Association between air pollution and sleep disordered breathing in children

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.

The Association between Air Pollution and Sleep Duration: A Cohort Study of Freshmen at a University in Beijing, China

“…Our findings are also consistent with previous research [23,26,28,38], which found that increasing levels of ozone and PM 10 were associated with a reduction in sleep efficiency [23], an increase in sleep–disordered breathing (SDB) [23,26,28], and an increase in the severity of sleep apnea [38]. In a recent study across seven northeastern Chinese cities, higher long-term exposure to PM 2.5 , PM 10 , SO 2 , NO 2, and O 3 was associated with a 1.02–1.53 greater odds ratio (OR) of sleep disorders in Chinese children [39].…”

“…To our knowledge, only a few studies have examined the relationship between air pollution and sleep duration. Previous studies have focused primarily on the effect of air pollution on sleep-related respiratory symptoms such as sleep-disordered breathing [23,26,27,28], obstructive sleep apnea (OSA), and sleep apnea [29,30]. However, to our knowledge, no study has examined the relationship between ambient air pollution and sleep duration.…”

Snoring and environmental exposure: results from the Swedish GA2LEN study

“…16 Air pollutants such as particulate matter, ozone (O 3 ) and nitrogen dioxide all have adverse effects on the airways. 17 An association between exposure to air pollutants and snoring have been reported in children 18 19 and habitual snoring was associated with having a bedroom with traffic noise but not to high exposure to traffic pollution in a Nordic population study . 20 In another study, exposure to O 3 was associated with an increase in AHI.…”

Impact of Environmental Injustice on Children’s Health—Interaction between Air Pollution and Socioeconomic Status

“…Outdoor air pollution is mainly associated with negative respiratory health outcomes [28]. Specific air pollutants were found to be linked to sleep disordered breathing in children, such as wheezing and snoring [29]. Inadequate sleep is associated with many other health problems, such as heart disease [30] and obesity [31].…”