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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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3
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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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Li A, Zhang Q, Yao Y, Zhu X, Liu C, Guo Y, Kan H, Chen R. Higher ambient temperatures may worsen obstructive sleep apnea: A nationwide smartwatch-based analysis of 6.2 million person-days. Sci Bull (Beijing) 2024; 69:2114-2121. [PMID: 38821748 DOI: 10.1016/j.scib.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 06/02/2024]
Abstract
Obstructive sleep apnea (OSA) is a serious type of sleep disorder that can lead to cardiometabolic and neurocognitive diseases. We utilized smart device-based photoplethysmography technology to collect sleep data from the Chinese population from 2019 to 2022. Distributed lag nonlinear models combined with a generalized nonlinear model or a linear mixed effects model were used to investigate the short-term associations between daily temperature and indicators of OSA severity. We included a total of 6,232,056 d of sleep monitoring data from 51,842 participants with moderate to severe risk of OSA from 313 Chinese cities. The relationships between ambient temperature and OSA exacerbation, apnea-hypopnea index (AHI), and minimum oxygen saturation (MinSpO2) were almost linear and present only on the same day. Higher temperatures were associated with a greater risk of OSA exacerbation, with an 8.4% (95% confidence interval (CI): 7.6%-9.3%) increase per 10 °C increase in temperature. A 10 °C increase in daily temperature corresponded to an AHI increase of 0.70 events/h (95% CI: 0.65-0.76) and a MinSpO2 decrease of 0.18% (95% CI: 0.16%-0.19%). Exposure to elevated temperatures during the night can also lead to adverse effects. The effects of higher temperatures on OSA severity were stronger among men, participants with a body mass index ≥ 24 kg/m2, those aged 45 years and older, individuals with a history of hypertension and diabetes, and during the cold season. This large-scale, nationwide, longitudinal study provides robust evidence suggesting that higher ambient temperatures may immediately worsen OSA.
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Affiliation(s)
- Anni Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Qingli Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yuan Yao
- Department of Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China; Institute for Hospital Management Research, Chinese PLA General Hospital, Beijing 100048, China
| | - Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yutao Guo
- Department of Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China.
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5
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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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Gui ZH, Heinrich J, Min Qian Z, Schootman M, Zhao TY, Xu SL, Jin NX, Huang HH, He WT, Wu QZ, Zhang JL, Wang DS, Yang M, Liu RQ, Zeng XW, Dong GH, Lin LZ. Exposures to particulate matters and childhood sleep disorders-A large study in three provinces in China. ENVIRONMENT INTERNATIONAL 2024; 190:108841. [PMID: 38917626 DOI: 10.1016/j.envint.2024.108841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/10/2024] [Accepted: 06/20/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES Evidence on the link between long-term ambient particulate matter (PM) exposures and childhood sleep disorders were scarce. We examined the associations between long-term exposures to PM2.5 and PM1 (PM with an aerodynamic equivalent diameter <2.5 μm and <1 μm, respectively) with sleep disorders in children. METHODS We performed a population-based cross-sectional survey in 177,263 children aged 6 to 18 years in 14 Chinese cities during 2012-2018. A satellite-based spatiotemporal model was employed to estimate four-year annual average PM2.5 and PM1 exposures at residential and school addresses. Parents or guardians completed a checklist using the Sleep Disturbance Scale for Children. We estimated the associations using generalized linear mixed models with adjustment for characteristics of children, parents, and indoor environments. RESULTS Long-term PM2.5 and PM1 exposures were positively associated with odds of sleep disorders for almost all domains. For example, increments in PM2.5 and PM1 per 10 μg/m3 were associated with odds ratios of global sleep disorder of 1.24 (95 % confidence interval [CI]: 1.14, 1.35) and 1.31 (95 %CI: 1.18, 1.46), respectively. Similar results were observed for subtypes of sleep disorder. These associations were heterogeneous regionally, with stronger associations among children residing in southeast region than in northeast and northwest regions. Moreover, larger estimates of PM1 were found than that of PM2.5 in southeast region. CONCLUSION Long-term PM2.5 and PM1 exposures are independently associated with higher risks of childhood sleep disorders, and these associations vary by geographical region.
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Affiliation(s)
- Zhao-Huan Gui
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich 80336, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, United States
| | - Mario Schootman
- Department of Internal Medicine, College of Medicine, University of Arkansas for Medical Sciences, 2708 S. 48th Street, Springdale, AR 72762, United States
| | - Tian-Yu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich 80336, Germany
| | - Shu-Li Xu
- Department of Occupational and Environmental Health, Shenzhen Baoan District Public Health Service Center, Shenzhen 518100, China
| | - Nan-Xiang Jin
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, Neulaniementie 2, 70210 Kuopio, Finland
| | - He-Hai Huang
- Department of Occupational and Environmental Health, Shenzhen Baoan District Public Health Service Center, Shenzhen 518100, China
| | - Wan-Ting He
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qi-Zhen Wu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jing-Lin Zhang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Dao-Sen Wang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Mo Yang
- Department of Environmental and Biological Science, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Ru-Qing Liu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao-Wen Zeng
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Zi Lin
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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7
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Chevance G, Minor K, Vielma C, Campi E, O'Callaghan-Gordo C, Basagaña X, Ballester J, Bernard P. A systematic review of ambient heat and sleep in a warming climate. Sleep Med Rev 2024; 75:101915. [PMID: 38598988 DOI: 10.1016/j.smrv.2024.101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/31/2024] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
Climate change is elevating nighttime and daytime temperatures worldwide, affecting a broad continuum of behavioral and health outcomes. Disturbed sleep is a plausible pathway linking rising ambient temperatures with several observed adverse human responses shown to increase during hot weather. This systematic review aims to provide a comprehensive overview of the literature investigating the relationship between ambient temperature and valid sleep outcomes measured in real-world settings, globally. We show that higher outdoor or indoor temperatures are generally associated with degraded sleep quality and quantity worldwide. The negative effect of heat persists across sleep measures, and is stronger during the hottest months and days, in vulnerable populations, and the warmest regions. Although we identify opportunities to strengthen the state of the science, limited evidence of fast sleep adaptation to heat suggests rising temperatures induced by climate change and urbanization pose a planetary threat to human sleep, and therefore health, performance, and wellbeing.
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Affiliation(s)
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, United States.
| | | | | | - Cristina O'Callaghan-Gordo
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Québec, Canada
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Wang K, Ghafurian M, Chumachenko D, Cao S, Butt ZA, Salim S, Abhari S, Morita PP. Application of artificial intelligence in active assisted living for aging population in real-world setting with commercial devices - A scoping review. Comput Biol Med 2024; 173:108340. [PMID: 38555702 DOI: 10.1016/j.compbiomed.2024.108340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/23/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The aging population is steadily increasing, posing new challenges and opportunities for healthcare systems worldwide. Technological advancements, particularly in commercially available Active Assisted Living devices, offer a promising alternative. These readily accessible products, ranging from smartwatches to home automation systems, are often equipped with Artificial Intelligence capabilities that can monitor health metrics, predict adverse events, and facilitate a safer living environment. However, there is no review exploring how Artificial Intelligence has been integrated into commercially available Active Assisted Living technologies, and how these devices monitor health metrics and provide healthcare solutions in a real-world environment for healthy aging. This review is essential because it fills a knowledge gap in understanding AI's integration in Active Assisted Living technologies in promoting healthy aging in real-world settings, identifying key issues that require to be addressed in future studies. OBJECTIVE The aim of this overview is to outline current understanding, identify potential research opportunities, and highlight research gaps from published studies regarding the use of Artificial Intelligence in commercially available Active Assisted Living technologies that assists older individuals aging at home. METHODS A comprehensive search was conducted in six databases-PubMed, CINAHL, IEEE Xplore, Scopus, ACM Digital Library, and Web of Science-to identify relevant studies published over the past decade from 2013 to 2024. Our methodology adhered to the PRISMA extension for scoping reviews to ensure rigor and transparency throughout the review process. After applying predefined inclusion and exclusion criteria on 825 retrieved articles, a total of 64 papers were included for analysis and synthesis. RESULTS Several trends emerged from our analysis of the 64 selected papers. A majority of the work (39/64, 61%) was published after the year 2020. Geographically, most of the studies originated from East Asia and North America (36/64, 56%). The primary application goal of Artificial Intelligence in the reviewed literature was focused on activity recognition (34/64, 53%), followed by daily monitoring (10/64, 16%). Methodologically, tree-based and neural network-based approaches were the most prevalent Artificial Intelligence algorithms used in studies (32/64, 50% and 31/64, 48% respectively). A notable proportion of the studies (32/64, 50%) carried out their research using specially designed smart home testbeds that simulate the conditions in real-world. Moreover, ambient technology was a common thread (49/64, 77%), with occupancy-related data (such as motion and electrical appliance usage logs) and environmental sensors (indicators like temperature and humidity) being the most frequently used. CONCLUSION Our results suggest that Artificial Intelligence has been increasingly deployed in the real-world Active Assisted Living context over the past decade, offering a variety of applications aimed at healthy aging and facilitating independent living for the older adults. A wide range of smart home indicators were leveraged for comprehensive data analysis, exploring and enhancing the potentials and effectiveness of solutions. However, our review has identified multiple research gaps that need further investigation. First, most research has been conducted in controlled testbed environments, leaving a lack of real-world applications that could validate the technologies' efficacy and scalability. Second, there is a noticeable absence of research leveraging cloud technology, an essential tool for large-scale deployment and standardized data collection and management. Future work should prioritize these areas to maximize the potential benefits of Artificial Intelligence in Active Assisted Living settings.
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Affiliation(s)
- Kang Wang
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Moojan Ghafurian
- Department of Systems Design Engineering, University of Waterloo, ON, Canada
| | - Dmytro Chumachenko
- National Aerospace University "Kharkiv Aviation Institute", Kharkiv, Ukraine
| | - Shi Cao
- Department of Systems Design Engineering, University of Waterloo, ON, Canada
| | - Zahid A Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shahan Salim
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shahabeddin Abhari
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Plinio P Morita
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Department of Systems Design Engineering, University of Waterloo, ON, Canada; Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
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9
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Lamichhane DK, Ha E, Hong YC, Lee DW, Park MS, Song S, Kim S, Kim WJ, Bae J, Kim HC. Ambient particulate matter and surrounding greenness in relation to sleep quality among pregnant women: A nationwide cohort study. Heliyon 2024; 10:e26742. [PMID: 38434397 PMCID: PMC10904245 DOI: 10.1016/j.heliyon.2024.e26742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Particulate air pollution and residential greenness are associated with sleep quality in the general population; however, their influence on maternal sleep quality during pregnancy has not been assessed. Objective This cross-sectional study investigated the individual and interactive effects of exposure to particulate matter (PM) air pollution and residential greenness on sleep quality in pregnant women. Methods Pregnant women (n = 4933) enrolled in the Korean Children's Environmental Health Study with sleep quality information and residential address were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The average concentrations of PM (PM2.5 and PM10) during pregnancy were estimated through land use regression, and residential greenness in a 1000 m buffer area around participants' residences was estimated using the Normalized Difference Vegetation Index (NDVI1000-m). Modified Poisson regression models were used to estimate the associations between PM and NDVI and poor sleep quality (PSQI >5) after controlling for a range of covariates. A four-way mediation analysis was conducted to examine the mediating effects of PM. Results After adjusting for confounders, each 10 μg/m3 increase in PM2.5 and PM10 exposure was associated with a higher risk of poor sleep quality (relative risk [RR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11; and RR: 1.09; 95% CI: 1.06, 1.13, respectively), and each 0.1-unit increase in NDVI1000-m was associated with a lower risk of poor sleep quality (RR: 0.97; 95% CI: 0.95, 0.99). Mediation analysis showed that PM mediated approximately 37%-56% of the association between residential greenness and poor sleep quality. Conclusions This study identified a positive association between residential greenness and sleep quality. Furthermore, these associations are mediated by a reduction in exposure to particulate air pollution and highlight the link between green areas, air pollution control, and human health.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Myung-Sook Park
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Sanghwan Song
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Suejin Kim
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
| | - Jisuk Bae
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Ko-CHENS Study Group
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Kendzerska T, Szyszkowicz M, Saymeh M, Mallick R, Carlsten C, Ayas NT, Laratta CR, Orach J, Dales R. Air pollution, weather and positive airway pressure treatment adherence in adults with sleep apnea: a retrospective community-based repeated-measures longitudinal study. J Sleep Res 2024:e14183. [PMID: 38439127 DOI: 10.1111/jsr.14183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/15/2024] [Accepted: 02/12/2024] [Indexed: 03/06/2024]
Abstract
We assessed the relation between air pollution, weather, and adherence to positive airway pressure (PAP) therapy in a retrospective community-based repeated-measures study of adults with obstructive sleep apnea who purchased PAP devices from a registered provider between 2013 and 2017 (Ottawa, Ontario, Canada) and had at least one day of data. Daily PAP-derived data, air pollution, and weather databases were linked using postal code. The exposures were mean nocturnal (8:00 p.m. to 8:00 a.m.) (i) residential concentrations of nitrogen dioxide (NO2 ), fine particulate matter <=2.5 μm (PM2.5 ), ozone (O3 ), and Air Quality Health Index (AQHI), and (ii) temperature, relative humidity, and barometric pressure. Covariates in the main model were demographics, season, exposure year, and PAP therapy mode. We analysed 8148 adults (median age of 54 years and 61% men) and 2,071,588 days of data. Based on daily data, the median (interquartile range) daily PAP usage was 416 (323-487) min. Using mixed-effect regression analyses to incorporate daily data and clustering by individuals, we found a statistically significant decrease in adherence for increased levels of NO2 , PM2.5 , and AQHI. The largest effect was for NO2 : a decrease in daily PAP use while comparing the highest versus lowest quartiles (Qs) was 3.4 (95% confidence interval [CI] 2.8-3.9) min. Decreased PAP adherence was also associated with increased temperature (Q4 versus Q1: 2.6 [95% CI: 1.5-3.7] min) and decreased barometric pressure (Q1 versus Q4: 2.0 [95% CI 1.5-2.5] min). We observed modest but statistically significant acute effects of air pollution and weather on daily PAP adherence.
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Affiliation(s)
- Tetyana Kendzerska
- Faculty of Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mieczysław Szyszkowicz
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Healthy Canada, Ottawa, Ontario, Canada
| | - Mouaz Saymeh
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Christopher Carlsten
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Najib T Ayas
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cheryl R Laratta
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Juma Orach
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Dales
- Faculty of Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Healthy Canada, Ottawa, Ontario, Canada
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11
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Pengo MF, Iodice S, Parati G, Meriggi P, Bollati V, Lombardi C. Fine particulate matter and sleep-disordered breathing severity in a large Italian cohort. Sleep Breath 2024; 28:371-375. [PMID: 37718355 DOI: 10.1007/s11325-023-02918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Air pollution and obstructive sleep apnea (OSA) are both linked with cardiovascular co-morbidities and share similar pathophysiological mechanisms. A causal association between the two has been postulated. However, the results of the studies on this topic are conflicting mainly because of the lack of adjustment for important confounders such as seasonality and temperature. We aimed to evaluate if such an association exists in a highly polluted area like Lombardy region (Italy) when accounting for all confounders. METHODS Data of adult patients seen at the Sleep Disorder Centre in Milan from 2010 to 2020 were analysed and the main polygraphic data were retrieved. Air pollutant concentrations of the following pollutants NO2, O3, PM2.5, and PM10 were collected through monitoring stations. RESULTS A total of 3493 patients were included: males (2358, 67.5%) mean age 60.1 (SD = 14.3) years, BMI 29.2 (6.2) kg/m2, mean AHI 16.5 (18.1) events/h. After adjusting for all confounders, in the multivariable analysis, the only associations that remained significant were long-term exposure to O3 with indexes of OSA severity (AHI and ODI) but only in spring. Furthermore, a positive association was seen between long-term exposure to PM10 and ODI but in springtime only. CONCLUSION The findings of the current study does not support an association between fine particulate matter and OSA severity.
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Affiliation(s)
- M F Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano - IRCCS, Milan, Italy.
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
| | - S Iodice
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - G Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano - IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - P Meriggi
- IRCCS Fondazione Don Carlo Gnocchi, Italy, Milan, Italy
| | - V Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - C Lombardi
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano - IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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12
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Shaw S, Kundu S, Chattopadhyay A, Rao S. Indoor air pollution and cognitive function among older adults in India: a multiple mediation approach through depression and sleep disorders. BMC Geriatr 2024; 24:81. [PMID: 38253994 PMCID: PMC10802029 DOI: 10.1186/s12877-024-04662-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Studies across multiple countries reveal that depression and sleep disorders can lead to cognitive decline. This study aims to speculate on the effect of different sources of indoor air pollution on cognition and to explore the mediation effect of depression and sleep disorders on cognition when exposed to indoor air pollution. We hypothesize that an older adult experiences higher cognitive decline from indoor pollution when mediated by depression and sleep disorders. METHODS We use data from Longitudinal Aging Study in India (LASI), 2017-2018, and employ a multiple mediation model to understand the relationship between indoor air pollution and cognition through sleep disorders and depression while adjusting for possible confounders. Sensitivity analysis was applied to see the effect of different sources of indoor pollution (cooking fuel, indoor smoke products, and secondhand smoke) on cognitive performance. RESULTS The effect of three sources of indoor pollutants on cognition increased when combined, indicating stronger cognitive decline. Unclean cooking practices, indoor smoke (from incense sticks and mosquito coils), and secondhand smoke were strongly associated with sleep disorders and depression among older adults. Indoor air pollution was negatively associated with cognitive health (β= -0.38) while positively associated with depression (β= 0.18) and sleep disorders (β= 0.038) acting as mediators. Sensitivity analysis explained 45% variability while adjusting for confounders. CONCLUSION The study lays a foundation for future investigations into the nexus of indoor pollution and mental health. It is essential to formulate policies to reduce exposure to varying sources of indoor air pollutants and improve screening for mental health services as a public health priority.
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Affiliation(s)
- Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 88, India
| | - Sampurna Kundu
- Centre of Social Medicine & Community Health, Jawaharlal Nehru University, New Delhi, Delhi, 110067, India
| | - Aparajita Chattopadhyay
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 88, India.
| | - Smitha Rao
- College of Social Work, The Ohio State University, Columbus, 43214, USA
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13
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Roldán Sevilla A, Díaz Cambriles T, Villena Garrido MV, Fontenla A, Santos Sanchez AI, Villagraz Tecedor L, Asensio Nogueira J, Huertas Nieto S, García Fernández FJ. Seasonal influence on sleep apnoea recorded daily by pacemakers. Sleep Breath 2023; 27:2181-2189. [PMID: 36973595 DOI: 10.1007/s11325-023-02789-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 10/16/2022] [Accepted: 02/01/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE Obstructive sleep apnoea (OSA) and cardiac conduction disorders are pathologies with a rising prevalence due to increased life expectancy. Upper airway patency is affected by environmental factors that may be associated with seasonal periods. The ability to record the degree of nocturnal apnoea on a daily basis may provide a more accurate picture of seasonal variability. METHODS This study used an observational, cross-sectional design recruiting consecutive patients with Sorin/Livanova/Microport® pacemakers. The study assessed the seasonal influence on the daily degree of nocturnal apnoea over a minimum period of 180 days. The respiratory events were recorded using a pacemaker-integrated detection algorithm based on transthoracic impedance variation. A generalised linear repeated measure mixed model was used to study the seasonal effect. RESULTS A sample of 101 subjects with a mean of 227 valid nights was compiled. Summer was associated with higher RDI (respiratory disturbance index) values and winter with lower values. The mean daily RDI ratio in summer was 1.099 times higher than in winter. CONCLUSIONS Slight seasonal influences on the degree of nocturnal apnoea were detected through the daily observation of an unselected sample of pacemaker wearers. The degree of apnoea is higher in warmer months and lower in colder months.
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Affiliation(s)
- Alvaro Roldán Sevilla
- Cardiology Division, Internal Medicine Department, Santos Reyes Hospital, Avenida Ruperta Baraya S/N, Aranda de Duero, Burgos, Spain.
- Clinical Cardiology Unit, Cardiology Department, Burgos University Hospital, Burgos, Spain.
| | - Trinidad Díaz Cambriles
- Sleep Disorders Unit, Pneumology Department, University Hospital 12 de Octubre, Madrid, Spain
| | - María Victoria Villena Garrido
- Sleep Disorders Unit, Pneumology Department, University Hospital 12 de Octubre, Madrid, Spain
- Department of Medicine, Complutense de Madrid University, Madrid, Spain
| | - Adolfo Fontenla
- Electrophysiology Unit and hemodynamics Unit, Cardiology Department, University Hospital Quirónsalud Madrid, Pozuelo de Alarcón, Spain
| | | | - Lola Villagraz Tecedor
- Electrophysiology Unit, Cardiology Department, Burgos University Hospital, Burgos, Spain
| | - Juan Asensio Nogueira
- Clinical Cardiology Unit, Cardiology Department, Burgos University Hospital, Burgos, Spain
| | - Sergio Huertas Nieto
- Electrophysiology Unit and hemodynamics Unit, Cardiology Department, University Hospital Quirónsalud Madrid, Pozuelo de Alarcón, Spain
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Mallah MA, Soomro T, Ali M, Noreen S, Khatoon N, Kafle A, Feng F, Wang W, Naveed M, Zhang Q. Cigarette smoking and air pollution exposure and their effects on cardiovascular diseases. Front Public Health 2023; 11:967047. [PMID: 38045957 PMCID: PMC10691265 DOI: 10.3389/fpubh.2023.967047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/26/2023] [Indexed: 12/05/2023] Open
Abstract
Cardiovascular disease (CVD) has no socioeconomic, topographical, or sex limitations as reported by the World Health Organization (WHO). The significant drivers of CVD are cardio-metabolic, behavioral, environmental, and social risk factors. However, some significant risk factors for CVD (e.g., a pitiable diet, tobacco smoking, and a lack of physical activities), have also been linked to an elevated risk of cardiovascular disease. Lifestyles and environmental factors are known key variables in cardiovascular disease. The familiarity with smoke goes along with the contact with the environment: air pollution is considered a source of toxins that contribute to the CVD burden. The incidence of myocardial infarction increases in males and females and may lead to fatal coronary artery disease, as confirmed by epidemiological studies. Lipid modification, inflammation, and vasomotor dysfunction are integral components of atherosclerosis development and advancement. These aspects are essential for the identification of atherosclerosis in clinical investigations. This article aims to show the findings on the influence of CVD on the health of individuals and human populations, as well as possible pathology and their involvement in smoking-related cardiovascular diseases. This review also explains lifestyle and environmental factors that are known to contribute to CVD, with indications suggesting an affiliation between cigarette smoking, air pollution, and CVD.
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Affiliation(s)
| | - Tahmina Soomro
- Department of Sociology, Shah Abdul Latif University, Khairpur, Pakistan
| | - Mukhtiar Ali
- Department of Chemical Engineering, Quaid-e-Awam University of Engineering, Science and Technology, Nawabshah, Sindh, Pakistan
| | - Sobia Noreen
- Department of Pharmaceutics Technology, Institute of Pharmacy, University of Innsbruck, Insbruck, Austria
| | - Nafeesa Khatoon
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Akriti Kafle
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Feifei Feng
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Muhammad Naveed
- Department of Physiology and Pharmacology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
| | - Qiao Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Zhang Q, Wang H, Zhu X, Li A, Liu C, Guo Y, Kan H, Chen R. Air pollution may increase the sleep apnea severity: A nationwide analysis of smart device-based monitoring. Innovation (N Y) 2023; 4:100528. [PMID: 38028136 PMCID: PMC10654035 DOI: 10.1016/j.xinn.2023.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Obstructive sleep apnea (OSA) can lead to sleep deprivation, accidents, and cardiovascular diseases. However, research on the short-term effects of air pollutants on OSA severity is limited and inconsistent. We conducted a novel case time series analysis using a nationwide dataset among Huawei smart device users to assess the association between air pollution and OSA severity in a population at moderate-to-severe risk of OSA. Fixed-effects regression models were used to assess the associations between air pollution and the risk of OSA exacerbation, apnea-hypopnea index (AHI), and oxygen saturation. A total of 51,842 participants who were at moderate-to-severe risk of OSA (mean age [SD]: 45.4 [11.0], 95.5% male) were included, with 6,232,056 person-days of monitoring. The associations of fine particulate matter, nitrogen dioxide, carbon monoxide, and sulfur dioxide with OSA severity could occur during the sleep period, and last for 2 days. An increase of 1 interquartile range in the moving average concentrations of air pollution during the sleep period and the 2 previous days was associated with a 1.14%-4.31% increase in the risk of OSA exacerbation, an increase in AHI by 0.05-0.17 events/h, and a decrease in oxygen saturation (%) by 0.003-0.014. The exposure-response curves were almost linear. The associations between air pollutants and OSA were consistently stronger in participants aged 45 years or older. By virtue of the smart device-based technology, this large-scale, nationwide, longitudinal study provides compelling evidence that short-term exposure to air pollution may worsen sleep apnea. Our findings highlight the significance of ongoing efforts to improve air quality in mitigating OSA severity and the relevant disease burden in an aging era.
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Affiliation(s)
- Qingli Zhang
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Ministry of Education - Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Hong Wang
- Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Xinlei Zhu
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Anni Li
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Cong Liu
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yutao Guo
- Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
- Chinese PLA Medical College, Beijing 100039, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
| | - Renjie Chen
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
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Tsai CY, Liu M, Huang HT, Hsu WH, Kuan YC, Majumdar A, Lee KY, Feng PH, Tseng CH, Chen KY, Kang JH, Lee HC, Wu CJ, Liu WT. Association between air pollutant exposure, body water distribution and sleep disorder indices in individuals with low-arousal-threshold obstructive sleep apnoea. BMJ Open Respir Res 2023; 10:e001802. [PMID: 37940353 PMCID: PMC10632889 DOI: 10.1136/bmjresp-2023-001802] [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: 04/30/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Air pollution may alter body water distribution, it may also be linked to low-arousal-threshold obstructive sleep apnoea (low-ArTH OSA). Here, we explored the mediation effects of air pollution on body water distribution and low-ArTH OSA manifestations. METHODS In this retrospective study, we obtained sleep centre data from healthy participants and patients with low-ArTH OSA (N=1924) in northern Taiwan. Air pollutant exposure at different time intervals (1, 3, 6 and 12 months) was estimated using the nearest station estimation method, and government air-quality data were also obtained. Regression models were used to assess the associations of estimated exposure, sleep disorder indices and body water distribution with the risk of low-ArTH OSA. Mediation analysis was performed to explore the relationships between air pollution, body water distribution and sleep disorder indices. RESULTS First, exposure to particulate matter (PM) with a diameter of ≤10 µm (PM10) for 1 and 3 months and exposure to PM with a diameter of ≤2.5 µm (PM2.5) for 3 months were significantly associated with the Apnoea-Hypopnoea Index (AHI), Oxygen Desaturation Index (ODI), Arousal Index (ArI) and intracellular-to-extracellular water ratio (I-E water ratio). Significant associations were observed between the risk of low-ArTH OSA and 1- month exposure to PM10 (OR 1.42, 95% CI 1.09 to 1.84), PM2.5 (OR 1.33, 95% CI 1.02 to 1.74) and ozone (OR 1.27, 95% CI 1.01 to 1.6). I-E water ratio alternation caused by 1-month exposure to PM10 and 3-month exposure to PM2.5 and PM10 had partial mediation effects on AHI and ODI. CONCLUSION Air pollution can directly increase sleep disorder indices (AHI, ODI and ArI) and alter body water distribution, thus mediating the risk of low-ArTH OSA.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Ming Liu
- Department of Biology, University of Oxford, Oxford, UK
| | - Huei-Tyng Huang
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Pulmonary Medicine,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Pulmonary Medicine,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Hua Tseng
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Pulmonary Medicine,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Jiunn-Horng Kang
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University College of Medicine, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, 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 Ministry of Health and Welfare, New Taipei, Taiwan
| | - Wen-Te Liu
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University College of Medicine, Taipei, Taiwan
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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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18
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Xiong Q, Wang W, Wang Y, Zhang M, Rao B, Ji X, Xu Z, Wu S, Deng F. Long-term exposures to ambient particulate matter and ozone pollution with lower extremity deep vein thrombosis after surgical operations: a retrospective case-control study in Beijing, China. BMC Public Health 2023; 23:1956. [PMID: 37814263 PMCID: PMC10563341 DOI: 10.1186/s12889-023-16882-3] [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: 05/10/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Lower extremity deep vein thrombosis (LEDVT) after surgical operations is a common and fatal disease leading to unfavorable outcomes including death. Nevertheless, there has been insufficient evidence on the associations between ambient air pollution and LEDVT, particularly studies from developing regions. METHODS Based on 302 LEDVT cases and 302 controls in a general hospital in Beijing, China, this unmatched retrospective case-control study investigated the associations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), and ozone (O3) with odds of LEDVT. RESULTS Per 10 μg/m3 increase in PM2.5, PM10, and O3 at 3-month, 6-month, and 2-year average was associated with increased LEDVT odds [odds ratios (ORs) for PM2.5: 1.10 (95%CI: 1.05, 1.14), 1.14 (95%CI: 1.09, 1.18), and 1.30 (95%CI: 1.06, 1.61); ORs for PM10: 1.06 (95%CI: 1.02, 1.10), 1.12 (95%CI: 1.08, 1.16), and 1.29 (95%CI: 1.03, 1.61); ORs for O3: 1.00 (95%CI: 0.96, 1.04), 1.16 (95%CI: 1.02, 1.31), and 2.08 (95%CI: 1.03, 4.18), respectively]. The stratified analyses, exposure-responses curves, and sensitivity analyses further highlighted the robustness of our findings. CONCLUSIONS Long-term exposures to ambient PM2.5, PM10, and O3 may increase the risk of LEDVT in patients after surgical operations. The results may be implicated in the prevention and control of adverse clinical outcomes of surgical patients associated with ambient air pollution.
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Affiliation(s)
- Qin Xiong
- Education Department, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
| | - Wanzhou Wang
- Education Department, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
- National Institute of Health Data Science, Peking University Health Science Center, Beijing, China
| | - Yong Wang
- Beijing First Aid Center, Beijing, 100031, China
| | - Min Zhang
- Medical Insurance Management Office, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Benqiang Rao
- Second Ward of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Xuezhao Ji
- Education Department, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhihu Xu
- Education Department, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
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19
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Balakrishnan B, Callahan SJ, Cherian SV, Subramanian A, Sarkar S, Bhatt N, Scholand MB. Climate Change for the Pulmonologist: A Focused Review. Chest 2023; 164:963-974. [PMID: 37054776 DOI: 10.1016/j.chest.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/15/2023] Open
Abstract
Climate change adversely impacts global health. Increasingly, temperature variability, inclement weather, declining air quality, and growing food and clean water supply insecurities threaten human health. Earth's temperature is projected to increase up to 6.4 °C by the end of the 21st century, exacerbating the threat. Public and health care professionals, including pulmonologists, perceive the detrimental effects of climate change and air pollution and support efforts to mitigate its effects. In fact, evidence is strong that premature cardiopulmonary death is associated with air pollution exposure via inhalation through the respiratory system, which functions as a portal of entry. However, little guidance is available for pulmonologists in recognizing the effects of climate change and air pollution on the diverse range of pulmonary disorders. To educate and mitigate risk for patients competently, pulmonologists must be armed with evidence-based findings of the impact of climate change and air pollution on specific pulmonary diseases. Our goal is to provide pulmonologists with the background and tools to improve patients' health and to prevent adverse outcomes despite climate change-imposed threats. In this review, we detail current evidence of climate change and air pollution impact on a diverse range of pulmonary disorders. Knowledge enables a proactive and individualized approach toward prevention strategies for patients, rather than merely treating ailments reactively.
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Affiliation(s)
- Bathmapriya Balakrishnan
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, West Virginia University, Morgantown, WV; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL.
| | - Sean J Callahan
- Division of Pulmonary Medicine, University of Utah Health, Salt Lake City, UT; Division of Pulmonary Medicine, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Sujith V Cherian
- Division of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Abirami Subramanian
- Department of Pulmonary and Critical Care Medicine, Baylor Scott and White Health, Dallas, TX; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Sauradeep Sarkar
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, West Virginia University, Morgantown, WV
| | - Nitin Bhatt
- Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University, Columbus, OH; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Mary-Beth Scholand
- Division of Pulmonary Medicine, University of Utah Health, Salt Lake City, UT; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
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20
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Gueye-Ndiaye S, Williamson AA, Redline S. Disparities in Sleep-Disordered Breathing: Upstream Risk Factors, Mechanisms, and Implications. Clin Chest Med 2023; 44:585-603. [PMID: 37517837 PMCID: PMC10513750 DOI: 10.1016/j.ccm.2023.03.012] [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] [Indexed: 08/01/2023]
Abstract
Sleep-disordered breathing (SDB) refers to a spectrum of disorders ranging from habitual snoring without frank episodes of obstructed breathing or desaturation during sleep to obstructive sleep apnea, where apneas and hypopneas repetitively occur with resultant intermittent hypoxia, arousal, and sleep disruption. Disparities in SDB reflect its overall high prevalence in children and adults from racially and ethnically minoritized or low socioeconomic status backgrounds coupled with high rates of underdiagnosis and suboptimal treatment.
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Affiliation(s)
- Seyni Gueye-Ndiaye
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Ariel A Williamson
- Children's Hospital of Philadelphia, 2716 South Street Boulevard, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan Redline
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA.
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21
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Wallace DA, Gallagher JP, Peterson SR, Ndiaye-Gueye S, Fox K, Redline S, Johnson DA. Is exposure to chemical pollutants associated with sleep outcomes? A systematic review. Sleep Med Rev 2023; 70:101805. [PMID: 37392613 PMCID: PMC10528206 DOI: 10.1016/j.smrv.2023.101805] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/25/2023] [Accepted: 06/08/2023] [Indexed: 07/03/2023]
Abstract
Environmental exposures may influence sleep; however, the contributions of environmental chemical pollutants to sleep health have not been systematically investigated. We conducted a systematic review to identify, evaluate, summarize, and synthesize the existing evidence between chemical pollutants (air pollution, exposures related to the Gulf War and other conflicts, endocrine disruptors, metals, pesticides, solvents) and dimensions of sleep health (architecture, duration, quality, timing) and disorders (sleeping pill use, insomnia, sleep-disordered breathing)). Of the 204 included studies, results were mixed; however, the synthesized evidence suggested associations between particulate matter, exposures related to the Gulf War, dioxin and dioxin-like compounds, and pesticide exposure with worse sleep quality; exposures related to the Gulf War, aluminum, and mercury with insomnia and impaired sleep maintenance; and associations between tobacco smoke exposure with insomnia and sleep-disordered breathing, particularly in pediatric populations. Possible mechanisms relate to cholinergic signaling, neurotransmission, and inflammation. Chemical pollutants are likely key determinants of sleep health and disorders. Future studies should aim to evaluate environmental exposures on sleep across the lifespan, with a particular focus on developmental windows and biological mechanisms, as well as in historically marginalized or excluded populations.
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Affiliation(s)
- Danielle A Wallace
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Jayden Pace Gallagher
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shenita R Peterson
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | - Seyni Ndiaye-Gueye
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kathleen Fox
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Dayna A Johnson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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22
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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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23
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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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24
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Lin Y, Gao Y, Sun X, Wang J, Ye S, Wu IXY, Xiao F. Long-term exposure to ambient air pollutants and their interaction with physical activity on insomnia: A prospective cohort study. ENVIRONMENTAL RESEARCH 2023; 224:115495. [PMID: 36813065 DOI: 10.1016/j.envres.2023.115495] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Exposure to air pollution or lack of physical activity (PA) increases the risk of insomnia. However, evidence on joint exposure to air pollutants is limited, and the interaction of joint air pollutants and PA on insomnia is unknown. This prospective cohort study included 40,315 participants with related data from the UK Biobank, which recruited participants from 2006 to 2010. Insomnia was assessed by self-reported symptoms. The annual average air pollutant concentrations of particulate matter (PM2.5, PM10), nitrogen oxides (NO2, NOX), sulfur dioxide (SO2) and carbon monoxide (CO) were calculated based on participants' addresses. We applied a weighted Cox regression model to evaluate the correlation between air pollutants and insomnia and newly proposed an air pollution score to assess joint air pollutants effect using a weighted concentration summation after obtaining the weights of each pollutant in the Weighted-quantile sum regression. With a median follow-up of 8.7 years, 8511 participants developed insomnia. For each 10 μg/m³ increase in NO2, NOX, PM10, SO2, the average hazard ratios (AHRs) and 95% confidence interval (CI) of insomnia were 1.10 (1.06, 1.14), 1.06 (1.04, 1.08), 1.35 (1.25, 1.45) and 2.58 (2.31, 2.89), respectively; For each 5 μg/m³ increase in PM2.5 and each 1 mg/m³ increase in CO, the corresponding AHRs (95%CI) were 1.27 (1.21, 1.34) and 1.83 (1.10, 3.04), respectively. The AHR (95%CI) for insomnia associated with per interquartile range (IQR) increase in air pollution scores were 1.20 (1.15, 1.23). In addition, potential interactions were examined by setting cross-product terms of air pollution score with PA in the models. We observed an interaction between air pollution scores and PA (P = 0.032). The associations between joint air pollutants and insomnia were attenuated among participants with higher PA. Our study provides evidence on developing strategies for improving healthy sleep by promoting PA and reducing air pollution.
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Affiliation(s)
- Yijuan Lin
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Jiali Wang
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Shuzi Ye
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Fang Xiao
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China.
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Zhang W, Wang J, Chen B, Ji X, Zhao C, Chen M, Liao S, Jiang S, Pan Z, Wang W, Li L, Chen Y, Guo X, Deng F. Association of multiple air pollutants with oxygen saturation during sleep in COPD patients: Effect modification by smoking status and airway inflammatory phenotypes. JOURNAL OF HAZARDOUS MATERIALS 2023; 454:131550. [PMID: 37148791 DOI: 10.1016/j.jhazmat.2023.131550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/11/2023] [Accepted: 04/30/2023] [Indexed: 05/08/2023]
Abstract
Air pollution contributes substantially to the development of chronic obstructive pulmonary disease (COPD). To date, the effect of air pollution on oxygen saturation (SpO2) during sleep and potential susceptibility factors remain unknown. In this longitudinal panel study, real-time SpO2 was monitored in 132 COPD patients, with 270 nights (1615 h) of sleep SpO2 recorded. Exhaled nitric oxide (NO), hydrogen sulfide (H2S) and carbon monoxide (CO) were measured to assess airway inflammatory characteristics. Exposure levels of air pollutants were estimated by infiltration factor method. Generalized estimating equation was used to investigate the effect of air pollutants on sleep SpO2. Ozone, even at low levels (<60 μg/m3), was significantly associated with decreased SpO2 and extended time of oxygen desaturation (SpO2 < 90%), especially in the warm season. The associations of other pollutants with SpO2 were weak, but significant adverse effects of PM10 and SO2 were observed in the cold season. Notably, stronger effects of ozone were observed in current smokers. Consistently, smoking-related airway inflammation, characterized by higher levels of exhaled CO and H2S but lower NO, significantly augmented the effect of ozone on SpO2 during sleep. This study highlights the importance of ozone control in protecting sleep health in COPD patients.
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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
| | - 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
| | - Baiqi Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Chen Zhao
- Community Health Service Center, Huayuan Road, Haidian District, Beijing 100088, China
| | - Maike Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 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
| | - Zihan Pan
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 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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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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Liu F, Zhou F, Zhang K, Wu T, Pan M, Wang X, Tong J, Chen Z, Xiang H. Effects of air pollution and residential greenness on sleep disorder: A 8-year nationwide cohort study. ENVIRONMENTAL RESEARCH 2023; 220:115177. [PMID: 36584850 DOI: 10.1016/j.envres.2022.115177] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Sleep disorder influencing the quality of life, however, its contributing factors have not been fully identified yet. Recently the potential effects of environmental exposures like air pollution and greenness on sleep disorder have attracted attention, but the evidence in China is limited, particularly in the middle-aged and elderly. METHODS We conducted a nationwide prospective study that included 21,878 Chinese citizens aged 45 years or above. For each participant, the 3-year averaged exposure concentrations of air pollutants (including PM10, PM2.5, PM1, NO2) and greenness (assessed by NDVI) were estimated based on residential address. We used mixed-effects logistic models to examine the associations of sustained air pollutants and greenness exposures with the occurrence of sleep disorder, and used linear mixed-effects models to assess the associations with sleep duration. Specifically, interaction effects models were employed to identify potential modificators of the above associations. RESULTS A total of 39,580 survey responses were received, with the overall occurrence rate of sleep disorder was 25.7%. A 10 μg/m3 increment in PM10 and PM2.5 were associated with increased occurrence of sleep disorder at 2% (aOR = 1.02, 95%CI:1.01, 1.04) and 7% (aOR = 1.07, 95%CI: 1.04, 1.11), and were associated with reduced sleep duration by 0.07 (95% CI: 0.08, 0.05) and 0.04 (95% CI: 0.05, 0.03) hours, respectively. Residential greenness appears to the potential protective factor for sleep disorder, that a 0.1 higher of the NDVI was associated a 9% (aOR = 0.91, 95%CI: 0.86, 0.96) decreased occurrence of sleep disorder and 0.09 h (95% CI: 0.05, 0.13) longer of sleep duration. Age and residence were identified as modificators of the above significant associations. CONCLUSION Sustained exposure to air pollutants can increase the occurrence of sleep disorder and can reduce sleep duration, while exposure to higher levels of greenness can protect sleep health from the side effects of air pollutants.
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Affiliation(s)
- 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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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28
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Balmes JR. Can Breathing Poor-quality Air Lead to Poor-quality Sleep in Children? Am J Respir Crit Care Med 2023; 207:510-511. [PMID: 36342427 PMCID: PMC10870902 DOI: 10.1164/rccm.202210-1968ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- John R Balmes
- Department of Medicine University of California San Francisco San Francisco, California
- School of Public Health University of California Berkeley Berkeley, California
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29
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Sowho MO, Koch AL, Putcha N, Woo H, Gassett A, Paulin LM, Koehler K, Barr RG, Comellas AP, Cooper CB, Barjaktarevic I, Zeidler MR, Billings ME, Bowler RP, Han MK, Kim V, Paine Iii R, Parekh TM, Krishnan JA, Peters SP, Woodruff PG, Baugh AM, Kaufman JD, Couper D, Hansel NN. Ambient Air Pollution Exposure and Sleep Quality in COPD. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:102-111. [PMID: 36599095 PMCID: PMC9995229 DOI: 10.15326/jcopdf.2022.0350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/05/2023]
Abstract
Rationale Ambient air pollution exposure is associated with respiratory morbidity among individuals with chronic obstructive pulmonary disease (COPD), particularly among those with concomitant obesity. Although people with COPD report high incidence of poor sleep quality, no studies have evaluated the association between air pollution exposure, obesity, and sleep disturbances in COPD. Methods We analyzed data collected from current and former smokers with COPD enrolled in the Subpopulations and Intermediate Outcome Measures in COPD -Air Pollution ancillary study (SPIROMICS AIR). Socio-demographics and anthropometric measurements were collected, and 1-year mean historical ambient particulate matter (PM2.5) and ozone concentrations at participants' residences were estimated by cohort-specific spatiotemporal modeling. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and regression models were constructed to determine the association of 1-year PM2.5 (1Yr-PM2.5) and 1-year ozone (1Yr-ozone) with the PSQI score, and whether obesity modified the association. Results In 1308 participants (age: 65.8±7.8 years, 42% women), results of regression analyses suggest that each 10µg/m3 increase in 1Yr-PM2.5 was associated with a 2.1-point increase in PSQI (P=0.03). Obesity modified the association between 1Yr-PM2.5 and PSQI (P=0.03). In obese and overweight participants, a 10µg/m3 increase in 1Yr-PM2.5 was associated with a higher PSQI (4.0 points, P<0.01, and 3.4 points, P<0.01, respectively); but no association in lean-normal weight participants (P=0.51). There was no association between 1 Yr-ozone and PSQI. Conclusions Overweight and obese individuals with COPD appear to be susceptible to the effects of ambient PM2.5 on sleep quality. In COPD, weight and ambient PM2.5 may be modifiable risk factors to improve sleep quality.
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Affiliation(s)
- Mudiaga O Sowho
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Abigail L Koch
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States
| | - Nirupama Putcha
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Han Woo
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Amanda Gassett
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
| | - Laura M Paulin
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York, United States
| | - Alejandro P Comellas
- Division of Pulmonary, Critical Care, and Occupational Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Christopher B Cooper
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Michelle R Zeidler
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Martha E Billings
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
| | - Russell P Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, United States
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Victor Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States
| | - Robert Paine Iii
- Division of Respiratory, Critical Care and Occupational Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Trisha M Parekh
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Stephen P Peters
- Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University, Winston-Salem, North Carolina, United States
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Francisco, San Francisco, California, United States
| | - Aaron M Baugh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Francisco, San Francisco, California, United States
| | - Joel D Kaufman
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
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Haugen T, Prichardo P, Hellums R, Lindemann L. Climate Change and Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 2023; 168:1261-1263. [PMID: 36939516 DOI: 10.1002/ohn.189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 01/20/2023]
Abstract
The COVID-19 pandemic has illustrated that global events can have a profound impact on our health systems. While the pandemic is unprecedented, it does underscore the need to prepare for future global health concerns. Climate change is a looming threat with significant consequences for otolaryngologists and our patients. In this commentary, we discuss the need to assess our preparedness for climate change as well as the importance of reflecting on our responsibility to minimize our footprint.
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Affiliation(s)
- Thorsen Haugen
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Priscilla Prichardo
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Ryan Hellums
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Logan Lindemann
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, Pennsylvania, USA
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Examining the influence of built environment on sleep disruption. ENVIRONMENTAL EPIDEMIOLOGY (PHILADELPHIA, PA.) 2023; 7:e239. [PMID: 36777529 PMCID: PMC9916058 DOI: 10.1097/ee9.0000000000000239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023]
Abstract
Modifying aspects of the built environment may be an effective strategy for population-level improvements to sleep. However, few comprehensive evaluations of built environment and sleep have been completed. Methods We conducted a cross-sectional study among participants of the British Columbia Generations Project (BCGP) who self-reported sleep duration (n = 28,385). Geospatial measures of light-at-night (LAN), greenness, air pollution (PM2.5, NO2, SO2), and road proximity were linked to participant baseline residential postal codes. Logistic regression models, adjusted for age and sex, were used to estimate the association between these factors and self-reported sleep duration (<7 vs. ≥7 hours). Results Interquartile range (IQR) increases in LAN intensity, greenness, and SO2 were associated with 1.04-fold increased (95% CI = 1.02, 1.07), 0.95-fold decreased (95% CI = 0.91, 0.98), and 1.07-fold increased (95% CI = 1.03, 1.11) odds, respectively, of reporting insufficient sleep (i.e., <7 hours per night). Living <100 m from a main roadway was associated with a 1.09-fold greater odds of insufficient sleep (95% CI = 1.02, 1.17). Results were unchanged when examining all factors together within a single regression model. In stratified analyses, associations with SO2 were stronger among those with lower reported annual household incomes and those living in more urban areas. Conclusions BCGP's rich data enabled a comprehensive evaluation of the built environment, revealing multiple factors as potentially modifiable determinants of sleep disruption. In addition to longitudinal evaluations, future studies should pay careful attention to the role of social disparities in sleep health.
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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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Zare Sakhvidi MJ, Lafontaine A, Lequy E, Berr C, de Hoogh K, Vienneau D, Goldberg M, Zins M, Lemogne C, Jacquemin B. Ambient air pollution exposure and depressive symptoms: Findings from the French CONSTANCES cohort. ENVIRONMENT INTERNATIONAL 2022; 170:107622. [PMID: 36384066 DOI: 10.1016/j.envint.2022.107622] [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: 07/13/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM Few studies have reported the association between air pollution exposure with different dimensions of depression. We aimed to explore this association across different dimensions of depressive symptoms in a large population. METHODS Data from the enrollment phase of the French CONSTANCES cohort (2012-2020) were analyzed cross-sectionally. Annual concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) from the land-use regression models were assigned to the residential addresses of participants. Total depressive symptoms and its four dimensions (depressed affect, disturbed interpersonal relations, low positive affect, somatic complaints) were measured using Centre of Epidemiologic Studies Depression questionnaire (CES-D). We reported results of negative binomial regression models (reported as Incidence Rate Ratio (IRR) and 95 % confidence interval (CI) for an interquartile range (IQR) increase in exposure), for each pollutant separately. Stratified analyses were performed by sex, income, family status, education, and neighborhood deprivation. RESULTS The study included 123,754 participants (mean age, 46.50 ± 13.61 years; 52.4 % women). The mean concentration of PM2.5, BC and NO2 were 17.14 µg/m3 (IQR = 4.89), 1.82 10-5/m (IQR = 0.88) and 26.58 µg/m3 (IQR = 17.41) respectively. Exposures to PM2.5, BC and NO2 were significantly associated with a higher CES-D total (IRR = 1.022; 95 % CI = 1.002: 1.042, IRR = 1.027; 95 % CI = 1.013: 1.040, and IRR = 1.029; 95 % CI = 1.015: 1.042 respectively), and with depressed affect, and somatic complaints. For all pollutants, a higher estimate was observed for depressed affect. We found stronger adverse associations for men, lower-income participants, low and middle education groups, those living in highly deprived areas, and single participants. CONCLUSION Our finding could assist the exploration of the etiological pathway of air pollution on depression and also considering primary prevention strategies in the areas with air pollution.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Antoine Lafontaine
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Emeline Lequy
- Université Paris Cité, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Claudine Berr
- University of Montpellier, INM, Inserm U1198 Neuropeps team, Montpellier, France; Memory Research and Resources Center, Department of Neurology, Montpellier, France
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Marcel Goldberg
- Université Paris Cité, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Marie Zins
- Université Paris Cité, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Cédric Lemogne
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, F-75014 Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
| | - Bénédicte Jacquemin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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Association between ambient air pollution exposure and insomnia among adults in Taipei City. Sci Rep 2022; 12:19064. [PMID: 36351973 PMCID: PMC9646727 DOI: 10.1038/s41598-022-21964-0] [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: 06/09/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022] Open
Abstract
Ambient air pollution was known to cause central nervous system diseases and depressive symptoms. In this study, we examined the associations between air pollution exposure and the prevalence of insomnia in Taipei City of Taiwan. We applied the health information system of electrical medical records of Taipei City Hospital to collect a total of 5108 study subjects (insomniacs N = 912 and non-insomniacs N = 4196) over 18 years old from the family medicine and internal medicine outpatients of six branches of Taipei City Hospital. These patients were grouped into insomniacs and non-insomniacs following the primary insomnia diagnosis (ICD9:780.52, 780.54, 307.41, 307.42, ICD10: G47.00, G47.01, G47.09, F51.01, F51.09) and the prescription times of anxiolytics and hypnotics. We estimated one-year average concentrations of PM2.5, ozone, and NOx before the first date of insomnia diagnosis and the last date of outpatient visit for insomniacs and non-insomniacs, respectively, by using the data of nearest air quality monitoring stations relative to study subjects' residential addresses. Logistic regression analysis was employed to examine the independent effects of air pollution concentrations on the risk of insomnia. One-year average PM2.5, ozone, and NOx levels for insomniacs was significantly higher than those of non-insomniacs. After adjusting for confounding factors, increase each 1(μg/m3) in one-year average PM2.5 showed a statistically significant association with insomnia (the odds ratio 1.610, 95% CI [1.562,1.660]). As to multi pollutants, one-year average PM2.5 (1.624, [1.570, 1.681] and ozone (1.198, [1.094, 1.311]) exposure showed a significant association with insomnia. Subgroup analysis revealed that the influence of PM2.5 and ozone on insomnia have significant risks in people with major chronic disease. This study demonstrated a positive association between PM2.5 and ozone exposure and the prevalence of hypnotic-treated insomnia. Especially, the people with major chronic diseases were with obvious effect of PM2.5 and ozone on risk of insomnia.
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Dasari SS, Archer M, Mohamed NE, Tewari AK, Figueiro MG, Kyprianou N. Circadian Rhythm Disruption as a Contributor to Racial Disparities in Prostate Cancer. Cancers (Basel) 2022; 14:cancers14205116. [PMID: 36291899 PMCID: PMC9600368 DOI: 10.3390/cancers14205116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 01/27/2023] Open
Abstract
In the United States, African American (AA) men have a 2.4 times higher mortality rate due to prostate cancer than White men. The multifactorial causes of the racial disparities in prostate cancer involve various social determinants of health, socioeconomic status, and access to healthcare. However, emerging evidence also suggests that circadian rhythm disruption (CRD) contributes to prostate cancer, and AA men may be more susceptible to developing CRDs. Circadian rhythms play a significant role in metabolism, hormone secretion, and sleep/wake cycles. Disruption in these circadian rhythms can be caused by airplane travel/jetlag, night shift work, exposure to light, and neighborhood noise levels, which can contribute to sleep disorders and chronic conditions such as obesity, diabetes, cardiovascular disease, and depression. The drivers of the racial disparities in CRD include night shift work, racial discrimination, elevated stress, and residing in poor neighborhoods characterized by high noise pollution. Given the increased vulnerability of AA men to CRDs, and the role that CRDs play in prostate cancer, elucidating the clock-related prostate cancer pathways and their behavior and environmental covariates may be critical to better understanding and reducing the racial disparities in prostate cancer.
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Affiliation(s)
- Sonali S. Dasari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maddison Archer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
| | - Ashutosh K. Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mariana G. Figueiro
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
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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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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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Li D, Wang L, Yang Y, Hu Y, Wang Y, Tian Y, Wang F. Associations of long-term exposure to ambient air pollution and road traffic noise with sleep health in UK Biobank. J Affect Disord 2022; 310:1-9. [PMID: 35513113 DOI: 10.1016/j.jad.2022.04.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/06/2022] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence about associations of pollutants with sleep is limited, and most of studies focused on individual sleep behaviors, neglecting their interrelation. We aimed to assess the relationship between ambient air pollution and road traffic noise with overall sleep health. METHODS The study included 378,223 participants from the UK Biobank. Including five sleep behaviors (chronotype, sleep duration, insomnia, snoring, and daytime sleepiness) to construct overall sleep pattern. Ambient air pollution exposure was estimated using Land Use Regression model. Road traffic noise exposure was estimated using a simplified version of the Common Noise Assessment Methods model. Using multinomial and binary logistic regression models to identify the associations between pollutants with overall and individual sleep behaviors, respectively. RESULTS Participants were derived in three sleep patterns: healthy (n = 140,490), intermediate (n = 220,627), and poor (n = 17,106). After adjustment for potential confounders, compared with the lowest quartile of PM2.5, the highest quartile had higher odds of intermediate and poor compared to healthy sleep pattern [OR (95% CI) for poor: 1.28 (1.21-1.36); for intermediate: 1.11 (1.09-1.14)]. We observed similar relationships for PM10, PM2.5 absorbance, PMcoarse, NOx, and NO2. In unadjusted model, compared with low exposure of Lnight, high Lnight exposure had higher odds of intermediate and poor compared to healthy sleep pattern [OR (95% CI) for poor: 1.13 (1.06-1.20); for intermediate: 1.03 (1.00-1.06)]. However, such associations disappeared after further adjustment for potential confounders. CONCLUSIONS Long-term ambient air pollution is associated with overall sleep health. Road traffic noise itself is weakly associated with overall sleep health.
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Affiliation(s)
- Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China
| | - Lulin Wang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China
| | - Yingping Yang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, China, 100191
| | - Youjie Wang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan 430030, China.
| | - Feng Wang
- Chinese Center for Health Education, Building 12, Block 1, Andingmenwai Anhuaxili, Beijing 100011, 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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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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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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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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Fausto BA, Gluck MA. Low body mass and high-quality sleep maximize the ability of aerobic fitness to promote improved cognitive function in older African Americans. ETHNICITY & HEALTH 2022; 27:909-928. [PMID: 32931310 PMCID: PMC7956916 DOI: 10.1080/13557858.2020.1821176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
ABSTRACTObjectives: Because African Americans are at elevated risk for cognitive decline and Alzheimer's disease, it is important to understand which health and lifestyle factors are most important for reducing this risk. Obesity and poor sleep quality are common in lower-income, urban African Americans and have been linked to cognitive decline in older age. Fortunately, increasing aerobic fitness via regular exercise can improve cognitive function. This study sought to (1) examine the cross-sectional relationship between aerobic fitness and cognitive function in older African Americans, and (2) determine whether body mass index and sleep quality moderated the relationship between aerobic fitness and cognition.Design: 402 older African Americans, ages 60-90 (84% female, mean education level = 14 years) completed neuropsychological testing, computerized behavioral tasks, physical performance measures, and health and lifestyle questionnaires. Hierarchical linear regressions were performed to determine associations between aerobic fitness and cognition and whether body mass index and sleep quality moderate the fitness-cognition relationship while controlling for age, sex, education, depressive symptoms, and literacy.Results: Higher aerobic fitness levels were significantly associated with better executive function. The relationships between fitness and hippocampal-dependent cognitive functions (learning and memory, generalization) were attenuated in those who are obese (body mass index ≥ 30 kg/m2) or rated their sleep quality as poor, ps < .05.Conclusion: Our results suggest that while exercise and associated improvements in aerobic fitness are key for improved cognition, these benefits are maximized in those who maintain low body weight and get sufficient, high quality sleep. Exercise programs for older African Americans will be most effective if they are integrated with education programs that emphasize healthy eating, weight control, and sleep hygiene and conceptualize individuals as part of their broader social and environmental context.
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Affiliation(s)
- Bernadette A. Fausto
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, NJ, United States
- Corresponding author: Bernadette A. Fausto, PhD, Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, 197 University Ave., Suite 209, Newark, NJ 07102, United States, Phone: (973) 353-3673,
| | - Mark A. Gluck
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, NJ, United States
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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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Kim B, Branas CC, Rudolph KE, Morrison CN, Chaix B, Troxel WM, Duncan DT. Neighborhoods and sleep health among adults: A systematic review. Sleep Health 2022; 8:322-333. [DOI: 10.1016/j.sleh.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
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Nathu VD, Virkutyte J, Rao MB, Nieto-Caballero M, Hernandez M, Reponen T. Direct-Read Fluorescence-Based Measurements of Bioaerosol Exposure in Home Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063613. [PMID: 35329300 PMCID: PMC8951687 DOI: 10.3390/ijerph19063613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/06/2023]
Abstract
Home healthcare workers (HHCWs) are subjected to variable working environments which increase their risk of being exposed to numerous occupational hazards. One of the potential occupational hazards within the industry includes exposure to bioaerosols. This study aimed to characterize concentrations of three types of bioaerosols utilizing a novel fluorescence-based direct-reading instrument during seven activities that HHCWs typically encounter in patients’ homes. Bioaerosols were measured in an indoor residence throughout all seasons in Cincinnati, OH, USA. A fluorescence-based direct-reading instrument (InstaScope, DetectionTek, Boulder, CO, USA) was utilized for all data collection. Total particle counts and concentrations for each particle type, including fluorescent and non-fluorescent particles, were utilized to form the response variable, a normalized concentration calculated as a ratio of concentration during activity to the background concentration. Walking experiments produced a median concentration ratio of 52.45 and 2.77 for pollen and fungi, respectively. Fungi and bacteria produced the highest and lowest median concentration ratios of 17.81 and 1.90 for showering, respectively. Lastly, our current study showed that sleeping activity did not increase bioaerosol concentrations. We further conclude that utilizing direct-reading methods may save time and effort in bioaerosol-exposure assessment.
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Affiliation(s)
- Vishal D. Nathu
- Department of Environmental & Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45267-0056, USA; (V.D.N.); (J.V.); (M.B.R.)
| | - Jurate Virkutyte
- Department of Environmental & Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45267-0056, USA; (V.D.N.); (J.V.); (M.B.R.)
| | - Marepalli B. Rao
- Department of Environmental & Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45267-0056, USA; (V.D.N.); (J.V.); (M.B.R.)
| | - Marina Nieto-Caballero
- Department of Environmental Engineering, College of Engineering & Applied Science, University of Colorado Boulder, Boulder, CO 80309-0428, USA; (M.N.-C.); (M.H.)
| | - Mark Hernandez
- Department of Environmental Engineering, College of Engineering & Applied Science, University of Colorado Boulder, Boulder, CO 80309-0428, USA; (M.N.-C.); (M.H.)
| | - Tiina Reponen
- Department of Environmental & Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45267-0056, USA; (V.D.N.); (J.V.); (M.B.R.)
- Correspondence:
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47
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Chen L, Xie J, Ma T, Chen M, Gao D, Li Y, Ma Y, Wen B, Jiang J, Wang X, Zhang J, Chen S, Wu L, Li W, Liu X, Dong B, Wei J, Guo X, Huang S, Song Y, Dong Y, Ma J. Greenness alleviates the effects of ambient particulate matter on the risks of high blood pressure in children and adolescents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152431. [PMID: 34942264 DOI: 10.1016/j.scitotenv.2021.152431] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/01/2021] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
Both ambient particulate matter (PM) and decrease of greenness have been suggested as risk factors for high blood pressure (HBP) in children and adolescents. But most evidence were from cross-sectional studies with limited data from prospective cohorts. In this cohort study, we included 588,004 children and adolescents aged 7 to 18 years without HBP from 2005 to 2018 in Beijing (240,081) and Zhongshan (347,923) city of China. The cumulative incidence of HBP was 32.04%, and incidence rate was 14.86 per 100 person-year. After adjustment for confounders, the ten-unit increase in PM1, PM2.5, and PM10 exposure was significantly associated with 43%, 70%, and 43%- higher risks of HBP, respectively, but the 0.1-unit increase in NDVI exposure was significantly associated with a 25% lower risk of HBP. The HRs of PM1 on the HBP risk were 1.486 and 1.150 in the low and the high-level of greenness, and they were 2.635 and 2.507 for PM2.5, and for PM10 1.367 and 1.702 in the two groups. The attributable fraction (AFs) of PM1, PM2.5, and PM10 on HBP incidents were 13.74%, 40.08%, and 15.47% in the low-level of greenness, which simultaneously was higher than those in the high-level of greenness (AF = 4.62%, 17.28%, and 9.96%). The exposure to higher ambient PM air pollution and lower greenness around schools were associated with a higher risk of HBP in children and adolescents, but higher greenness alleviated the adverse effects of ambient PM1 and PM2.5 on the HBP risks. Our findings highlighted a synergic strategy in preventing childhood HBP by decreasing air pollution reduction and improving greenness concurrently.
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Affiliation(s)
- Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Junqing Xie
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Di Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Jun Jiang
- Department of Plant Science and Landscape Architecture, University of Maryland, USA
| | - Xijie Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China; Wanke School of Public Health, Tsinghua University, Beijing, China
| | - Jingbo Zhang
- Beijing Health Center for Physical Examination, Beijing 100191, China
| | - Shuo Chen
- Beijing Health Center for Physical Examination, Beijing 100191, China
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Weiming Li
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Sizhe Huang
- Zhongshan Health Care Centers for Primary and Secondary School, Zhongshan 528403, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
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Mata C, Lappharat S, Chusiri Y, Khumjorhor M, Taneepanichskul N. Effect of residential proximity to the lignite-fired power plant on depression, sleep quality, and morning salivary cortisol in the elderly. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 811:151346. [PMID: 34728209 DOI: 10.1016/j.scitotenv.2021.151346] [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: 08/25/2021] [Revised: 10/14/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Exposures to air pollution of by-products emission from the lignite-fired power plant elevated risks of carcinogenic effects, endocrine disruptors, central nervous system structural and functional changes. Residence in the proximity of the lignite-fired power plant appeared to have more chance to have higher risks of health problems. This study aimed to assess associations of residential proximity to the lignite-fired power plant on depression, sleep quality, and morning salivary cortisol among the elderly. The distance of residential proximity to the power plant was categorized into three groups (units in kilometer): <10 km, 10-15 km, and >15 km. The coefficients of log (morning salivary cortisol) was -0.320 (95%CI: -0.460, -0.179; p-value < 0.001) for those living <10 km compared to those living >15 km. Coefficients of sleep quality score were 1.350 (95%CI: 0.265, 2.436; p-value = 0.015) for those living <10 km compared to those living >15 km. Residential proximity to the lignite-fired power plant was not associated with depression. Our study concluded that living within 10 km to the lignite-fired power plant was related to negative health outcomes among the elderly. Policymakers need to reconsider the distance of the buffer zone to the power plant.
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Affiliation(s)
- Chatsuda Mata
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand; Community Public Health, Lampang Rajabhat University, Lampang, Thailand.
| | - Sattamat Lappharat
- Department of Research and International Relations, Sirindhorn College of Public Health, Yala, Thailand.
| | - Yaowares Chusiri
- Chemistry Program, Faculty of Science, Lampang Rajabhat University, Lampang, Thailand.
| | | | - Nutta Taneepanichskul
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand; HAUS IAQ Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
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Park JW, Hamoda MM, Almeida FR, Wang Z, Wensley D, Alalola B, Alsaloum M, Tanaka Y, Huynh NT, Conklin AI. Socioeconomic inequalities in pediatric obstructive sleep apnea. J Clin Sleep Med 2022; 18:637-645. [PMID: 34170224 PMCID: PMC8805007 DOI: 10.5664/jcsm.9494] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To examine the association between multiple measures of socioeconomic status (SES) and objectively measured obstructive sleep apnea (OSA) in a Canadian pediatric population. METHODS This was a cross-sectional study of 188 children (4-17 years, mean age 9.3 ± 3.5 years) prospectively recruited from two hospital sleep clinics in Canada, using multivariable-adjusted linear and logistic regression of five measures of SES including parental education, income, social class, geographic location, and perceived SES based on the MacArthur Scale of Subjective Social Status, assessed in relation to four polysomnographic OSA variables including apnea-hypopnea index, apnea index, mean oxygen saturation level, and oxygen desaturation index. RESULTS Overall, low household-level SES appeared to be associated with both frequency (apnea index ≥ 1 events/h) and severity (apnea-hypopnea index ≥ 5 events/h) of OSA in children, with maternal education showing the most consistent and significant associations. Specifically, children with mothers reporting less than high school education had nearly three times the odds of having OSA after controlling factors including body mass index (odds ratio 2.96 [95% confidence interval, 1.05-8.37]), compared to university-educated participants. Consistent associations were also observed for geographic location with less frequency and severity of OSA among nonurban children. Perceived SES was minimally inversely associated with our outcomes. CONCLUSIONS This cross-sectional, multicenter study demonstrated that SES factors are linked to the occurrence and severity of OSA in children. Results indicated the need to incorporate the screening of SES in the diagnostic process of pediatric OSA to provide more targeted intervention and patient-centered care. CITATION Park JW, Hamoda MM, Almeida FR, et al. Socioeconomic inequalities in pediatric obstructive sleep apnea. J Clin Sleep Med. 2022;18(2):637-645.
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Affiliation(s)
- Ji Woon Park
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada,Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Mona M. Hamoda
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fernanda R. Almeida
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada,Address correspondence to: Fernanda R. Almeida, DDS, PhD, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada; Tel: +1-604-822-3623;
| | - Zitong Wang
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada,Department of Biostatistics, School of Global Public Health, New York University, New York, New York
| | - David Wensley
- Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bassam Alalola
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada,Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed Alsaloum
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia,Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yasue Tanaka
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada,Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Nelly T. Huynh
- Faculty of Dental Medicine, Université de Montréal, Montreal, Quebec, Canada,Centre de Recherche, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Annalijn I. Conklin
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Health Evaluation and Outcome Sciences, Providence Health Research Institute, St. Paul’s Hospital, Vancouver, British Columbia, Canada
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50
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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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