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Association of ambient air pollution exposure and its variability with subjective sleep quality in China: A multilevel modeling analysis

匹兹堡睡眠质量指数 空气污染 空气质量指数 环境卫生 置信区间 优势比 污染 气动直径 二氧化氮 环境科学 微粒 污染物 医学 气象学 睡眠质量 化学 地理 内科学 失眠症 有机化学 精神科 生物 生态学
作者
Lingli Wang,Jingxuan Zhang,Jing Wei,Jingru Zong,Chunyu Lu,Yajie Du,Qīng Wáng
出处
期刊:Environmental Pollution [Elsevier]
卷期号:312: 120020-120020 被引量:18
标识
DOI:10.1016/j.envpol.2022.120020
摘要

Growing epidemiological evidence has shown that exposure to ambient air pollution contributes to poor sleep quality. However, whether variability in air pollution exposure affects sleep quality remains unclear. Based on a large sample in China, this study linked individual air pollutant exposure levels and temporal variability with subjective sleep quality. Town-level data on daily air pollution concentration for 30 days prior to the survey date were collected, and the monthly mean value, standard deviations, number of heavily polluted days, and trajectory for six common pollutants were calculated to measure air pollution exposure and its variations. Sleep quality was subjectively assessed using the Pittsburgh Sleep Quality Index (PSQI), and a PSQI score above 5 indicated overall poor sleep quality. Multilevel and negative control models were used. Both air pollution exposure and variability contributed to poor sleep quality. A one-point increase in the one-month mean concentration of particulate matter with aerodynamic diameters of ≤2.5 μm (PM2.5) and ≤10 μm (PM10) led to 0.4% (95% confidence interval (CI): 1.002-1.006) and 0.3% (95% CI: 1.001-1.004) increases in the likelihoods of overall poor sleep quality (PSQI score >5), respectively; the odds ratios of a heavy pollution day with PM2.5 and PM10 were 2.2% (95% CI: 1.012-1.032) and 2.2% (95% CI: 1.012-1.032), respectively. Although the mean concentrations of nitrogen dioxide, sulfur dioxide, and carbon monoxide met the national standard, they contributed to the likelihood of overall poor sleep quality (PSQI score >5). A trajectory of air pollution exposure with maximum variability was associated with a higher likelihood of overall poor sleep quality (PSQI score >5). Subjective measures of sleep latency, duration, and efficiency (derived from PSQI) were affected in most cases. Thus, sleep health improvements should account for air pollution exposure and its variations in China under relatively high air pollution levels.
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