Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands; Health and Quality of Life in a Green and Sustainable Environment Research Group, Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria.
Health and Quality of Life in a Green and Sustainable Environment Research Group, Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Urban Planning, Faculty of Architecture, University of Architecture, Civil Engineering and Geodesy, Sofia, Bulgaria.
Environ Res. 2024 Dec 15;263(Pt 1):119897. doi: 10.1016/j.envres.2024.119897. Epub 2024 Aug 31.
Nighttime light is a growing anthropogenic health threat, particularly in urban areas. Limited evidence suggests that exposure to outdoor artificial light at night (ALAN) may be associated with people's mental health by disrupting sleep-wake cycles.
We assessed 1) the association between ALAN exposure and adults' symptoms of depression and anxiety, 2) whether the association was modified by sex, age, and income, and 3) the mediating role of sleep problems.
We obtained cross-sectional data from 4,068 adults from the five largest Bulgarian cities. Depression and anxiety symptoms were measured using the 4-item Patient Health Questionnaire (PHQ-4). Sleep problems were self-reported based on three items. Outdoor ALAN at residential addresses was assessed using annual radiance levels obtained from satellite imagery. Regression models were adjusted for person-level characteristics, green space, and nitrogen dioxide (NO). We also assessed effect modification by sex, age, and income. Using mediation analyses, we tested sleep problems as a mediator of the ALAN-PHQ-4 association.
Greater ALAN exposure in the fully adjusted model was marginally associated with higher PHQ-4 scores. We observed no effect modification. The mediator, sleep problems, was also positively associated with ALAN. The mediation of sleep problems was significantly positive. While the direct association was null, the total ALAN association was marginally and positively associated with PHQ-4 scores.
Our findings suggest a positive association between outdoor nighttime light pollution and mental health. Poor sleep quality is a possible pathway relating ALAN exposure to mental health. Considering the increasing ubiquity and intensity of urban nighttime illumination, light pollution-reducing policies may provide significant health benefits for urban populations.
夜间光污染是一种日益严重的人为健康威胁，尤其是在城市地区。有限的证据表明，夜间（ALAN）暴露于户外人工光可能通过扰乱睡眠-觉醒周期与人们的心理健康有关。
我们评估了 1）夜间光暴露与成年人抑郁和焦虑症状的关联，2）这种关联是否受性别、年龄和收入的影响，以及 3）睡眠问题的中介作用。
我们从保加利亚五个最大城市的 4068 名成年人中获得了横断面数据。使用 4 项患者健康问卷（PHQ-4）来衡量抑郁和焦虑症状。根据三个项目自我报告睡眠问题。使用卫星图像获得的年度辐亮度来评估住宅地址的户外 ALAN。回归模型调整了个人特征、绿地和二氧化氮（NO）。我们还评估了性别、年龄和收入的调节作用。使用中介分析，我们测试了睡眠问题作为 ALAN-PHQ-4 关联的中介。
在完全调整的模型中，较高的 ALAN 暴露与 PHQ-4 评分较高呈边缘相关。我们没有观察到调节作用。中介物，睡眠问题，也与 ALAN 呈正相关。睡眠问题的中介作用是显著的正相关。虽然直接关联为零，但总 ALAN 关联与 PHQ-4 评分呈边缘正相关。
我们的研究结果表明，户外夜间光污染与心理健康之间存在正相关。睡眠质量差可能是 ALAN 暴露与心理健康相关的一个途径。考虑到城市夜间照明的普及度和强度不断增加，减少光污染的政策可能会为城市人口带来显著的健康益处。
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