Association of air pollution exposure with low arousal threshold obstructive sleep apnea: A cross-sectional study in Taipei, Taiwan

Qiu, Hong; Liu, Wen‐Te; Lin, Shang‐Yang; Li, Zhiyuan; He, Yansu; Yim, Steve Hung Lam; Wong, Eliza Lai-Yi; Chuang, Hsiao-Chi; Ho, Kin Fai

doi:10.1016/j.envpol.2022.119393

Cited by 10 publications

(4 citation statements)

References 39 publications

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“…9 A related study on the effects of air pollution on the central nervous system reported that air pollutant exposure may increase sleep arousal frequency, and that air pollutant exposure may be associated with low-ArTH OSA. 7 Moreover, patients with low-ArTH OSA tend to exhibit sleep arousal due to respiratory disturbances, particularly minor events such as hypopnoea rather than apnoea. 10 Several mechanisms associated with this manifestation of low-ArTH OSA, which is partially linked to air pollutant exposure, have been identified.…”

Section: What This Study Addsmentioning

confidence: 99%

“…This propensity to be woken prematurely in response to respiratory events is defined as low-arousal-threshold (low-ArTH) OSA 4. Several risk factors for low-ArTH OSA have been identified, including ageing,5 body water distribution6 and air pollutant exposure 7. However, whether these factors exert a synergistic effect on low-ArTH OSA manifestations requires further investigation.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, in a review of 15 studies involving approximately 133 000 participants from 10 countries, the authors noted that air pollutants such as particulate matter (PM) with a diameter of ≤2.5 µm (PM 2.5 ) and 10 µm (PM 10 ), nitrogen oxide (NO) and nitrogen dioxide (NO 2 ) might be associated with increased mean AHI, ODI and ArI values, thereby resulting in sleep quality impairment 9. A related study on the effects of air pollution on the central nervous system reported that air pollutant exposure may increase sleep arousal frequency, and that air pollutant exposure may be associated with low-ArTH OSA 7. Moreover, patients with low-ArTH OSA tend to exhibit sleep arousal due to respiratory disturbances, particularly minor events such as hypopnoea rather than apnoea 10.…”

Section: Introductionmentioning

confidence: 99%

“…4 Several risk factors for low-ArTH OSA have been identified, including ageing, 5 body water distribution 6 and air pollutant exposure. 7 However, whether these factors exert a synergistic effect on low-ArTH OSA manifestations requires further investigation.…”

Section: Introductionmentioning

confidence: 99%

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Association between air pollutant exposure, body water distribution and sleep disorder indices in individuals with low-arousal-threshold obstructive sleep apnoea

Tsai,

Liu,

Huang

et al. 2023

BMJ Open Resp Res

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BackgroundAir 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.MethodsIn 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.ResultsFirst, 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 PM10and 3-month exposure to PM2.5and PM10had partial mediation effects on AHI and ODI.ConclusionAir 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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Section: What This Study Addsmentioning

confidence: 99%