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Proulx K, Daelmans B, Baltag V, Banati P. Climate change impacts on child and adolescent health and well-being: A narrative review. J Glob Health 2024; 14:04061. [PMID: 38781568 PMCID: PMC11115477 DOI: 10.7189/jogh.14.04061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Worldwide, the climate is changing and affecting the health and well-being of children in many ways. In this review, we provided an overview of how climate change-related events may affect child and adolescent health and well-being, including children's mental and physical health, nutrition, safety and security, learning opportunities, and family caregiving and connectedness. Methods In this narrative review, we highlighted and discussed peer-reviewed evidence from 2012-23, primarily from meta-analyses and systematic reviews. The search strategy used a large and varied number of search terms across three academic databases to identify relevant literature. Results There was consistent evidence across systematic reviews of impact on four themes. Climate-related events are associated with a) increases in posttraumatic stress and other mental health disorders in children and adolescents, b) increases in asthma, respiratory illnesses, diarrheal diseases and vector-borne diseases, c) increases in malnutrition and reduced growth and d) disruptions to responsive caregiving and family functioning, which can be linked to poor caregiver mental health, stress and loss of resources. Evidence of violence against children in climate-related disaster contexts is inconclusive. There is a lack of systematic review evidence on the associations between climate change and children's learning outcomes. Conclusions Systematic review evidence consistently points to negative associations between climate change and children's physical and mental health, well-being, and family functioning. Yet, much remains unknown about the causal pathways linking climate-change-related events and mental and physical health, responsive relationships and connectedness, nutrition, and learning in children and adolescents. This evidence is urgently needed so that adverse health and other impacts from climate change can be prevented or minimised through well-timed and appropriate action.
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Affiliation(s)
| | - Bernadette Daelmans
- World Health Organization, Child Health and Development Unit, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Valentina Baltag
- World Health Organization, Adolescent and Young Adult Health Unit, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Prerna Banati
- World Health Organization, Adolescent and Young Adult Health Unit, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
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2
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Magnusdottir S, Hill EA. Prevalence of obstructive sleep apnea (OSA) among preschool aged children in the general population: A systematic review. Sleep Med Rev 2024; 73:101871. [PMID: 37976758 DOI: 10.1016/j.smrv.2023.101871] [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: 06/01/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
Untreated pediatric obstructive sleep apnea (OSA) is associated with significant morbidities affecting behavior, neurocognitive development, endocrine and metabolic health. This systematic review evaluated prevalence of OSA reported in population-based studies among preschoolers as early intervention may have positive effects on health and quality of life. Thirty studies were included. High degrees of heterogeneity in methods and definitions were observed between the studies. Seven studies confirmed OSA by implementing objective methods after screening for habitual snoring with only two studies utilizing polysomnography, the reference standard, testing 1.2% of the combined cohorts (n = 82/4575) to confirm disease. Diagnosis of OSA was based on utilizing retired thresholds of the apnea-hypopnea-index (AHI), AHI4%≥5/hour of sleep (hrSleep), reporting prevalence of 1.8% and 6.4%, respectively. The remaining five studies implemented relatively insensitive objective recording methods to confirm disease in a limited number of children (n = 449/2486; 18.0%), estimating prevalence in the range of 0.7%-13.0%. The remaining literature is based on implementing questionnaires only to evaluate OSA. Studies published before 2014 reported 3.3%-9.4% prevalence, while more recent studies published 2016-2023 report higher prevalence, 12.8%-20.4%, when excluding outliers. This trend suggests that prevalence of OSA may possibly have been increasing in preschoolers over the past decade.
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Affiliation(s)
- Solveig Magnusdottir
- MyCardio LLC, SleepImage®, 3200 E Cherry Creek South Drive, Denver, CO, 80209, USA.
| | - Elizabeth A Hill
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Dorothy Crowfoot Hodgkin Building, South Parks Road, Oxford, OX1 3QU, UK
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Saelee R, Haardörfer R, Johnson DA, Gazmararian JA, Suglia SF. Neighborhood and Household Environment as Contributors to Racial Disparities in Sleep Duration among U.S. Adolescents. SLEEP EPIDEMIOLOGY 2023; 3:100065. [PMID: 38188485 PMCID: PMC10769009 DOI: 10.1016/j.sleepe.2023.100065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Objective Racial disparities in adolescent sleep duration have been documented, but pathways driving these disparities are not well understood. This study examined whether neighborhood and household environments explained racial disparities in adolescent sleep duration. Methods Participants came from Waves I and II of Add Health (n=13,019). Self-reported short sleep duration was defined as less than the recommended amount for age (<9 hours for 6-12 years, <8 hours for 13-18 years, and <7 hours for 18-64 years). Neighborhood factors included neighborhood socioeconomic disadvantage, perceived safety and social cohesion. Household factors included living in a single parent household and household socioeconomic status (HSES). Structural equation modeling was used to assess mediation of the neighborhood and household environment in the association between race/ethnicity and short sleep duration. Results Only HSES mediated racial disparities, explaining non-Hispanic (NH) African American-NH White (11.6%), NH American Indian-NH White (9.9%), and Latinx-NH White (42.4%) differences. Unexpectedly, higher HSES was positively associated with short sleep duration. Conclusion Household SES may be an important pathway explaining racial disparities in adolescent sleep duration. Future studies should examine mechanisms linking household SES to sleep and identify buffers for racial/ethnic minority adolescents against the detrimental impacts that living in a higher household SES may have on sleep.
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Affiliation(s)
- Ryan Saelee
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University
| | - Dayna A. Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | | | - Shakira F. Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University
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4
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Gaston SA, Singh R, Jackson CL. The need to study the role of sleep in climate change adaptation, mitigation, and resiliency strategies across the life course. Sleep 2023; 46:zsad070. [PMID: 36913312 PMCID: PMC10334480 DOI: 10.1093/sleep/zsad070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Indexed: 03/14/2023] Open
Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Rupsha Singh
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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5
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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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6
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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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7
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Zhang C, Zhang B, Ling Z, Xiao Y, Li S, Yu Y, Zou B, Chen X, Shen M. Long-term exposure to ambient black carbon is associated with sleep disturbance in college students. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156066. [PMID: 35605861 DOI: 10.1016/j.scitotenv.2022.156066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence suggests an association of air pollution with sleep quality. However, there is limited knowledge regarding the effect of black carbon, a key component of ambient particulate matter, on sleep. OBJECTIVES To investigate the association of long-term exposure to black carbon and sleep quality in a group of college students. METHODS A retrospective cohort study was conducted in five universities in different regions of China. The concentrations of black carbon and other environment factors were defined as the averages during the 6 years prior to the recruitment. Averagely daily dose of black carbon exposure was estimated according to the respiratory rate. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) with a cutoff >5 indicating sleep disturbance. Linear regression and logistic regression models were used to estimate the association. The sensitivity analyses were conducted to estimate the effects of 1-month, 6-month and 1-year mean levels of exposure to black carbon on sleep quality. RESULTS A total of 20,053 incoming college students were included. 29.3% reported impaired sleep quality, with a mean PSQI score of 4.3 ± 2.2. The logistic regression showed that the risk of impaired sleep quality was positively associated with black carbon exposure, especially in the highest quantile (OR: 1.26, 95% CI: 1.11-1.43) compared with the lowest quartile after adjusting for potential confounders. Subgroup analysis showed that the effect of black carbon on sleep quality was stronger in participants with higher BMI, lower household income, and lower parental educational level. The results of sensitivity analyses were similar with main analyses. CONCLUSION Long-term exposure to black carbon is associated with sleep disturbance in college students. Improvement of air quality may help improve sleep quality.
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Affiliation(s)
- Chengcheng Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Beisi Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhen Ling
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China
| | - Shenxin Li
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China.
| | - Yu Yu
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Bin Zou
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China; Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China.
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8
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Chevance G, Fresán U, Hekler E, Edmondson D, Lloyd SJ, Ballester J, Litt J, Cvijanovic I, Araújo-Soares V, Bernard P. Thinking Health-related Behaviors in a Climate Change Context: A Narrative Review. Ann Behav Med 2022; 57:193-204. [PMID: 35861123 PMCID: PMC10074036 DOI: 10.1093/abm/kaac039] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to, climate change. PURPOSE This article aims to identify potential bi-directional associations between climate change impacts and health-related behaviors, as well as a set of key actions for the behavioral medicine community. METHODS We synthesized the existing literature about (i) the impacts of rising temperatures, extreme weather events, air pollution, and rising sea level on individual behaviors (e.g., eating behaviors, physical activity, sleep, substance use, and preventive care) as well as the structural factors related to these behaviors (e.g., the food system); and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change. RESULTS Based on this literature review, we propose a first conceptual model of climate change and health-related behavior feedback loops. Key actions are proposed, with particular consideration for health equity implications of future behavioral interventions. Actions to bridge the fields of behavioral medicine and climate sciences are also discussed. CONCLUSIONS We contend that climate change is among the most urgent issues facing all scientists and should become a central priority for the behavioral medicine community.
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Affiliation(s)
| | | | - Eric Hekler
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, CA, USA.,Center for Wireless and Population Health Systems, Qualcomm Institute, UC San Diego, San Diego, CA, USA
| | - Donald Edmondson
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Jill Litt
- ISGlobal, Barcelona, Spain.,Environmental Studies, University of Colorado Boulder, CO, USA
| | | | - Vera Araújo-Soares
- Health Technology & Services Research, University of Twente, The Netherlands
| | - 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, Quebec, Canada
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9
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Sastry J, Agawane S, Rajan M, Black K, Laumbach R, Ramagopal M. The effect of the indoor environment on wheeze- and sleep-related symptoms in young Indian children. Lung India 2021; 38:307-313. [PMID: 34259167 PMCID: PMC8272434 DOI: 10.4103/lungindia.lungindia_120_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Environmental exposures have a significant effect on respiratory and sleep symptoms in young children. Although the effect of air pollution on the respiratory symptoms in young children is well-established, less is known about the effect of household environmental characteristics and practices on wheeze and sleep concerns. Aims The aim of this pilot study is to explore the association between household environmental characteristics and practices with the symptoms of wheezing and sleep concerns in the past year in a convenience sample of young Indian children. Materials and Methods A detailed questionnaire about the child's home environment and respiratory and sleep symptoms was administered to the caregivers of 190 outpatients aged between 6 months and 5 years old at a teaching hospital. Results Indoor environmental characteristics and cleaning techniques were analyzed for the association with wheeze and sleep disorders. Half (50%) of the cohort had the symptoms of wheezing and 21% had occasional or frequent sleep concerns. Sleeping with a stuffed toy was significantly associated with both wheezing and sleep concerns (P = 0.05). Conclusions : Sleeping with a stuffed toy was a risk factor for wheeze and a risk factor for sleep disorders independent of wheeze.
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Affiliation(s)
- Jayagowri Sastry
- Global and Women's Health Research Unit, Division of Planetary Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shubhangi Agawane
- Department of Community Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | - Mangala Rajan
- Division of General Internal Medicine, Weill Cornel Medicine, NY, NY, USA
| | - Kathleen Black
- Department of Environmental and Occupational Health, Rutgers University, Piscataway, Piscataway, New Jersey, USA
| | - Robert Laumbach
- Department of Environmental and Occupational Health, Rutgers University, Piscataway; Department of Environmental and Occupational Health, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Maya Ramagopal
- Department of Pediatrics, Division of Pulmonology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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10
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Clark DPQ, Son DB, Bowatte G, Senaratna CV, Lodge C, Perret JL, Hamilton GS, Dharmage S. The association between traffic-related air pollution and obstructive sleep apnea: A systematic review. Sleep Med Rev 2020; 54:101360. [PMID: 32755810 DOI: 10.1016/j.smrv.2020.101360] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/25/2020] [Accepted: 05/20/2020] [Indexed: 11/16/2022]
Abstract
Recent evidence suggests that air pollution exposure may be a contributing risk factor for obstructive sleep apnea (OSA), however, current evidence is conflicting. This systematic review aims to determine the association between air pollution and OSA in the general population, and examine for potential effect modification by seasonality, temperature and humidity. Five full-text articles were included in the review out of 905 articles found by systematically searching PubMed, Embase and Scopus databases. The included studies were limited to OSA in adults that were conducted in middle to high-income countries. The results highlight heterogeneity in the diagnostic criteria for OSA and method used to assess air pollution exposure. There is some evidence to support a relationship between air pollution exposure and OSA. However, the duration of exposure to different air pollutants including particulate matter (PM2.5 and PM10) and nitric oxides (NO2) in relation to OSA varied across different seasons, temperatures, and countries. This variability of the pollutants across studies warrants a more robust study design using time-series analysis with multiple follow-ups to strengthen the evidence for this relationship before considering its implications.
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Affiliation(s)
- David P Q Clark
- The University of Melbourne, School of Population & Global Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
| | - Dinh Bui Son
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
| | - Gayan Bowatte
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia; Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, National Institute of Fundamental Studies, Sri Lanka.
| | - Chamara V Senaratna
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia; Faculty of Medical Sciences, Non-Communicable Diseases Research Centre, University of Sri Jayewardenepura, Sri Lanka.
| | - Caroline Lodge
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
| | - Jennifer L Perret
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia; The Institute for Breathing and Sleep (IBAS), Heidelberg, Melbourne, VIC, Australia.
| | - Garun S Hamilton
- Dept of Lung and Sleep Medicine, Monash Health, Victoria, Australia; School of Clinical Sciences, Monash University, Victoria, Australia.
| | - Shyamali Dharmage
- The University of Melbourne, School of Population & Global Health, Centre for Epidemiology and Biostatistics, Allergy and Lung Health, 207, Bouverie Street, Carlton, VIC 3052, Australia.
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11
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Cao B, Chen Y, McIntyre RS. Comprehensive review of the current literature on impact of ambient air pollution and sleep quality. Sleep Med 2020; 79:211-219. [PMID: 32912798 DOI: 10.1016/j.sleep.2020.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 02/08/2023]
Abstract
Air pollution is associated with increasing morbidity, mortality and decreasing health and life span. Accumulating epidemiological and experimental evidence has shown that exposure to ambient air pollutants such as particulate matters (PM) and gaseous components [eg, nitrogen dioxide (NO2), ozone (O3)] has detrimental effects on sleep quality. We conducted this comprehensive review to explore the association between ambient air pollution and sleep quality. A systematic search was conducted with the databases of PubMed and Web of Science from inception to November 2019. Overall, 15 studies with 133,695 subjects that evaluated the association between ambient air pollution and sleep quality were conducted in 10 different countries (ie, USA, Brazil, Canada, Chile, China, Egypt, Germany, Iran, Mexico, and Turkey). Most included studies in the current review have shown that one or more air pollutants have negative influences on sleep quality. Air pollutants might be one of the triggers for poor sleep quality via disparate mechanisms including but not limited to the central ventilator control centers, central nervous system, allergic and non-allergic mechanisms. The possible association between air pollution and select chronic diseases (eg, mental illnesses, cardiovascular diseases) and behaviors (eg, impulsivity) may also play important roles in explaining the association between ambient air pollution and sleep quality. The associations and underlying mechanisms between ambient air pollutants and sleep quality need to be clarified with long-term, multi-centered cohort studies.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, PR China.
| | - Yan Chen
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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Tang M, Li D, Liew Z, Wei F, Wang J, Jin M, Chen K, Ritz B. The association of short-term effects of air pollution and sleep disorders among elderly residents in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 708:134846. [PMID: 31780155 DOI: 10.1016/j.scitotenv.2019.134846] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 06/10/2023]
Abstract
Sleep disorders, oftentimes co-occurring with other mental and neurological disorders in the elderly, have been previously linked to short-term exposures to air pollution. Here we assessed such associations among 395,651 elderly Chinese in Ningbo, China where air pollution exposures are high and the proportion of elderly in the population is growing. We utilized a regional health information database in China (2008-2017) that collected information on hospital visits for sleep disorders among the elderly (age 60+). Measures of daily air pollution concentrations including nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), inhalable particles (PM10), and ambient fine particulate matter (PM2.5) were generated from seven environmental air quality monitoring sites in the study area. We used a generalized additive model to evaluate the associations between hospital visits for sleep disorders and short-term air pollution exposures for up to 7 days prior to a hospital visit. Short-term exposure to multiple air pollutants was associated with hospital visits for sleep disorders in an elderly population; with the strongest associations during 2-3 days prior to a clinic visits for traffic-related pollutants including air quality index (AQI), PM2.5, PM10, and NO2 and for SO2 and O3 for 5 days prior to the visits. Our study based on large health care record system suggested that short-term air pollution exposures are associated with sleep disorders in the elderly. Considering the individual covariates that could not be adjusted in time-series analyses, future studies with individual level data and an ability to evaluate the severity of sleep disorders and their relation to mental and physical health in general and air pollution are needed. An aging population with increasing health problems and the frequency of high and very high air pollution events in China make our findings very health policy relevant.
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Affiliation(s)
- Mengling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Die Li
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, USA
| | - Fang Wei
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China.
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, CA, USA
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Yıldız Gülhan P, Güleç Balbay E, Elverişli MF, Erçelik M, Arbak P. Do the levels of particulate matters less than 10 μm and seasons affect sleep? Aging Male 2020; 23:36-41. [PMID: 31441672 DOI: 10.1080/13685538.2019.1655637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: There are few studies showing that the increase in particulate matters less than 10 μm (PM10) values increases the apnea-hypopnea index (AHI). We aimed to investigate relationship between air quality parameters and the seasons with the AHI.Methods: This was a retrospective study that included 500 adults. Polysomnography (PSG) was performed on all patients. Oxygen saturation, air temperature, relative humidity, and PM10 values were recorded in Düzce for every year. The parameters of the national air quality network and sleep parameters of 500 individuals hospitalized between 2015 and 2017 were checked.Results: A total of 500 patients were included in the study, of whom 316 (63.2%) were male and 184 (36.8%) were female. While the AHI value of patients who presented during 2016 was 27.5, it had significantly declined to 20.2 in 2017 (p = .024). A significant decline was observed in AHI values of OSA patients from 2016 to 2017 (p = .043). A significant positive correlation was observed between REM-related AHI and relative humidity (r = 0.183, p = .002). Conclusions: This study showed a clear relationship between AHI and PM10 during winter when air pollution parameters are high in the region. PM10 emerged as a parameter that substantially increases the relative risk for OSA.
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Affiliation(s)
- Pınar Yıldız Gülhan
- Department of Chest Diseases, School of Medicine, Düzce University, Düzce, Turkey
| | - Ege Güleç Balbay
- Department of Chest Diseases, School of Medicine, Düzce University, Düzce, Turkey
| | | | - Merve Erçelik
- Department of Chest Diseases, School of Medicine, Düzce University, Düzce, Turkey
| | - Peri Arbak
- Department of Chest Diseases, School of Medicine, Düzce University, Düzce, Turkey
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Sánchez T, Gozal D, Smith DL, Foncea C, Betancur C, Brockmann PE. Association between air pollution and sleep disordered breathing in children. Pediatr Pulmonol 2019; 54:544-550. [PMID: 30719878 DOI: 10.1002/ppul.24256] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 12/10/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE Similar to other respiratory diseases, sleep disordered breathing (SDB) may be exacerbated by air contaminants. Air pollution may have an impact on incidence and severity of SDB in children. The aims of this study were to examine potential associations between the exposure to different air pollutants and SDB symptoms in children. METHODS In this cross-sectional study, parents from first grade children of elementary schools throughout Chile were included. Data about clinical and family-related SDB risk factors, and the pediatric sleep questionnaire (PSQ) were obtained. Air pollution and meteorological data were obtained from the Chilean online air quality database. RESULTS A total of 564 children (44.9% males) aged (median) 6 years (5-9 year) were included. Prevalence of SDB based on PSQ was 17.7%. When examining air pollutants and conditions, only higher humidity (β = 0.005, 95%CI 0.001-0.009, P = 0.011) was significantly associated with higher PSQ scores after adjusting for demographic and household variables. Higher ozone (O3 ) levels (OR = 1.693, 95%CI 1.409-2.035, P < 0.001), higher humidity (OR = 1.161, 95%CI 1.041-2.035, P = 0.008) and higher dioxide sulfur (SO2 ) levels (OR = 1.16, 95%CI 1.07-1.94, P < 0.001]) were associated with increased odds of wheezing-related sleep disturbances after adjusting for confounders. Lower temperature was a significant predictor of snoring at least >3 nights/week, following adjustment (OR = 0.865, 95%CI 0.751-0.997, P < 0.05). CONCLUSION Sleep respiratory symptoms (wheezing and snoring) are significantly associated with air pollutants such as O3 and SO2 . In addition, meteorological conditions such as humidity and low temperatures may be also associated with SDB-related symptoms.
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Affiliation(s)
- Trinidad Sánchez
- Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, Illinois
| | - Dale L Smith
- Department of Public Health Sciences, Biological Sciences Division, The University of Chicago, Chicago, Illinois
| | | | - Carmen Betancur
- Department of Psychiatry and Mental Health, Universidad de Concepción, Concepción, Chile
| | - Pablo E Brockmann
- Pediatric Sleep Center, Department of Pediatric Cardiology and Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Bose S, Ross KR, Rosa MJ, Chiu YHM, Just A, Kloog I, Wilson A, Thompson J, Svensson K, Rojo MMT, Schnaas L, Osorio-Valencia E, Oken E, Wright RO, Wright RJ. Prenatal particulate air pollution exposure and sleep disruption in preschoolers: Windows of susceptibility. ENVIRONMENT INTERNATIONAL 2019; 124:329-335. [PMID: 30660846 PMCID: PMC6615028 DOI: 10.1016/j.envint.2019.01.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 05/18/2023]
Abstract
BACKGROUND The programming of sleep architecture begins in pregnancy and depends upon optimal in utero formation and maturation of the neural connectivity of the brain. Particulate air pollution exposure can disrupt fetal brain development but associations between fine particulate matter (PM2.5) exposure during pregnancy and child sleep outcomes have not been previously explored. METHODS Analyses included 397 mother-child pairs enrolled in a pregnancy cohort in Mexico City. Daily ambient prenatal PM2.5 exposure was estimated using a validated satellite-based spatio-temporally resolved prediction model. Child sleep periods were estimated objectively using wrist-worn, continuous actigraphy over a 1-week period at age 4-5 years. Data-driven advanced statistical methods (distributed lag models (DLMs)) were employed to identify sensitive windows whereby PM2.5 exposure during gestation was significantly associated with changes in sleep duration or efficiency. Models were adjusted for maternal education, season, child's age, sex, and BMI z-score. RESULTS Mother's average age was 27.7 years, with 59% having at least a high school education. Children slept an average of 7.7 h at night, with mean 80.1% efficiency. The adjusted DLM identified windows of PM2.5 exposure between 31 and 35 weeks gestation that were significantly associated with decreased sleep duration in children. In addition, increased PM2.5 during weeks 1-8 was associated with decreased sleep efficiency. In other exposure windows (weeks 39-40), PM2.5 was associated with increased sleep duration. CONCLUSION Prenatal PM2.5 exposure is associated with altered sleep in preschool-aged children in Mexico City. Pollutant exposure during sensitive windows of pregnancy may have critical influence upon sleep programming.
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Affiliation(s)
- Sonali Bose
- Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Kristie R Ross
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, United States of America
| | - Maria J Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, BeerSheba, Israel
| | - Ander Wilson
- Department of Statistics, Colorado State University, United States of America
| | - Jennifer Thompson
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | | | - Lourdes Schnaas
- Department of Developmental Neurobiology, National Institute of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Erika Osorio-Valencia
- Department of Developmental Neurobiology, National Institute of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America
| | - Robert O Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, United States of America; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States of America; Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Rosalind J Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, United States of America; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States of America; Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, United States of America.
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Rifkin DI, Long MW, Perry MJ. Climate change and sleep: A systematic review of the literature and conceptual framework. Sleep Med Rev 2018; 42:3-9. [DOI: 10.1016/j.smrv.2018.07.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/23/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
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Lappharat S, Taneepanichskul N, Reutrakul S, Chirakalwasan N. Effects of Bedroom Environmental Conditions on the Severity of Obstructive Sleep Apnea. J Clin Sleep Med 2018; 14:565-573. [PMID: 29609708 DOI: 10.5664/jcsm.7046] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022]
Abstract
STUDY OBJECTIVES Epidemiological associations have demonstrated the effects of long-term air pollution to obstructive sleep apnea (OSA) through a physiological mechanism linking particulate matter exposure to OSA. This study aimed to determine the relationship between bedroom environmental conditions, OSA severity, and sleep quality. METHODS Sixty-three participants were enrolled for an overnight polysomnography; OSA was diagnosed between May to August 2016. Personal characteristics and sleep quality were obtained by a face-to-face interview. Bedroom environments, including data on particulate matter with an aerodynamic diameter less than 10 μm (PM10), temperature, and relative humidity, were collected by personal air sampling and a HOBO tempt/RH data logger. RESULTS Sixty-eight percent of the participants experienced poor sleep. An elevation in 1-year mean PM10 concentration was significantly associated with an increase in apnea-hypopnea index (beta = 1.04, P = .021) and respiratory disturbance index (beta = 1.07, P = .013). An increase of bedroom temperature during sleep was significantly associated with poorer sleep quality (adjusted odds ratio 1.46, 95% confidence interval 1.01-2.10, P = .044). Associations between PM10 concentration and respiratory disturbance index were observed in the dry season (beta = 0.59, P = .040) but not in the wet season (beta = 0.39, P = .215). PM10 was not associated with subjective sleep quality. CONCLUSIONS Elevation of PM10 concentration is significantly associated with increased OSA severity. Our findings suggest that reduction in exposure to particulate matter and suitable bedroom environments may lessen the severity of OSA and promote good sleep.
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Affiliation(s)
- Sattamat Lappharat
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | - Sirimon Reutrakul
- Division of Endocrinology and Metabolism, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, Thailand.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Naricha Chirakalwasan
- Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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