Association of traffic air pollution with severity of obstructive sleep apnea in urban areas of Northern Taiwan: A cross-sectional study

He, Yansu; Liu, Wente; Lin, Shang‐Yang; Li, Zhiyuan; Qiu, Hong; Yim, Steve Hung Lam; Chuang, Hsiao-Chi; Ho, Kin-Fai

doi:10.1016/j.scitotenv.2022.154347

Cited by 14 publications

(4 citation statements)

References 44 publications

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“…One study found that long-term exposure to nitrogen dioxide was associated with an increased risk of poor sleep quality 28 . Both short- and long-term exposure to NO 2 was associated with increased AHI, and this effect was caused by periods of rapid eye movement 35 . Therefore, it is worth exploring how urban air pollution affects sleep.…”

Section: Discussionmentioning

confidence: 99%

Association between ambient air pollution exposure and insomnia among adults in Taipei City

Tsai

Yuan

Shie

et al. 2022

Sci Rep

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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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Section: Discussionmentioning

confidence: 99%

Association between ambient air pollution exposure and insomnia among adults in Taipei City

Tsai

Yuan

Shie

et al. 2022

Sci Rep

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“…All the exposure data for the participants were calculated backward from the time of visiting the sleep centre. This study used an adjusted form of a previously reported estimation approach for air pollutant exposure values, which were determined using the data from the nearest station 22. Specifically, in this method, we employed the data obtained from air pollution monitoring stations situated within a 3 km radius of the homes of the participants; these stations were considered to be neighbouring stations.…”

Section: Methodsmentioning

confidence: 99%

“…This study used an adjusted form of a previously reported estimation approach for air pollutant exposure values, which were determined using the data from the nearest station. 22 Specifically, in this method, we employed the data obtained from air pollution monitoring stations situated within a 3 km radius of the homes of the participants; these stations were considered to be neighbouring stations. Next, as shown in online supplemental figure S1, weights were assigned to these selected stations based on the distances between the stations and the participants' homes; then, the weighted average of daily exposure levels was computed.…”

Section: Body Composition and Body Water Distributionmentioning

confidence: 99%

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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“…We used data from 16 stations and excluded those from the other 3 stations because 1 was located in a national park and the other 2 were background stations. To estimate exposure to air pollutants, we used an adjusted method that was proposed in another study and considered data from the nearest station (17). In the present study, only stations located within 3 km of a patient's residential address were selected.…”

Section: Estimation Of Exposure To Air Pollutantsmentioning

confidence: 99%

Associations between air pollution, intracellular-to-extracellular water distribution, and obstructive sleep apnea manifestations

Tsai

Huang

Liu

et al. 2023

Front. Public Health

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BackgroundExposure 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.ObjectivesThis study aimed to investigate the mediating effects of air pollution on the exacerbation of OSA severity through body water distribution.MethodsThis 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.ResultsSignificant 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.ConclusionBecause 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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Association of traffic air pollution with severity of obstructive sleep apnea in urban areas of Northern Taiwan: A cross-sectional study

Cited by 14 publications

References 44 publications

Association between ambient air pollution exposure and insomnia among adults in Taipei City

Association between ambient air pollution exposure and insomnia among adults in Taipei City

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

Associations between air pollution, intracellular-to-extracellular water distribution, and obstructive sleep apnea manifestations

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