Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano - IRCCS, Milan, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Sleep Breath. 2024 Mar;28(1):371-375. doi: 10.1007/s11325-023-02918-w. Epub 2023 Sep 18.
Air pollution and obstructive sleep apnea (OSA) are both linked with cardiovascular co-morbidities and share similar pathophysiological mechanisms. A causal association between the two has been postulated. However, the results of the studies on this topic are conflicting mainly because of the lack of adjustment for important confounders such as seasonality and temperature. We aimed to evaluate if such an association exists in a highly polluted area like Lombardy region (Italy) when accounting for all confounders.
Data of adult patients seen at the Sleep Disorder Centre in Milan from 2010 to 2020 were analysed and the main polygraphic data were retrieved. Air pollutant concentrations of the following pollutants NO, O, PM, and PM were collected through monitoring stations.
A total of 3493 patients were included: males (2358, 67.5%) mean age 60.1 (SD = 14.3) years, BMI 29.2 (6.2) kg/m, mean AHI 16.5 (18.1) events/h. After adjusting for all confounders, in the multivariable analysis, the only associations that remained significant were long-term exposure to O with indexes of OSA severity (AHI and ODI) but only in spring. Furthermore, a positive association was seen between long-term exposure to PM and ODI but in springtime only.
The findings of the current study does not support an association between fine particulate matter and OSA severity.
空气污染和阻塞性睡眠呼吸暂停（OSA）都与心血管合并症有关，并具有相似的病理生理机制。有人假设两者之间存在因果关系。然而，由于缺乏对季节性和温度等重要混杂因素的调整，该主题的研究结果存在冲突。我们旨在评估在像伦巴第地区（意大利）这样污染严重的地区，当考虑到所有混杂因素时，这种关联是否存在。
分析了 2010 年至 2020 年在米兰睡眠障碍中心就诊的成年患者的数据，并检索了主要的多导睡眠图数据。通过监测站收集了以下污染物的空气污染物浓度：NO、O、PM 和 PM。
共纳入 3493 例患者：男性（2358 例，67.5%），平均年龄 60.1（SD=14.3）岁，BMI 29.2（6.2）kg/m，平均 AHI 16.5（18.1）事件/h。在调整所有混杂因素后，在多变量分析中，唯一仍具有显著意义的关联是长期暴露于 O 与 OSA 严重程度的指标（AHI 和 ODI）相关，但仅在春季。此外，还发现长期暴露于 PM 与 ODI 呈正相关，但仅在春季。
本研究的结果不支持细颗粒物与 OSA 严重程度之间的关联。
