中国南方成年人群室外夜间灯光暴露与阻塞性睡眠呼吸暂停的横断面关联研究

Association of outdoor light at night with obstructive sleep apnoea: A cross-sectional study among adults in Southern China

  • 摘要:
    背景 阻塞性睡眠呼吸暂停(OSA)是一种以睡眠期间反复发作的上气道阻塞为特征的睡眠呼吸障碍性疾病。鉴于OSA患者数量庞大,亟须解决这一问题给社会带来的负担。目前国际上将室外夜间灯光(LAN)与OSA患病风险进行研究的证据较少。
    目的 探讨中国南方人群室外LAN暴露与OSA患病风险的关联性。
    方法 研究对象为2005年1月1日至2015年12月31日在广东省人民医院睡眠中心进行睡眠监测的3925例住院患者。采用多导睡眠监测或家庭睡眠测试测定呼吸暂停低通气指数(AHI),AHI可用来诊断和判定OSA的严重程度。使用500 m空间分辨率的可见光红外成像辐射计套件(NPP-VIIRS)的LAN数据来评估受试者进行睡眠监测前1、3、5年的室外LAN暴露水平。采用广义线性回归模型分析室外LAN暴露水平与OSA患病风险的关联性。
    结果 3年平均室外LAN每增加1个四分位间距,以未患OSA为参照,OSA、轻度OSA和中度OSA患病风险的OR值(95%CI)分别为1.175(1.021~1.351)、1.215(1.038~1.421)和1.195(1.003~1.425)。性别分层分析结果显示,女性OSA 患病风险的OR值(95%CI)为1.933(1.424~2.637)(P交互作用< 0.001)。此外,使用1年/ 5年的室外LAN做敏感性分析,OSA的OR值变化没有统计学意义。
    结论 在中国南方人群中,室外LAN的升高与较高的OSA(尤其是轻、中度OSA)患病风险显著相关,在女性人群中更为明显。进行户外LAN的有效管控并制订相关的政策框架,有望减轻OSA的疾病负担。

     

    Abstract:
    Background Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent episodes of obstruction of the upper airway during sleep. Given the substantial number of OSA patients, it is urgently in need to address the burden on society. Current available evidence linking outdoor light at night (LAN) to OSA is scarce.
    Objective To explore the relationships regarding outdoor LAN and OSA among residents in Southern China.
    Methods A total of 3925 hospitalized patients in Guangdong Provincial People's Hospital Sleep Center were recruited between January 1, 2005 and December 31, 2015. The severity of OSA was determined by apnea-hypopnea index (AHI) using polysomnography or home sleep test. The annual Suomi National Polar-orbiting Partnership Visible Infrared Imaging Radiometer Suite (NPP-VIIRS)-like LAN data with a 500 m spatial resolution were used to evaluate outdoor LAN levels of the participants 1, 3, and 5 years before undergoing sleep monitoring. Generalized linear regression models were utilized to examine the associations of outdoor LAN with OSA.
    Results The ORs (95%CIs) of OSA, mild OSA, and moderate OSA were 1.175 (1.021, 1.351), 1.215 (1.038, 1.421), and 1.195 (1.003, 1.425) respectively for per interquartile range (IQR) increment in three-year average outdoor LAN. The results of stratified analyses showed a higher OR of 1.933 (95%CI: 1.424, 2.637) in female than male participants (P interaction < 0.001). Additionally, the ORs of OSA did not substantially change using one-year/ five-year instead of three-year average outdoor LAN.
    Conclusion Our findings demonstrate that an elevated outdoor LAN is significantly associated with higher odds of OSA (especially mild and moderate OSA) in Southern China, especially in females. An effective outdoor LAN management and policy-making framework has been suggested as potential preventive measures to reduce burden of OSA.

     

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