TY - JOUR
T1 - Association between air pollutant exposure, body water distribution and sleep disorder indices in individuals with low-arousal-threshold obstructive sleep apnoea
AU - Tsai, Cheng Yu
AU - Liu, Ming
AU - Huang, Huei Tyng
AU - Hsu, Wen Hua
AU - Kuan, Yi Chun
AU - Majumdar, Arnab
AU - Lee, Kang Yun
AU - Feng, Po Hao
AU - Tseng, Chien Hua
AU - Chen, Kuan Yuan
AU - Kang, Jiunn Horng
AU - Lee, Hsin Chien
AU - Wu, Cheng Jung
AU - Liu, Wen Te
N1 - © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/8
Y1 - 2023/8
N2 - BACKGROUND: Air 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. METHODS: In 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. RESULTS: First, 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 PM10 and 3-month exposure to PM2.5 and PM10 had partial mediation effects on AHI and ODI. CONCLUSION: Air pollution can directly increase sleep disorder indices (AHI, ODI and ArI) and alter body water distribution, thus mediating the risk of low-ArTH OSA.
AB - BACKGROUND: Air 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. METHODS: In 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. RESULTS: First, 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 PM10 and 3-month exposure to PM2.5 and PM10 had partial mediation effects on AHI and ODI. CONCLUSION: Air pollution can directly increase sleep disorder indices (AHI, ODI and ArI) and alter body water distribution, thus mediating the risk of low-ArTH OSA.
KW - Air Pollutants/adverse effects
KW - Arousal
KW - Body Water/chemistry
KW - Humans
KW - Oxygen
KW - Particulate Matter/adverse effects
KW - Retrospective Studies
KW - Sleep Apnea, Obstructive/epidemiology
KW - Water
UR - http://www.scopus.com/inward/record.url?scp=85176468437&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85176468437&partnerID=8YFLogxK
U2 - 10.1136/bmjresp-2023-001802
DO - 10.1136/bmjresp-2023-001802
M3 - Article
C2 - 37940353
AN - SCOPUS:85176468437
SN - 2052-4439
VL - 10
JO - BMJ Open Respiratory Research
JF - BMJ Open Respiratory Research
IS - 1
M1 - e001802
ER -