Linear regression and logistic regression models were used to estimate the association. The sensitivity analyses were conducted to estimate the effects of 1-month, 6-month and 1-year mean levels of exposure to black carbon on sleep quality. RESULTS A total of 20,053 incoming college students were included. 29.3% reported impaired sleep quality, with a mean PSQI score of 4.3 ± 2.2. The logistic regression showed that the risk of impaired sleep quality was positively associated with black carbon exposure, especially in the highest quantile (OR: 1.26, 95% CI: 1.11-1.43) compared with the lowest quartile after adjusting for potential confounders. Subgroup analysis showed that the effect of black carbon on sleep quality was stronger in participants with higher BMI, lower household income, and lower parental educational level. The results of sensitivity analyses were similar with main analyses. CONCLUSION Long-term exposure to black carbon is associated with sleep disturbance in college students. Improvement of air quality may help improve sleep quality.
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Affiliation(s)
- Chengcheng Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Beisi Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhen Ling
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China
| | - Shenxin Li
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China.
| | - Yu Yu
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Bin Zou
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China; Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China.
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27
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Zhou YM, An SJ, Cao Y, Xu C, Liu XL, Yao CY, Li X, Wu N, Li CY, Wu L, Li YF, Ji AL, Cai TJ. Elder people can be more susceptible to the association between short-term ambient air pollution and sleep disorder outpatient visits: a time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:64902-64913. [PMID: 35474431 DOI: 10.1007/s11356-022-20242-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
Sleep disorders attract increasing concerns. However, the evidence of the association between ambient air pollution and sleep disorders is limited. Therefore, our aim was to determine the association between short-term air pollution exposure and outpatient visits for sleep disorders in Xi'an, the largest city in Northwest China. Baseline outpatient data of daily sleep disorders between 2011 and 2013 were collected. Quasi-Poisson distribution was applied by adjusting the day of the week and weather conditions. A total of 49,282 sleep disorder outpatient visits were recorded. The most significant association between air pollutants and outpatient visits was observed on concurrent day: per 10 μg/m3 increase of NO2, SO2, and PM10 at lag 0 corresponded to increased outpatient sleep disorder visits at 0.22% (95% CI: 0.03%, 0.42%), 1.53% (95% CI: 0.53, 2.53%), and 2.57% (95% CI: 1.33%, 3.82%), respectively. As for gender-specific analysis, there was no statistically significant difference between males and females. The result of season-specific analysis showed no statistically significant difference between warm seasons and cool seasons, either. As for age-specific analysis, obvious associations were observed in 20-40 age group (NO2) and > 40 age group (PM10 and SO2), while no evident association was found for the young age group (< 20 years old). Conclusively, short-term exposure to air pollutants, especially gaseous air pollutants, might increase the risk of sleep disorders, and such association appears to be more obvious in elder people. We provide novel data that there may be age differences in the relationship between short-term air pollution exposure and sleep disorders.
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Affiliation(s)
- Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Shu-Jie An
- Health Management Center, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Yi Cao
- Department of Health Economics Management, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Chen Xu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
- Department of Hepatobiliary Surgery, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Xiao-Ling Liu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Chun-Yan Yao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Xiang Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, People's Republic of China
| | - Na Wu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Cheng-Ying Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Long Wu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 30 Gaotanyan Main Street, Shapingba, Chongqing, 400038, China.
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28
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Wang J, Wang W, Zhang W, Wang J, Huang Y, Hu Z, Chen Y, Guo X, Deng F, Zhang L. Co-exposure to multiple air pollutants and sleep disordered breathing in patients with or without obstructive sleep apnea: A cross-sectional study. ENVIRONMENTAL RESEARCH 2022; 212:113155. [PMID: 35351455 DOI: 10.1016/j.envres.2022.113155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/31/2022] [Accepted: 03/18/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Air pollution may be a contributing risk factor for obstructive sleep apnea (OSA). However, the health effects of co-exposure to multiple air pollutants on OSA patients remain unclear. OBJECTIVES To assess the joint effect of multi-pollutant on sleep disordered breathing (SDB) parameters in patients with or without OSA and identify the dominant pollutants. METHODS A total of 2524 outpatients from April 2020 to May 2021 were recruited in this cross-sectional study. Ambient air pollutant data were obtained from the nearest central monitoring stations to participants' residential address. SDB parameters were measured by the ApneaLink devices, including apnea-hypopnea index (AHI), hypopnea index (HI), oxygen desaturation index (ODI), average oxygen saturation (SpO2), percentage sleep time with <90% saturation (T90), and desaturation. Bayesian kernel machine regression (BKMR) was applied to evaluate the effects of multiple pollutants. RESULTS Significant associations were observed between air pollutants and SDB parameters (including increases in AHI, HI, ODI, and desaturation) among patients with OSA. Co-exposure to air pollutants was positively correlated with AHI, HI, and ODI. PM10 and O3 dominated the effects of pollutant mixtures on OSA, with the highest posterior inclusion probability (PIP) values of 0.592 and 0.640, respectively. Stratified analysis showed that, compared to male patients with OSA, stronger effects on the SDB parameters were observed in female patients. Stronger associations were also found in the warm season than those in the cold season. CONCLUSION Co-exposure to air pollutants was associated with SDB parameters among patients with OSA, PM10 and O3 might play the dominant roles.
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Affiliation(s)
- Junyi Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Jianli Wang
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yongwei Huang
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Zixuan Hu
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yahong Chen
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Liqiang Zhang
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, 100191, China.
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Kendzerska T, Szyszkowicz M, Alvarez JV, Mallick R, Carlsten C, Ayas N, Laratta CR, Jovic B, Orach J, Doiron MS, Dales R. Air Pollution and the Effectiveness of Positive Airway Pressure Therapy in Individuals With Sleep Apnea. Chest 2022; 162:1176-1187. [DOI: 10.1016/j.chest.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/18/2022] [Accepted: 07/21/2022] [Indexed: 11/28/2022] Open
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30
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Kow PY, Chang LC, Lin CY, Chou CCK, Chang FJ. Deep neural networks for spatiotemporal PM 2.5 forecasts based on atmospheric chemical transport model output and monitoring data. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119348. [PMID: 35487466 DOI: 10.1016/j.envpol.2022.119348] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 06/14/2023]
Abstract
Reliable long-horizon PM2.5 forecasts are crucial and beneficial for health protection through early warning against air pollution. However, the dynamic nature of air quality makes PM2.5 forecasts at long horizons very challenging. This study proposed a novel machine learning-based model (MCNN-BP) that fused multiple convolutional neural networks (MCNN) with a back-propagation neural network (BPNN) for making spatiotemporal PM2.5 forecasts for the next 72 h at 74 stations covering the whole Taiwan simultaneously. Model configuration involved an ensemble of massive hourly air quality and meteorological monitoring datasets and the existing publicly-available PM2.5 simulated (forecasted) datasets from an atmospheric chemical transport (ACT) model. The proposed methodology collaboratively constructed two CNNs to mine the observed data (the past) and the forecasted data from ACT (the future) separately. The results showed that the MCNN-BP model could significantly improve the accuracy of spatiotemporal PM2.5 forecasts and substantially reduce the forecast biases of the ACT model. We demonstrated that the proposed MCNN-BP model with effective feature extraction and good denoising ability could overcome the curse of dimensionality and offer satisfactory regional long-horizon PM2.5 forecasts. Moreover, the MCNN-BP model has considerably shorter computational time (5 min) and lower computational load than the compute-intensive ACT model. The proposed approach hits a milestone in multi-site and multi-horizon forecasting, which significantly contributes to early warning against regional air pollution.
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Affiliation(s)
- Pu-Yun Kow
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, 10617, Taiwan
| | - Li-Chiu Chang
- Department of Water Resources and Environmental Engineering, Tamkang University, New Taipei City, 25137, Taiwan
| | - Chuan-Yao Lin
- Research Center for Environmental Changes, Academia Sinica, Taipei, 11529, Taiwan
| | - Charles C-K Chou
- Research Center for Environmental Changes, Academia Sinica, Taipei, 11529, Taiwan
| | - Fi-John Chang
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, 10617, Taiwan.
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31
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Qiu H, Liu WT, Lin SY, Li ZY, He YS, Yim SHL, Wong ELY, Chuang HC, Ho KF. Association of air pollution exposure with low arousal threshold obstructive sleep apnea: A cross-sectional study in Taipei, Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119393. [PMID: 35525512 DOI: 10.1016/j.envpol.2022.119393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 06/14/2023]
Abstract
Emerging evidence witnesses the association of air pollution exposure with sleep disorders or the risk of obstructive sleep apnea (OSA); however, the results are not consistent. OSA patients with or without a low arousal threshold (LAT) have different pathology and therapeutic schemes. No study has evaluated the potential diverse effects of air pollution on the phenotypes of OSA. The current study aimed to evaluate the associations of short-term and long-term exposure to air pollution with sleep-disordered measures and OSA phenotypes. This cross-sectional study consisted of 4634 participants from a sleep center in Taipei from January 2015 to April 2019. The personal exposure to ambient PM2.5 and NO2 was assessed by a spatial-temporal model. Overnight polysomnography was used to measure the sleep parameters. According to a developed clinical tool, we defined the low arousal threshold (LAT) and identified the OSA patients with or without LAT. We applied a generalized linear model and multinomial logistic regression model to estimate the change of sleep measures and risk of the OSA phenotypes, respectively, associated with an interquartile range (IQR) increment of personal pollution exposure after adjusting for the essential confounders. In the single-pollutant model, we observed the associations of NO2 with sleep-disordered measures by decreasing the total sleep time, sleep efficiency, extending the time of wake after sleep onset, and the association of NO2 with the increased risk of LAT OSA by around 15%. The two-pollutant model with both long-term and short-term exposures confirmed the most robust associations of long-term NO2 exposure with sleep measures. An IQR increment of NO2 averaged over the past year (6.0 ppb) decreased 3.32 min of total sleep time and 0.85% of sleep efficiency. Mitigating exposure to air pollution may improve sleep quality and reduce the risk of LAT OSA.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China; JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Wen-Te Liu
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shang-Yang Lin
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Zhi-Yuan Li
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
| | - Yan-Su He
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Steve Hung Lam Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China; Department of Geography and Resource Management, The Chinese University of Hong Kong, HKSAR, China; The Asian School of the Environment, Nanyang Technological University, Singapore
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China; JC School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China.
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Smith MG, Cordoza M, Basner M. Environmental Noise and Effects on Sleep: An Update to the WHO Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:76001. [PMID: 35857401 PMCID: PMC9272916 DOI: 10.1289/ehp10197] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Nighttime noise carries a significant disease burden. The World Health Organization (WHO) recently published guidelines for the regulation of environmental noise based on a review of evidence published up to the year 2015 on the effects of environmental noise on sleep. OBJECTIVES This systematic review and meta-analysis will update the WHO evidence review on the effects of environmental noise on sleep disturbance to include more recent studies. METHODS Investigations of self-reported sleep among residents exposed to environmental traffic noise at home were identified using Scopus, PubMed, Embase, and PsycINFO. Awakenings, falling asleep, and sleep disturbance were the three outcomes included. Extracted data were used to derive exposure-response relationships for the probability of being highly sleep disturbed by nighttime noise [average outdoor A-weighted noise level (Lnight) 2300-0700 hours] for aircraft, road, and rail traffic noise, individually. The overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. RESULTS Eleven studies (n=109,070 responses) were included in addition to 25 studies (n=64,090 responses) from the original WHO analysis. When sleep disturbance questions specifically mentioned noise as the source of disturbance, there was moderate quality of evidence for the probability of being highly sleep disturbed per 10-dB increase in Lnight for aircraft [odds ratio (OR)=2.18; 95% confidence interval (CI): 2.01, 2.36], road (OR=2.52; 95% CI: 2.28, 2.79), and railway (OR=2.97; 95% CI: 2.57, 3.43) noise. When noise was not mentioned, there was low to very low quality of evidence for being sleep disturbed per 10-dB increase in Lnight for aircraft (OR=1.52; 95% CI: 1.20, 1.93), road (OR=1.14; 95% CI: 1.08, 1.21), and railway (OR=1.17; 95% CI: 0.91, 1.49) noise. Compared with the original WHO review, the exposure-response relationships closely agreed at low (40 dB Lnight) levels for all traffic types but indicated greater disturbance by aircraft traffic at high noise levels. Sleep disturbance was not significantly different between European and non-European studies. DISCUSSION Available evidence suggests that transportation noise is negatively associated with self-reported sleep. Sleep disturbance in this updated meta-analysis was comparable to the original WHO review at low nighttime noise levels. These low levels correspond to the recent WHO noise limit recommendations for nighttime noise, and so these findings do not suggest these WHO recommendations need revisiting. Deviations from the WHO review in this updated analysis suggest that populations exposed to high levels of aircraft noise may be at greater risk of sleep disturbance than determined previously. https://doi.org/10.1289/EHP10197.
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Affiliation(s)
- Michael G. Smith
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Makayla Cordoza
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Lo CC, Liu WT, Lu YH, Wu D, Wu CD, Chen TC, Fang YT, Lo YC, Chen YY, Kang L, Tsai CY, Lee YL, Chuang KJ, Ho KF, Chang TY, Chuang HC. Air pollution associated with cognitive decline by the mediating effects of sleep cycle disruption and changes in brain structure in adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:52355-52366. [PMID: 35258725 DOI: 10.1007/s11356-022-19482-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
The effects of air pollution on sleep and dementia remain unclear. The objective of this study was to investigate the effects of air pollution on cognitive function as mediated by the sleep cycle. A cross-sectional study design was conducted to recruit 4866 subjects on which PSG had been performed. Fifty of them were further given a cognitive function evaluation by the MMSE and CASI as well as brain images by CT and MRI. Associations of 1-year air pollution parameters with sleep parameters, cognitive function, and brain structure were examined. We observed that O3 was associated with a decrease in arousal, an increase in the N1 stage, and a decrease in the N2 stage of sleep. NO2 was associated with an increase in the N1 stage, a decrease in the N2 stage, and an increase in REM. PM2.5 was associated with a decrease in the N1 stage, increases in the N2 and N3 stages, and a decrease in REM. The N1 and N2 stages were associated with cognitive decline, but REM was associated with an increase in cognitive function. The N1 stage was a mediator of the effects of PM2.5 on the concentration domain of the MMSE. O3 was associated with an increase in the pars orbitalis volume of the left brain. NO2 was associated with increases in the rostral middle frontal volume, supramarginal gyrus volume, and transverse temporal volume of the left brain, and the pars opercularis volume of the right brain. PM2.5 was associated with increases in the pars triangularis volume of the left brain and the fusiform thickness of the right brain. In conclusion, we observed that air pollution was associated with cognitive decline by mediating effects on the sleep cycle with changes in the brain structure in controlling executive, learning, and language functions in adults.
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Affiliation(s)
- Chen-Chen Lo
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yueh-Hsun Lu
- Department of Radiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ting-Chieh Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Ting Fang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Chun Lo
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - You-Yin Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Industrial Ph.D. Program of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Lo Kang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kin-Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan.
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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He Y, Liu W, Lin S, Li Z, Qiu H, Yim SHL, Chuang H, Ho K. Association of traffic air pollution with severity of obstructive sleep apnea in urban areas of Northern Taiwan: A cross-sectional study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 827:154347. [PMID: 35257757 DOI: 10.1016/j.scitotenv.2022.154347] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although recent studies have indicated an association between obstructive sleep apnea (OSA) and air pollution, they have reported inconsistent results. Moreover, few studies investigated the effects of short-term air pollution exposure. OBJECTIVE To estimate the health effects of short- and long-term exposure to traffic air pollution on mild OSA in Taipei. METHODS We collected participants' data from Taipei Sleep Center and air pollution data from Taiwan Environmental Protection Administration. A spatiotemporal model was used to estimate the individual exposure level. Generalized linear models were used to assess the percent change of overall apnea-hypopnea index (AHI), AHI in rapid eye movement period (AHI-REM), AHI in non-REM (AHI-NREM), and oxygen desaturation index (ODI) associated with an interquartile (IQR) increase in personal pollution exposure. A generalized logistic model was used to estimate the ORs of different severities of OSA compared with the reference group. RESULTS In the patients with AHI of <15, both short- and long-term exposure to NO2 were significantly associated with AHI and ODI increases: an IQR increase in 2-year mean NO2 increased 7.3% of AHI and 8.4% of ODI; these values were the highest among all exposure windows. The effects of NO2 on AHI increase were stronger in the men and younger patients. Moreover, the association between AHI and NO2 in the patients with AHI of <15 was mediated by the REM stage. NO2 exposure was associated with an increased risk of mild OSA that reached up to 24.8% per IQR increase in NO2 averaged over 2 years. PM2.5 exerted no effects on AHI, but an IQR increase in 1-year and 2-year mean PM2.5 was associated with 6.8% and 8.8% increases in ODI, respectively. CONCLUSIONS Both short- and long-term exposure to traffic air pollution were associated with the risk of mild OSA, which was modified by REM stage.
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Affiliation(s)
- Yansu He
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wente Liu
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shangyang Lin
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Zhiyuan Li
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Steve Hung Lam Yim
- The Asian School of the Environment, Nanyang Technological University, Singapore
| | - Hsiaochi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kinfai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China.
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Johnson DA, Ohanele C, Alcántara C, Jackson CL. The Need for Social and Environmental Determinants of Health Research to Understand and Intervene on Racial/Ethnic Disparities in Obstructive Sleep Apnea. Clin Chest Med 2022; 43:199-216. [PMID: 35659019 DOI: 10.1016/j.ccm.2022.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Obstructive sleep apnea (OSA), a sleep-disordered breathing (SDB) disorder, affects at least 25 million adults in the United States and is associated with increased risk for hypertension, diabetes, and cardiovascular disease (CVD). Racial/ethnic minorities have a disproportionate burden of OSA along with the health sequelae associated with this condition. Despite supporting evidence of racial/ethnic disparities, few studies have investigated SDB including OSA among minoritized racial/ethnic groups. In this scoping review of the literature, the authors summarize current findings related to racial/ethnic disparities in OSA, identified social and environmental determinants of health, treatment inequities, and promising evidence-based interventions and conclude with future research directions.
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Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR Room 3025, Atlanta, GA 30322, USA.
| | - Chidinma Ohanele
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR Room 3025, Atlanta, GA 30322, USA
| | - Carmela Alcántara
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, Room 917, New York, NY 10027, USA
| | - Chandra L Jackson
- Epidemiology Branch, Social and Environmental Determinants of Health Equity, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Room A327, Research Triangle Park, 27709 Post: P.O. Box 12233, Mail Drop A3-05, NC 27709, USA; Intramural Program, Department of Health and Human Services, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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36
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Xu X, Lian Z. Objective sleep assessments for healthy people in environmental research: A literature review. INDOOR AIR 2022; 32:e13034. [PMID: 35622713 DOI: 10.1111/ina.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/04/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
To date, although many studies had focused on the impact of environmental factors on sleep, how to choose the proper assessment method for objective sleep quality was often ignored, especially for healthy subjects in bedroom environment. In order to provide methodological guidance for future research, this paper reviewed the assessments of objective sleep quality applied in environmental researches, compared them from the perspective of accuracy and interference, and statistically analyzed the impact of experimental type and subjects' information on method selection. The review results showed that, in contrast to polysomnography (PSG), the accuracy of actigraphy (ACT), respiratory monitoring-oxygen saturation monitoring (RM-OSM), and electrocardiograph (ECG) could reach up to 97%, 80.38%, and 79.95%, respectively. In terms of sleep staging, PSG and ECG performed the best, ACT the second, and RM-OSM the worst; as compared to single methods, mix methods were more accurate and better at sleep staging. PSG interfered with sleep a great deal, while ECG and ACT could be non-contact, and thus, the least interference with sleep was present. The type of experiment significantly influenced the choice of assessment method (p < 0.001), 85.3% of researchers chose PSG in laboratory study while 82.5% ACT in field study; moreover, PSG was often used in a relatively small number of young subjects, while ACT had a wide applicable population. In general, researchers need to pay more attention at selection of assessments in future studies, and this review can be used as a reliable reference for experimental design.
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Affiliation(s)
- Xinbo Xu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiwei Lian
- School of Design, Shanghai Jiao Tong University, Shanghai, China
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The Association between Childhood Exposure to Ambient Air Pollution and Obesity: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084491. [PMID: 35457358 PMCID: PMC9030539 DOI: 10.3390/ijerph19084491] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 02/06/2023]
Abstract
Obesity has become a worldwide epidemic; 340 million of children and adolescents were overweight or obese in 2016, and this number continues to grow at a rapid rate. Epidemiological research has suggested that air pollution affects childhood obesity and weight status, but the current evidence remains inconsistent. Therefore, the aim of this meta-analysis was to estimate the effects of childhood exposure to air pollutants on weight. A total of four databases (PubMed, Web of Science, Embase, and Cochrane Library) were searched for publications up to December 31, 2021, and finally 15 studies met the inclusion criteria for meta-analysis. Merged odds ratios (ORs), coefficients (β), and 95% confidence intervals (95% CIs) that were related to air pollutants were estimated using a random-effects model. The meta-analysis indicated that air pollutants were correlated with childhood obesity and weight gain. For obesity, the association was considerable for PM10 (OR = 1.12, 95% CI: 1.06, 1.18), PM2.5 (OR = 1.28, 95% CI: 1.13, 1.45), PM1 (OR = 1.41, 95% CI: 1.30, 1.53), and NO2 (OR = 1.11, 95% CI: 1.06, 1.18). Similarly, BMI status increased by 0.08 (0.03-0.12), 0.11 (0.05-0.17), and 0.03 (0.01-0.04) kg/m2 with 10 μg/m3 increment in exposure to PM10, PM2.5, and NO2. In summary, air pollution can be regarded as a probable risk factor for the weight status of children and adolescents. The next step is to conduct longer-term and large-scale studies on different population subgroups, exposure concentrations, and pollutant combinations to provide detailed evidence. Meanwhile, integrated management of air pollution is essential.
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Fan H, Wang Y, Wang Y, Coyte PC. The impact of environmental pollution on the physical health of middle-aged and older adults in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:4219-4231. [PMID: 34403062 DOI: 10.1007/s11356-021-15832-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
While several studies have demonstrated the negative impacts of environmental pollution on population health, in general, few studies have examined the potential differential effects on the physical health of middle-aged and older populations, i.e., 45 years and older. Given the twin concerns of environmental pollution and population aging in China, this article employed a fixed effects model to infer the impact of environmental pollution on public health with a particular focus on middle-aged and older adults. The analyses were based on data from the 2011 to 2018 waves of the CHARLS and pollutant data from prefecture-level cities. The results showed that both the level and intensity of environmental pollution significantly increased the risk of chronic diseases and negatively impacted the physical health of middle-aged and older adults. Environmental pollution had its greatest negative effect on the physical health of the elderly, urban residents, residents of the Eastern region, and those with lower incomes than their counterparts. We further found that the potential channels of health effect were through reduced physical exercise and sleep duration and an increase in depressive symptoms, and the pollution prevention actions alleviated the health deterioration of environmental pollution for the middle-aged and the elderly. It is imperative for the government to urgently reinforce policy enforcement to decrease air and water pollution and enhance the ability to circumvent pollution for the lower socioeconomic groups.
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Affiliation(s)
- Hongli Fan
- School of Insurance, Shandong University of Finance and Economics, 40 Shungeng Street, Jinan, 250000, Shandong, China.
| | - Yingcheng Wang
- School of Insurance, Shandong University of Finance and Economics, 40 Shungeng Street, Jinan, 250000, Shandong, China
| | - Ying Wang
- School of Finance, Shandong University of Finance and Economics, Jinan, Shandong, China
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Tung NT, Lee YL, Lin SY, Wu CD, Dung HB, Thuy TPC, Kuan YC, Tsai CY, Lo CC, Lo K, Ho KF, Liu WT, Chuang HC. Associations of ambient air pollution with overnight changes in body composition and sleep-related parameters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148265. [PMID: 34119796 DOI: 10.1016/j.scitotenv.2021.148265] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
This study aims to investigate the association of air pollution with overnight change in 4body composition and sleep-related parameters. Body composition of 197 subjects in New Taipei city was measured before and after sleep by bioelectric impedance analysis. Air pollutant data were collected from Taiwan Environmental Protection Administration. Sleep parameters were examined by polysomnography. We observed fine particulate matter (PM2.5) decreased arterial oxygen saturation (SaO2) and increased apnea-hypopnea index (AHI); NO2 increased arousal, AHI, and decreased mean SaO2; and O3 inmcreased mean SaO2. We observed 0.99-μg/m3 increase in PM2.5 was associated with 18.8% increase in changes of right arm fat percentage (95% confidence interval (CI): 0.004, 0.375) and 0.011-kg increase in changes of right arm fat mass (95% CI: 0.000, 0.021). 2.45-ppb increase in NO2 was associated with 0.181-kg decrease in changes of muscle mass (95% CI: -0.147, -0.001), 0.192-kg decrease in changes of fat free mass (95% CI: -0.155, -0.001), 21.1% increase in changes of right leg fat percentage (95% CI: 0.012, 0.160), and 21.3% increase in changes of left leg fat percentage (95% CI: 0.006, 0.168). 1.56-ppb increase in O3 was associated with 29.3% decrease in changes of right leg fat percentage (95% CI: -0.363, -0.013), 0.058-kg increase in changes of right leg fat free mass (95% CI: 0.008, 0.066), and 0.059-kg increase in changes of right leg muscle mass (95% CI: 0.010, 0.066). We observed AHI was associated with overnight changes in fat percentage, total fat mass, muscle mass, bone mass, fat free mass, extracellular water, basal metabolic rate, leg fat percentage, leg fat mass, and trunk fat percentage (p < 0.05). In conclusion, exposure to air pollutants was associated with overnight body composition changes and sleep-related parameters. Nocturnal changes in total muscle mass and leg fat percentage likely contribute to the relationship between air pollution and obstructive sleep apnea.
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Affiliation(s)
- Nguyen Thanh Tung
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, Viet Nam.
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Shang-Yang Lin
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
| | - Hoang Ba Dung
- Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, Viet Nam
| | - Tran Phan Chung Thuy
- Otorhinolaryngology Department, Faculty of Medicine, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Yi-Chun Kuan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Chen-Chen Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kin-Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Wen-Te Liu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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Lo K, Chiang LL, Hsu SM, Tsai CY, Wu D, Chou CJ, Chuang HC, Liu WT. Association of short-term exposure to air pollution with depression in patients with sleep-related breathing disorders. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 786:147291. [PMID: 33965829 DOI: 10.1016/j.scitotenv.2021.147291] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/30/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
Air pollution is associated with sleep-related breathing disorders; however, the effects of air pollution on depression in patients with SRBDs remain unclear. A cross-sectional study was conducted to collect polysomnographic (PSG) data and Beck Depression Inventory-IA (BDI-IA) responses from 568 subjects with SRDBs in a sleep center in 2015 to 2017. Exposure to air pollution, including particulate matter with an aerodynamic diameter of ≤10 μm (PM10), particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5), nitrogen (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3), in 1-month averages was collected. Associations of air pollution with the respiratory disturbance index (RDI), oxygen desaturation index (ODI), arousal index (ARI), sleep architecture, and BDI-IA were examined. We observed that interquartile range (IQR) increases in 1-month PM2.5, PM10, and NO2 levels were respectively associated with 4.1/hour (h) (95% confidence interval (CI): 1.7/h to 6.4/h), 3.7/h (95% CI: 1.4/h to 6.0/h) and 1.9/h (95% CI: 0.1/h to 3.7/h) increases in the ARI. For sleep architecture, IQR increases in 1-month PM2.5 and CO levels were respectively associated with a 6.2% (95% CI: 6.1% to 6.3%) increase in non-rapid eye movement sleep 1 (N1) and a 2.0% (95% CI: -3.8% to -0.1%) decrease in non-rapid eye movement sleep 2 (N2). For depression, an IQR change in the 1-month CO was associated a moderate/severe depressive status according to the BDI-IA (odds ratio, OR: 2.981, p < 0.05; 95% CI: 1.032 to 8.611). Short-term exposure to air pollution increased the risk of arousal and light sleep as well as depression in patients with SRBDs. The results suggest that SRBD patients could be a population at risk for depression due to short-term exposure to air pollution.
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Affiliation(s)
- Kang Lo
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Ling-Ling Chiang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shin-Mei Hsu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Dean Wu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chia-Jung Chou
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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Chair SY, Choi KC, Cao X, Cheng HY, Chau JPC, Liu T, Chien WT. Association between household solid fuel use for cooking and sleep disturbance in rural China: findings from the China Kadoorie Biobank data. Sleep Med 2021; 83:13-20. [PMID: 33990061 DOI: 10.1016/j.sleep.2021.04.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Solid fuel use for cooking is a main source of household air pollution, particularly in rural China. Evidence on the association between household air pollution and sleep quality remains limited. This study aimed to examine the association between household solid fuels used for cooking and sleep disturbance. METHODS The data of 283,170 adults from baseline survey of the China Kadoorie Biobank Study were included. Detailed information about exposure to solid fuels used for cooking were collected. Sleep disturbance was indicated as any of the three sleep disorders, including disorders of initiating and maintaining sleep, disorders of early morning awakening, and daytime dysfunction. Logistic regression analysis was used to examine the association between sleep disturbance and level of exposure to household solid fuels used for cooking. RESULTS About 18% of participants reported sleep disturbance. Fully adjusted analysis indicated exposure to household solid fuels used for cooking was significantly associated with sleep disturbance. Compared to those with 0-3 years exposure (first tertile) to solid fuels used for cooking, the participants with 3-26 years exposure (second tertile) and >26 years exposure (third tertile) had greater odds of having sleep disturbance at 1.16 (95% CI: 1.12-1.19) and 1.33 (95% CI: 1.29-1.37) times, respectively. CONCLUSIONS Use of household solid fuels is associated with prevalence of sleep disturbance; the longer duration of exposure to solid fuels use for cooking, the higher is the prevalence of sleep disturbance. Further study is warranted to examine the underlying mechanisms of the association.
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Affiliation(s)
- Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xi Cao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ting Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Janson E, Johannessen A, Holm M, Franklin K, Holst GJ, Gislason T, Jögi R, Lindberg E, Svartengren M, Janson C. Insomnia associated with traffic noise and proximity to traffic-a cross-sectional study of the Respiratory Health in Northern Europe III population. J Clin Sleep Med 2021; 16:545-552. [PMID: 32022662 DOI: 10.5664/jcsm.8274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
STUDY OBJECTIVES Exposure to traffic noise increases the risk of sleeping disturbance, but little is known about the effect of traffic-related air pollution on insomnia symptoms. We aimed to investigate the separate associations of self-reported proximity to traffic and traffic noise with insomnia. METHODS This is a cross-sectional study of the population included in the Respiratory Health in Northern Europe study, consisting of randomly selected men and women born between 1945 and 1973, from 7 Northern European centers. Hearing traffic noise in the bedroom, bedroom window proximity to traffic, and insomnia symptoms were self-reported. Bedroom window proximity to traffic was used as a surrogate for exposure to traffic-related air pollution. The following insomnia symptoms were assessed: difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening. RESULTS A total of 12,963 individuals was included. Traffic noise was positively associated with all three insomnia symptoms: difficulty initiating sleep (odds ratio [OR] = 3.54; 95% confidence interval [CI]: 1.85, 6.76), difficulty maintaining sleep (OR = 2.95; 95% CI: 1.62, 5.37), and early morning awakening (OR = 3.25; 95% CI: 1.97, 5.37). Proximity to traffic without disturbing noise was associated with difficulty initiating sleep (OR = 1.62; 95% CI: 1.45, 1.82). CONCLUSIONS This study adds further support to the identification of traffic noise as a risk factor for insomnia. Proximity to traffic without being exposed to noise was associated with an increased risk of difficulty initiating sleep. Our findings indicate that insomnia may be associated with both traffic noise and traffic-related air pollution.
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Affiliation(s)
- Emma Janson
- Department of Medical Sciences: Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umea University, Umea, Sweden
| | - Gitte Juel Holst
- Department of Public Health, Section for Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, the National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland
| | - Rain Jögi
- Lung Clinic, Tartu University Clinics, Tartu, Estonia
| | - Eva Lindberg
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Magnus Svartengren
- Department of Medical Sciences: Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Lai CH, Ho SC, Pan CH, Chen WL, Wang CC, Liang CW, Chien CY, Riediker M, Chuang KJ, Chuang HC. Chronic exposure to metal fume PM 2.5 on inflammation and stress hormone cortisol in shipyard workers: A repeat measurement study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 215:112144. [PMID: 33743405 DOI: 10.1016/j.ecoenv.2021.112144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5) has been linked to adverse health outcomes in welding workers. The objective of this study was to investigate associations of chronic exposure to metal fume PM2.5 in shipyard workers with health outcomes. A longitudinal study was conducted to determine the effects of metal fume PM2.5 on FeNO, urinary metals, urinary oxidative stress, inflammation, and stress hormones in workers. There were 20 office workers and 49 welding workers enrolled in this study who were followed-up for a second year. We observed that Fe, Zn, and Mn were abundant in PM2.5 to which welding workers were personally exposed, whereas PM2.5 to which office workers were personally exposed was dominated by Pb, Cu, and Zn. We observed in the first and/or second visits that urinary 8-iso-prostaglandin F2-α (PGF2α) and 8-hydroxy-2'-deoxy guanosine (8-OHdG) were significantly increased by exposure. An increase in urinary interleukin (IL)-6 and decreases in urinary serotonin and cortisol were observed in the first and/or second visits after exposure. PM2.5 was associated with decreases in urinary 8-OHdG and cortisol among workers. Next, we observed that urinary Ni, Co, and Fe had significantly increased among workers after a year of exposure. Urinary metals were associated with decreases in urinary 8-iso-PGF2α and cortisol among workers. Urinary Ni, Cu, and Fe levels were associated with an increase in urinary IL-6 and a decrease in urinary cortisol among workers. In conclusion, chronic exposure to metal fume PM2.5 was associated with inflammation and a cortisol deficiency in shipyard workers, which could associate with adrenal glands dysfunction.
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Affiliation(s)
- Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chih-Hong Pan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei City, Taiwan.
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
| | - Che-Wi Liang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
| | - Chi-Yu Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
| | - Michael Riediker
- Swiss Centre for Occupational and Environmental Health, Winterthur, Switzerland.
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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Liu J, Ghastine L, Um P, Rovit E, Wu T. Environmental exposures and sleep outcomes: A review of evidence, potential mechanisms, and implications. ENVIRONMENTAL RESEARCH 2021; 196:110406. [PMID: 33130170 PMCID: PMC8081760 DOI: 10.1016/j.envres.2020.110406] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 06/02/2023]
Abstract
Environmental exposures and poor sleep outcomes are known to have consequential effects on human health. This integrative review first seeks to present and synthesize existing literature investigating the relationship between exposure to various environmental factors and sleep health. We then present potential mechanisms of action as well as implications for policy and future research for each environmental exposure. Broadly, although studies are still emerging, empirical evidence has begun to show a positive association between adverse effects of heavy metal, noise pollution, light pollution, second-hand smoke, and air pollution exposures and various sleep problems. Specifically, these negative sleep outcomes range from subjective sleep manifestations, such as general sleep quality, sleep duration, daytime dysfunction, and daytime sleepiness, as well as objective sleep measures, including difficulties with sleep onset and maintenance, sleep stage or circadian rhythm interference, sleep arousal, REM activity, and sleep disordered breathing. However, the association between light exposure and sleep is less clear. Potential toxicological mechanisms are thought to include the direct effect of various environmental toxicants on the nervous, respiratory, and cardiovascular systems, oxidative stress, and inflammation. Nevertheless, future research is required to tease out the exact pathways of action to explain the associations between each environmental factor and sleep, to inform possible therapies to negate the detrimental effects, and to increase efforts in decreasing exposure to these harmful environmental factors to improve health.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
| | - Lea Ghastine
- Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Phoebe Um
- Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Elizabeth Rovit
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Tina Wu
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
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Yu Z, Wei F, Wu M, Lin H, Shui L, Jin M, Wang J, Tang M, Chen K. Association of long-term exposure to ambient air pollution with the incidence of sleep disorders: A cohort study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 211:111956. [PMID: 33493724 DOI: 10.1016/j.ecoenv.2021.111956] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/09/2021] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Sleep disorders have been verified to be associated with adverse health outcomes. Recent studies have linked ambient air pollution to sleep disorders. However, evidence with large sample size and especially prospective studies is very limited. METHODS We used data from a prospective cohort study established from 2015 to 2018 in Ningbo, China. Participants were followed-up after baseline survey through linkage to the regional Health Information System (HIS). Sleep disorders were defined based on International Classification of Disease 10 (ICD-10). Spatial-temporal land-use regression (LUR) models were used to estimate the annual exposure to particulate matter with diameter ≤ 2.5 µm (PM2.5), ≤ 10 µm (PM10) and nitrogen dioxides (NO2). The associations between long-term exposure to air pollutants and prevalence of sleep disorders were examined using logistic regression models, and Cox regression models for the effects of air pollution on the incidence of sleep disorders. A generalized weighted quantile sum (gWQS) regression was used in the multipollutant analysis. RESULTS A total of 38,775 participants were included in the final analysis. Based on baseline data, we observed significant positive associations between air pollution exposure and increased odds of prevalent sleep disorders (Odds Ratio (OR)= 1.48, 95% confidence interval (CI): 1.41-1.55 for PM2.5; OR= 1.47,95%CI:1.38-1.57 for PM10; OR= 1.38, 95%CI:1.31-1.46 for NO2). In the longitudinal analysis, hazard ratios for incident sleep disorders associated with per interquartile range (IQR) increase in PM2.5, PM10 and NO2 were 1.14 (1.03, 1.25), 1.13 (1.01, 1.27) and 1.13 (1.04, 1.23), respectively. A gWQS regression analysis showed significant association between air pollution mixture and incident sleep disorders (OR=1.11, 95%CI: 1.03-1.20). CONCLUSIONS Long-term exposure to PM2.5, PM10 and NO2 were associated with increased risk of sleep disorders in a Chinese population. Our findings could provide evidence for a more general role in the adverse health impact of air pollution.
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Affiliation(s)
- Zhebin Yu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Fang Wei
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Mengyin Wu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hongbo Lin
- The Center for Disease Control and Prevention of Yinzhou District, Ningbo, Zhejiang, China
| | - Liming Shui
- Health Commission of Ningbo, Zhejiang, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China.
| | - Mengling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
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Chiang KL, Lee JY, Chang YM, Kuo FC, Huang CY. The effect of weather, air pollution and seasonality on the number of patient visits for epileptic seizures: A population-based time-series study. Epilepsy Behav 2021; 115:107487. [PMID: 33323341 DOI: 10.1016/j.yebeh.2020.107487] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The objective of the study was to explore the influences of seasonality, meteorological conditions, and air pollution exposure on the number of patients who visit the hospital due to seizures. METHODS Outpatient and inpatient data from the National Health Insurance Database of Taiwan from 2009 to 2013, meteorological data from the Meteorological Bureau, and air pollution exposure data from the Taiwan Air Quality Monitoring Stations were collected and integrated into daily time series data. The following data processing and analysis results are based on the mean of the 7 days' lag data of the 18 meteorological condition/air pollution exploratory factors to identify the critical meteorological conditions and air pollution exposure factors by executing univariate analysis. The average hospital visits for seizure per day by month were used as an index of observation. The effect of seasonality has also been examined. RESULTS The average visits per day by month had a significant association with 10 variables. Overall, the number of visits due to these factors has been estimated to be 71.529 (13.7%). The most obvious factors affecting the estimated number of visits include ambient temperature, CH4, and NO. Six air pollutants, namely CH4, NO, CO, NO2, PM2.5, and NMHC had a significantly positive correlation with hospital visits due to seizures. Moreover, the average daily number of hospital visits was significantly high in January and February (winter season in Taiwan) than in other months (R2 = 0.422). CONCLUSION The prediction model obtained in this study indicates the necessity of rigorous monitoring and early warning of these air pollutants and climate changes by governments. Additionally, the study provided a firm basis for establishing prediction models to be used by other countries or for other diseases.
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Affiliation(s)
- Kuo-Liang Chiang
- Department of Pediatric Neurology, Kuang-Tien General Hospital, Taichung, Taiwan; Department of Nutrition, Hungkuang University, Taichung, Taiwan; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
| | - Jen-Yu Lee
- Department of Statistics, Feng Chia University, Taichung, Taiwan
| | - Yu-Mei Chang
- Department of Statistics, Tunghai University, Taichung, Taiwan
| | - Fang-Chuan Kuo
- Department of Physical Therapy, Hungkuang University, Taichung, Taiwan.
| | - Chin-Yin Huang
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan; Program for Health Administration, Tunghai University, Taichung, Taiwan
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Cox LA. How Do Exposure Estimation Errors Affect Estimated Exposure-Response Relations? INTERNATIONAL SERIES IN OPERATIONS RESEARCH & MANAGEMENT SCIENCE 2021:449-474. [DOI: 10.1007/978-3-030-57358-4_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Wang Y, Liu X, Chen G, Tu R, Abdulai T, Qiao D, Liu X, Dong X, Luo Z, Wang Y, Li R, Huo W, Yu S, Guo Y, Li S, Wang C. Association of long-term exposure to ambient air pollutants with prolonged sleep latency: The Henan Rural Cohort Study. ENVIRONMENTAL RESEARCH 2020; 191:110116. [PMID: 32846171 DOI: 10.1016/j.envres.2020.110116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Prolonged sleep latency is associated with far-reaching public health consequences. Although evidence about the effect of air pollution on sleep problem has been shown, the effect on sleep latency remained unknown. The study aimed to analyze the association between long-term exposure to air pollution and prolonged sleep latency in rural China. METHODS In all, 27935 participants were included in the study from Henan Rural Cohort Study. A satellite-based spatiotemporal model was used to evaluate the 3-year average concentration of air pollutants at the home address of participants before the baseline survey. Air pollutants included NO2 (nitrogen dioxide), PM1 (particulate matter with aerodynamic diameters ≤1 μm), PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 μm), and PM10 (particulate matter with aerodynamic diametes ≤ 10 μm). A logistic regression model was conducted to assess the odds ratio (OR) and 95% confidence interval (95% CI) between air pollutants and prolonged sleep latency. RESULTS There were 5825 (20.85%) participants with prolonged sleep latency. The average concentration of NO2, PM1, PM2.5, and PM10 were 38.22 (2.54) μg/m3, 56.29 (1.75) μg/m3, 72.30 (1.87) μg/m3, and 130.01 (4.58) μg/m3. The odds ratio (95%CI) of prolonged sleep latency with an IQR increase of NO2, PM1, PM2.5, and PM10 were 1.59 (1.33-1.90), 1.23 (1.13-1.33), 1.28 (1.13-1.45) and 1.43 (1.22-1.67). The stratified analysis showed the effect of air pollutants was stronger among those with stroke. CONCLUSION Long-term exposure to NO2, PM1, PM2.5 and PM10 were associated with prolonged sleep latency. The adverse impact of air pollution should be considered when treating sleep problems.
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Affiliation(s)
- Yan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Tanko Abdulai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Dou Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xue Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yikang Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Songcheng Yu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Effects of atmospheric particulate matter pollution on sleep disorders and sleep duration: a cross-sectional study in the UK biobank. Sleep Med 2020; 74:152-164. [DOI: 10.1016/j.sleep.2020.07.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/03/2020] [Accepted: 07/27/2020] [Indexed: 12/27/2022]
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Clark DPQ, Son DB, Bowatte G, Senaratna CV, Lodge C, Perret JL, Hamilton GS, Dharmage S. The association between traffic-related air pollution and obstructive sleep apnea: A systematic review. Sleep Med Rev 2020; 54:101360. [PMID: 32755810 DOI: 10.1016/j.smrv.2020.101360] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/25/2020] [Accepted: 05/20/2020] [Indexed: 11/16/2022]
Abstract
Recent evidence suggests that air pollution exposure may be a contributing risk factor for obstructive sleep apnea (OSA), however, current evidence is conflicting. This systematic review aims to determine the association between air pollution and OSA in the general population, and examine for potential effect modification by seasonality, temperature and humidity. Five full-text articles were included in the review out of 905 articles found by systematically searching PubMed, Embase and Scopus databases. The included studies were limited to OSA in adults that were conducted in middle to high-income countries. The results highlight heterogeneity in the diagnostic criteria for OSA and method used to assess air pollution exposure. There is some evidence to support a relationship between air pollution exposure and OSA. However, the duration of exposure to different air pollutants including particulate matter (PM2.5 and PM10) and nitric oxides (NO2) in relation to OSA varied across different seasons, temperatures, and countries. This variability of the pollutants across studies warrants a more robust study design using time-series analysis with multiple follow-ups to strengthen the evidence for this relationship before considering its implications.
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Affiliation(s)
- David P Q Clark
- The University of Melbourne, School of Population & Global Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
| | - Dinh Bui Son
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
| | - Gayan Bowatte
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia; Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, National Institute of Fundamental Studies, Sri Lanka.
| | - Chamara V Senaratna
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia; Faculty of Medical Sciences, Non-Communicable Diseases Research Centre, University of Sri Jayewardenepura, Sri Lanka.
| | - Caroline Lodge
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
| | - Jennifer L Perret
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia; The Institute for Breathing and Sleep (IBAS), Heidelberg, Melbourne, VIC, Australia.
| | - Garun S Hamilton
- Dept of Lung and Sleep Medicine, Monash Health, Victoria, Australia; School of Clinical Sciences, Monash University, Victoria, Australia.
| | - Shyamali Dharmage
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
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