Air Pollution & Sleep Apnea.

A review of the 'The Association of Ambient Air Pollution with Sleep Apnea: The Multi-Ethnic Study of AtherosclerosiS"

· Sleep Disorders,Sleep apnea,Sleep science,Sleep Environment,Sleep and lifestyle

Sleep apnea is a common sleep disorder characterized by pauses in breathing during sleep. It affects a large number of people globally and has been linked to several serious health problems, including high blood pressure, heart disease, stroke, and diabetes. There is growing evidence that air pollution can have an impact on sleep apnea, as air pollution has been linked to airway inflammation, alterations in the autonomic nervous system, and sleep disruption.

In the study "The Association of Ambient Air Pollution with Sleep Apnea: The Multi-Ethnic Study of Atherosclerosis," researchers aimed to determine whether exposure to ambient air pollution was associated with obstructive sleep apnea and objective sleep disruption.

The study analyzed data from 1,974 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who participated in both the Sleep and Air studies. The participants were an average of 68 years old, 46% were male, and they represented a diverse range of races and ethnicities.

The researchers estimated the participants' annual and 5-year exposure levels to nitrogen dioxide (NO2) and particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) using spatiotemporal models based on monitoring data specific to the cohort.

The participants completed in-home full polysomnography and 7 days of wrist actigraphy to assess their sleep patterns.

The results showed that participants with higher annual exposure levels to NO2 and PM2.5 had a greater likelihood of having sleep apnea. A 10 ppb increase in annual NO2 exposure was associated with a 39% greater adjusted odds of sleep apnea, while a 5 μg/m3 increase in annual PM2.5 exposure was associated with a 60% greater odds of sleep apnea. However, the study did not find a significant association between air pollution levels and sleep efficiency as measured by actigraphy.

The study highlights the importance of considering environmental factors, such as air pollution, in the development and management of sleep apnea. It also highlights the need for further research to better understand the mechanisms through which air pollution affects sleep and the implications for health disparities.

The study also provides evidence that air pollution levels may contribute to the variation of sleep disorders across different demographic groups, such as socioeconomic status, race, and ethnicity. Disadvantaged communities with low socioeconomic status residents are often exposed to higher levels of air pollution, which may contribute to sleep health disparities.

Additionally, air pollution may have a direct effect on sleep quality through upper airway irritation, congestion, and narrowing, as well as through neuroinflammation and neurotoxicity.

Further research is needed to fully understand the impact of air pollution on sleep apnea and the implications for public health. 

Billings ME, Gold D, Szpiro A, Aaron CP, Jorgensen N, Gassett A, Leary PJ, Kaufman JD, Redline SR. The Association of Ambient Air Pollution with Sleep Apnea: The Multi-Ethnic Study of Atherosclerosis. Ann Am Thorac Soc. 2019 Mar;16(3):363-370. doi: 10.1513/AnnalsATS.201804-248OC. PMID: 30571166; PMCID: PMC6394120.