Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, No.17, Xu-Zhou Rd., Taipei, 10055, Taiwan.
Department of Family Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
Sci Rep. 2022 Nov 9;12(1):19064. doi: 10.1038/s41598-022-21964-0.
Ambient air pollution was known to cause central nervous system diseases and depressive symptoms. In this study, we examined the associations between air pollution exposure and the prevalence of insomnia in Taipei City of Taiwan. We applied the health information system of electrical medical records of Taipei City Hospital to collect a total of 5108 study subjects (insomniacs N = 912 and non-insomniacs N = 4196) over 18 years old from the family medicine and internal medicine outpatients of six branches of Taipei City Hospital. These patients were grouped into insomniacs and non-insomniacs following the primary insomnia diagnosis (ICD9:780.52, 780.54, 307.41, 307.42, ICD10: G47.00, G47.01, G47.09, F51.01, F51.09) and the prescription times of anxiolytics and hypnotics. We estimated one-year average concentrations of PM, ozone, and NO before the first date of insomnia diagnosis and the last date of outpatient visit for insomniacs and non-insomniacs, respectively, by using the data of nearest air quality monitoring stations relative to study subjects' residential addresses. Logistic regression analysis was employed to examine the independent effects of air pollution concentrations on the risk of insomnia. One-year average PM, ozone, and NO levels for insomniacs was significantly higher than those of non-insomniacs. After adjusting for confounding factors, increase each 1(μg/m) in one-year average PM showed a statistically significant association with insomnia (the odds ratio 1.610, 95% CI [1.562,1.660]). As to multi pollutants, one-year average PM (1.624, [1.570, 1.681] and ozone (1.198, [1.094, 1.311]) exposure showed a significant association with insomnia. Subgroup analysis revealed that the influence of PM and ozone on insomnia have significant risks in people with major chronic disease. This study demonstrated a positive association between PM and ozone exposure and the prevalence of hypnotic-treated insomnia. Especially, the people with major chronic diseases were with obvious effect of PM and ozone on risk of insomnia.
已知，空气污染会导致中枢神经系统疾病和抑郁症状。本研究调查了空气污染暴露与台湾台北市失眠症患病率之间的关系。我们应用台北市医院电子病历的健康信息系统，从台北市六家医院的家庭医学和内科门诊中收集了总共 5108 名研究对象（失眠症患者 N=912，非失眠症患者 N=4196），年龄均在 18 岁以上。这些患者根据原发性失眠症诊断（ICD9：780.52、780.54、307.41、307.42、ICD10：G47.00、G47.01、G47.09、F51.01、F51.09）和镇静催眠药的处方次数，被分为失眠症患者和非失眠症患者。我们根据距研究对象居住地址最近的空气质量监测站的数据，分别估算了每位失眠症患者和非失眠症患者首次诊断为失眠症和最后一次门诊就诊前一年的 PM、臭氧和 NO 的平均浓度。采用 logistic 回归分析检验了空气污染浓度对失眠症风险的独立影响。与非失眠症患者相比，失眠症患者的一年平均 PM、臭氧和 NO 水平显著更高。在调整了混杂因素后，每年 PM 平均浓度增加 1μg/m，与失眠症有统计学显著关联（比值比 1.610，95%CI[1.562，1.660]）。对于多污染物，每年 PM 平均浓度（1.624，[1.570，1.681]）和臭氧（1.198，[1.094，1.311]）暴露与失眠症显著相关。亚组分析显示，PM 和臭氧对失眠症的影响在患有主要慢性疾病的人群中存在显著风险。本研究表明，PM 和臭氧暴露与催眠药物治疗的失眠症患病率呈正相关。特别是，患有主要慢性疾病的人群，PM 和臭氧对失眠症风险的影响明显。
