School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Sci Bull (Beijing). 2024 Jul 15;69(13):2114-2121. doi: 10.1016/j.scib.2024.05.016. Epub 2024 May 18.
Obstructive sleep apnea (OSA) is a serious type of sleep disorder that can lead to cardiometabolic and neurocognitive diseases. We utilized smart device-based photoplethysmography technology to collect sleep data from the Chinese population from 2019 to 2022. Distributed lag nonlinear models combined with a generalized nonlinear model or a linear mixed effects model were used to investigate the short-term associations between daily temperature and indicators of OSA severity. We included a total of 6,232,056 d of sleep monitoring data from 51,842 participants with moderate to severe risk of OSA from 313 Chinese cities. The relationships between ambient temperature and OSA exacerbation, apnea-hypopnea index (AHI), and minimum oxygen saturation (MinSpO) were almost linear and present only on the same day. Higher temperatures were associated with a greater risk of OSA exacerbation, with an 8.4% (95% confidence interval (CI): 7.6%-9.3%) increase per 10 °C increase in temperature. A 10 °C increase in daily temperature corresponded to an AHI increase of 0.70 events/h (95% CI: 0.65-0.76) and a MinSpO decrease of 0.18% (95% CI: 0.16%-0.19%). Exposure to elevated temperatures during the night can also lead to adverse effects. The effects of higher temperatures on OSA severity were stronger among men, participants with a body mass index ≥ 24 kg/m, those aged 45 years and older, individuals with a history of hypertension and diabetes, and during the cold season. This large-scale, nationwide, longitudinal study provides robust evidence suggesting that higher ambient temperatures may immediately worsen OSA.
阻塞性睡眠呼吸暂停（OSA）是一种严重的睡眠障碍，可导致心脏代谢和神经认知疾病。我们利用基于智能设备的光体积描记术技术，从 2019 年至 2022 年收集中国人群的睡眠数据。我们使用分布式滞后非线性模型结合广义非线性模型或线性混合效应模型，研究了每日温度与 OSA 严重程度指标之间的短期关联。我们共纳入了来自中国 313 个城市的 51842 名中重度 OSA 风险患者的 6232056 天睡眠监测数据。环境温度与 OSA 加重、呼吸暂停低通气指数（AHI）和最低血氧饱和度（MinSpO）之间的关系几乎是线性的，仅在同一天出现。较高的温度与 OSA 加重的风险增加有关，温度每升高 10°C，风险增加 8.4%（95%置信区间（CI）：7.6%-9.3%）。每日温度升高 10°C 对应 AHI 增加 0.70 次/小时（95%CI：0.65-0.76）和 MinSpO 下降 0.18%（95%CI：0.16%-0.19%）。夜间暴露于高温也会导致不良影响。夜间高温对 OSA 严重程度的影响在男性、BMI≥24kg/m²、45 岁及以上、有高血压和糖尿病病史以及在寒冷季节的人群中更为明显。这项大规模、全国性、纵向研究提供了强有力的证据，表明较高的环境温度可能会立即使 OSA 恶化。
