University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA.
Environ Res. 2021 May;196:110406. doi: 10.1016/j.envres.2020.110406. Epub 2020 Oct 29.
Environmental exposures and poor sleep outcomes are known to have consequential effects on human health. This integrative review first seeks to present and synthesize existing literature investigating the relationship between exposure to various environmental factors and sleep health. We then present potential mechanisms of action as well as implications for policy and future research for each environmental exposure. Broadly, although studies are still emerging, empirical evidence has begun to show a positive association between adverse effects of heavy metal, noise pollution, light pollution, second-hand smoke, and air pollution exposures and various sleep problems. Specifically, these negative sleep outcomes range from subjective sleep manifestations, such as general sleep quality, sleep duration, daytime dysfunction, and daytime sleepiness, as well as objective sleep measures, including difficulties with sleep onset and maintenance, sleep stage or circadian rhythm interference, sleep arousal, REM activity, and sleep disordered breathing. However, the association between light exposure and sleep is less clear. Potential toxicological mechanisms are thought to include the direct effect of various environmental toxicants on the nervous, respiratory, and cardiovascular systems, oxidative stress, and inflammation. Nevertheless, future research is required to tease out the exact pathways of action to explain the associations between each environmental factor and sleep, to inform possible therapies to negate the detrimental effects, and to increase efforts in decreasing exposure to these harmful environmental factors to improve health.
环境暴露和睡眠质量差已知会对人类健康产生重大影响。本综述首先旨在呈现和综合现有文献，调查各种环境因素暴露与睡眠健康之间的关系。然后，我们为每种环境暴露呈现潜在的作用机制以及对政策和未来研究的影响。尽管研究仍在不断涌现，但实证证据已开始表明，重金属、噪声污染、光污染、二手烟和空气污染暴露等不良影响与各种睡眠问题之间存在正相关关系。具体而言，这些负面睡眠结果包括主观睡眠表现，如整体睡眠质量、睡眠时间、日间功能障碍和日间嗜睡，以及客观睡眠测量，包括入睡和维持困难、睡眠阶段或昼夜节律干扰、睡眠觉醒、快速眼动活动和睡眠呼吸障碍。然而，光照与睡眠之间的关联不太明确。潜在的毒理学机制可能包括各种环境毒物对神经系统、呼吸系统和心血管系统、氧化应激和炎症的直接影响。然而，需要进一步的研究来梳理确切的作用途径，以解释每种环境因素与睡眠之间的关联，为可能的治疗方法提供信息以抵消这些有害环境因素的不利影响，并加大努力减少对这些有害环境因素的暴露，以改善健康。
