Associations between indoor fine particulate matter (PM) and sleep-disordered breathing in an urban sample of school-aged children.

OBJECTIVES

Environmental risk factors may contribute to sleep-disordered breathing. We investigated the association between indoor particulate matter ≤2.5µm in aerodynamic diameter (PM) and sleep-disordered breathing in children in an urban US community.

METHODS

The sample consisted of children aged 6-12years living in predominantly low-income neighborhoods in Boston, Massachusetts. Indoor PM was measured in participants' main living areas for 7days using the Environmental Multipollutant Monitoring Assembly device. High indoor PM exposure was defined as greater than the sample weekly average 80th percentile level (≥15.6 μg/m). Sleep-disordered breathing was defined as an Apnea-Hypopnea-Index (AHI) or Oxygen-Desaturation-Index (ODI) (≥3% desaturation) of ≥5 events/hour. Habitual loud snoring was defined as caregiver-report of loud snoring (most or all the time each week) over the past 4weeks. We examined the associations of PM with sleep-disordered breathing or snoring using logistic regression adjusting for potential confounders.

RESULTS

The sample included 260 children (mean age 9.6years; 41% female), with 32% (n = 76) classified as having sleep-disordered breathing. In a logistic regression model adjusted for socioeconomics and seasonality, children exposed to high indoor PM levels (n = 53) had a 3.53-fold increased odds for sleep-disordered breathing (95%CI: 1.57, 8.11, p = .002) compared to those with lower indoor PM. This association persisted after additional adjustments for physical activity, outdoor PM, environmental tobacco smoke, and health characteristics. Similar associations were observed for snoring and indoor PM CONCLUSIONS: Children with higher indoor PM exposure had greater odds of sleep-disordered breathing and habitual loud snoring, suggesting that indoor air quality contributes to sleep disparities.