Abstract：
BACKGROUND: The objective of this study was to examine associations of daily averages and daily variations in ambient relative humidity (RH), temperature, and PM2.5 on the obstructive sleep apnea (OSA) severity.
METHODS: A case-control study was conducted to retrospectively recruit 8628 subjects in a sleep center between January 2015 and December 2021, including 1307 control (apnea-hypopnea index (AHI) < 5 events/h), 3661 mild-to-moderate OSA (AHI of 5-30 events/h), and 3597 severe OSA subjects (AHI > 30 events/h). A logistic regression was used to examine the odds ratio (OR) of outcome variables (daily mean or difference in RH, temperature, and PM2.5 for 1, 7, and 30 days) with OSA severity (by the groups). Two-factor logistic regression models were conducted to examine the OR of RH with the daily mean or difference in temperature or PM2.5 with OSA severity. An exposure-response relationship analysis was conducted to examine the outcome variables with OSA severity in all, cold and warm seasons.
RESULTS: We observed associations of mean PM2.5 and RH with respective increases of 0.04-0.08 and 0.01-0.03 events/h for the AHI in OSA patients. An increase in the daily difference of 1 % RH increased the AHI by 0.02-0.03 events/h in OSA patients. A daily PM2.5 decrease of 1 μg/m3 reduced the AHI by 0.03 events/h, whereas a daily decrease in the RH of 1 % reduced the AHI by 0.03-0.04 events/h. The two-factor model confirmed the most robust associations of ambient RH with AHI in OSA patients. The exposure-response relationship in temperature and RH showed obviously seasonal patterns with OSA severity.
CONCLUSIONS: Short-term ambient variations in RH and PM2.5 were associated with changes in the AHI in OSA patients, especially RH in cold season. Reducing exposure to high ambient RH and PM2.5 levels may have protective effects on the AHI in OSA patients.
METHODS: A case-control study was conducted to retrospectively recruit 8628 subjects in a sleep center between January 2015 and December 2021, including 1307 control (apnea-hypopnea index (AHI) < 5 events/h), 3661 mild-to-moderate OSA (AHI of 5-30 events/h), and 3597 severe OSA subjects (AHI > 30 events/h). A logistic regression was used to examine the odds ratio (OR) of outcome variables (daily mean or difference in RH, temperature, and PM2.5 for 1, 7, and 30 days) with OSA severity (by the groups). Two-factor logistic regression models were conducted to examine the OR of RH with the daily mean or difference in temperature or PM2.5 with OSA severity. An exposure-response relationship analysis was conducted to examine the outcome variables with OSA severity in all, cold and warm seasons.
RESULTS: We observed associations of mean PM2.5 and RH with respective increases of 0.04-0.08 and 0.01-0.03 events/h for the AHI in OSA patients. An increase in the daily difference of 1 % RH increased the AHI by 0.02-0.03 events/h in OSA patients. A daily PM2.5 decrease of 1 μg/m3 reduced the AHI by 0.03 events/h, whereas a daily decrease in the RH of 1 % reduced the AHI by 0.03-0.04 events/h. The two-factor model confirmed the most robust associations of ambient RH with AHI in OSA patients. The exposure-response relationship in temperature and RH showed obviously seasonal patterns with OSA severity.
CONCLUSIONS: Short-term ambient variations in RH and PM2.5 were associated with changes in the AHI in OSA patients, especially RH in cold season. Reducing exposure to high ambient RH and PM2.5 levels may have protective effects on the AHI in OSA patients.
摘要：
背景：这项研究的目的是研究环境相对湿度（RH）的日平均值和日变化之间的关系，温度,和PM2.5对阻塞性睡眠呼吸暂停（OSA）的严重程度。
方法：在2015年1月至2021年12月期间，在睡眠中心进行了一项病例对照研究，回顾性招募了8628名受试者，包括1307名对照（呼吸暂停低通气指数（AHI）<5次事件/h），3661轻度至中度OSA（AHI为5-30事件/h），和3597名重度OSA受试者(AHI>30事件/h)。逻辑回归用于检查结果变量的比值比（OR）（RH的日平均值或差异，温度,和PM2.5持续1、7和30天），OSA严重程度（按各组）。进行了双因素logistic回归模型，以检查RH与每日平均值或温度或PM2.5与OSA严重程度的差异的OR。进行了暴露-反应关系分析，以检查所有OSA严重程度的结果变量，寒冷和温暖的季节。
结果：我们观察到OSA患者AHI的平均PM2.5和RH分别增加0.04-0.08和0.01-0.03事件/h。在OSA患者中，每日1％RH差异的增加使AHI增加0.02-0.03事件/小时。PM2.5每天减少1μg/m3，AHI减少0.03次/小时，而每天RH降低1％，则AHI降低0.03-0.04事件/小时。双因素模型证实了OSA患者中环境RH与AHI的最紧密关联。温度和RH的暴露-响应关系与OSA严重程度呈明显的季节性模式。
结论：RH和PM2.5的短期环境变化与OSA患者的AHI变化有关，尤其是RH在寒冷的季节。减少暴露于高环境RH和PM2.5水平可能对OSA患者的AHI具有保护作用。
方法：在2015年1月至2021年12月期间，在睡眠中心进行了一项病例对照研究，回顾性招募了8628名受试者，包括1307名对照（呼吸暂停低通气指数（AHI）<5次事件/h），3661轻度至中度OSA（AHI为5-30事件/h），和3597名重度OSA受试者(AHI>30事件/h)。逻辑回归用于检查结果变量的比值比（OR）（RH的日平均值或差异，温度,和PM2.5持续1、7和30天），OSA严重程度（按各组）。进行了双因素logistic回归模型，以检查RH与每日平均值或温度或PM2.5与OSA严重程度的差异的OR。进行了暴露-反应关系分析，以检查所有OSA严重程度的结果变量，寒冷和温暖的季节。
结果：我们观察到OSA患者AHI的平均PM2.5和RH分别增加0.04-0.08和0.01-0.03事件/h。在OSA患者中，每日1％RH差异的增加使AHI增加0.02-0.03事件/小时。PM2.5每天减少1μg/m3，AHI减少0.03次/小时，而每天RH降低1％，则AHI降低0.03-0.04事件/小时。双因素模型证实了OSA患者中环境RH与AHI的最紧密关联。温度和RH的暴露-响应关系与OSA严重程度呈明显的季节性模式。
结论：RH和PM2.5的短期环境变化与OSA患者的AHI变化有关，尤其是RH在寒冷的季节。减少暴露于高环境RH和PM2.5水平可能对OSA患者的AHI具有保护作用。
