School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Sci Total Environ. 2023 Feb 25;861:160586. doi: 10.1016/j.scitotenv.2022.160586. Epub 2022 Nov 28.
The objective of this study was to examine associations of daily averages and daily variations in ambient relative humidity (RH), temperature, and PM on the obstructive sleep apnea (OSA) severity.
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 PM 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 PM with OSA severity. An exposure-response relationship analysis was conducted to examine the outcome variables with OSA severity in all, cold and warm seasons.
We observed associations of mean PM 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 PM decrease of 1 μg/m 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.
Short-term ambient variations in RH and PM were associated with changes in the AHI in OSA patients, especially RH in cold season. Reducing exposure to high ambient RH and PM levels may have protective effects on the AHI in OSA patients.
本研究旨在探讨环境相对湿度（RH）、温度和 PM 的日平均值和日变化与阻塞性睡眠呼吸暂停（OSA）严重程度的关系。
采用病例对照研究，回顾性招募 2015 年 1 月至 2021 年 12 月期间睡眠中心的 8628 例患者，包括对照组（呼吸暂停低通气指数（AHI）<5 次/小时）1307 例，轻中度 OSA 组（AHI 为 5-30 次/小时）3661 例，重度 OSA 组（AHI>30 次/小时）3597 例。采用 logistic 回归分析评估 OSA 严重程度（按组）与每日平均 RH、温度和 PM 的差异（1、7 和 30 天）的比值比（OR）。采用二因素 logistic 回归模型分析 RH 与每日平均温度或 PM 与 OSA 严重程度的差异与 OSA 严重程度的 OR。进行暴露-反应关系分析，以评估所有、冷季和暖季中与 OSA 严重程度相关的变量。
我们观察到 PM 和 RH 平均值与 OSA 患者 AHI 相应增加 0.04-0.08 和 0.01-0.03 次/小时有关。1%RH 日差增加 1%，OSA 患者的 AHI 增加 0.02-0.03 次/小时。每日 PM 减少 1μg/m3，可使 AHI 减少 0.03 次/小时，而 RH 每日减少 1%，可使 AHI 减少 0.03-0.04 次/小时。二因素模型证实了环境 RH 与 OSA 患者 AHI 之间最显著的关联。温度和 RH 的暴露-反应关系与 OSA 严重程度呈明显的季节性模式。
短期环境 RH 和 PM 的变化与 OSA 患者的 AHI 变化有关，尤其是冷季的 RH。减少高环境 RH 和 PM 水平的暴露可能对 OSA 患者的 AHI 具有保护作用。
