Association of long-term exposure to air pollution with sleep among middle-aged and older adults in China: A nationwide study from 2015 to 2018
Abstract
Background: This study aims to evaluate the associations of long-term exposure to five major air pollutants (PM2.5, PM10, NO2, SO2, and CO) with sleep duration and quality among middle-aged and older Chinese adults.
Methods: This study used data from 14856 adults aged 45 and above participating in the China Health and Retirement Longitudinal Study (CHARLS). Changes in nocturnal sleep duration between baseline (2015) and follow-up (2018) were categorized into three groups: reductions ≥1 h, 1.5 h, or 2 h. The increase in the number of days with restless sleep at follow-up was defined as a deterioration in sleep quality. We used the STET model to estimate air pollution exposure and calculate the concentration differences over 1- or 2-year periods preceding each interview. We investigated the associations of exposure differences to five pollutants with sleep duration and quality through generalized linear mixed and ordinal logistic regression models. Interaction analyses were employed to identify potential effect modifiers.
Results: All 1-year exposure differences to air pollution positively correlated with reductions in sleep duration of both ≥1.5 h and ≥2 h. CO exposure demonstrated the highest risk for a ≥ 1.5 h reduction (OR = 1.451; 95% CI: 1.065-1.975) and a ≥ 2 h reduction (OR = 1.557; 95% CI: 1.135-2.135) per 1 μg/m3 increment. Higher exposure levels to PM2.5, PM10, NO2 and SO2 correlated with elevated risks of sleep quality deterioration. NO2 exposure demonstrated the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 14,856 participants or records.
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