Associations of PM10 with sleep and sleep-disordered breathing in adults from seven U.S. urban areas - PubMed (original) (raw)

Associations of PM10 with sleep and sleep-disordered breathing in adults from seven U.S. urban areas

Antonella Zanobetti et al. Am J Respir Crit Care Med. 2010.

Abstract

Rationale: Sleep-disordered breathing (SDB), the recurrent episodic disruption of normal breathing during sleep, affects as much as 17% of U.S. adults, and may be more prevalent in poor urban environments. SDB and air pollution have been linked to increased cardiovascular diseases and mortality, but the association between pollution and SDB is poorly understood.

Objectives: We used data from the Sleep Heart Health Study (SHHS), a U.S. multicenter cohort study assessing cardiovascular and other consequences of SDB, to examine whether particulate air matter less than 10 μm in aerodynamic diameter (PM(10)) was associated with SDB among persons 39 years of age and older.

Methods: Using baseline data from SHHS urban sites, outcomes included the following: the respiratory disturbance index (RDI); percentage of sleep time at less than 90% O(2) saturation; and sleep efficiency, measured by overnight in-home polysomnography. We applied a fixed-effect model containing a city effect, controlling for potential predictors. In all models we included both the 365-day moving averages of PM(10) and temperature (long-term effects) and the differences between the daily measures of these two predictors and their 365-day average (short-term effects).

Measurements and main results: In summer, increases in RDI or percentage of sleep time at less than 90% O(2) saturation, and decreases in sleep efficiency, were all associated with increases in short-term variation in PM(10). Over all seasons, we found that increased RDI was associated with an 11.5% (95% confidence interval: 1.96, 22.01) increase per interquartile range increase (25.5°F) in temperature.

Conclusions: Reduction in air pollution exposure may decrease the severity of SDB and nocturnal hypoxemia and may improve cardiac risk.

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Figures

Figure 1.

City-specific distribution of respiratory disturbance indices (RDIs). The RDI was computed as the ratio of the count of all apneas and hypopneas to the total sleep time expressed as hours.

Figure 2.

City- and season-specific distribution of 24-hour (daily) particulate air matter less than 10 μm in aerodynamic diameter (PM10). Aut = autumn; Spr = spring; Sum = summer; Win = winter.

Figure 3.

Season-specific percent change and 95% confidence intervals in sleep-disordered breathing outcomes, for an interquartile increase in short-term particulate air matter less than 10 μm in aerodynamic diameter (PM10), adjusting for seasonality, daily mean temperature, age, body mass index, sex, education, an age by sex interaction, smoking status, daily number of glasses of coffee, tea, and soda, and number of glasses of wine and beer 4 hours before going to sleep and long-term PM10 averages. O2sat = oxygen saturation; Aut = autumn; Spr = spring; Sum = summer; Win = winter.

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Associations of PM10 with sleep and sleep-disordered breathing in adults from seven U.S. urban areas - PubMed (original) (raw)