OBJECTIVE: To estimate the health effects of short- and long-term exposure to traffic air pollution on mild OSA in Taipei.
METHODS: We collected participants\' data from Taipei Sleep Center and air pollution data from Taiwan Environmental Protection Administration. A spatiotemporal model was used to estimate the individual exposure level. Generalized linear models were used to assess the percent change of overall apnea-hypopnea index (AHI), AHI in rapid eye movement period (AHI-REM), AHI in non-REM (AHI-NREM), and oxygen desaturation index (ODI) associated with an interquartile (IQR) increase in personal pollution exposure. A generalized logistic model was used to estimate the ORs of different severities of OSA compared with the reference group.
RESULTS: In the patients with AHI of <15, both short- and long-term exposure to NO2 were significantly associated with AHI and ODI increases: an IQR increase in 2-year mean NO2 increased 7.3% of AHI and 8.4% of ODI; these values were the highest among all exposure windows. The effects of NO2 on AHI increase were stronger in the men and younger patients. Moreover, the association between AHI and NO2 in the patients with AHI of <15 was mediated by the REM stage. NO2 exposure was associated with an increased risk of mild OSA that reached up to 24.8% per IQR increase in NO2 averaged over 2 years. PM2.5 exerted no effects on AHI, but an IQR increase in 1-year and 2-year mean PM2.5 was associated with 6.8% and 8.8% increases in ODI, respectively.
CONCLUSIONS: Both short- and long-term exposure to traffic air pollution were associated with the risk of mild OSA, which was modified by REM stage.
目的:评估台北短期和长期暴露于交通空气污染对轻度OSA的健康影响。
方法:我们收集了来自台北睡眠中心的参与者数据和来自台湾环境保护局的空气污染数据。使用时空模型来估计个体暴露水平。广义线性模型用于评估总体呼吸暂停低通气指数(AHI)的变化百分比,快速眼动期AHI(AHI-REM),非REM中的AHI(AHI-NREM),和氧气去饱和指数(ODI)与四分位数(IQR)增加有关。与参考组相比,使用广义逻辑模型来估计不同严重程度OSA的OR。
结果:在AHI<15的患者中,短期和长期暴露于NO2均与AHI和ODI增加显着相关:2年平均NO2的IQR增加AHI的7.3%和ODI的8.4%;这些值在所有暴露窗口中最高。在男性和年轻患者中,NO2对AHI增加的影响更强。此外,在AHI<15的患者中,AHI和NO2之间的关联是由REM分期介导的.NO2暴露与轻度OSA的风险增加相关,在2年内,NO2平均每IQR增加高达24.8%。PM2.5对AHI没有影响,但1年和2年平均PM2.5的IQR增加与ODI增加6.8%和8.8%相关,分别。
结论:短期和长期暴露于交通空气污染与轻度OSA的风险有关,通过REM阶段进行了修改。