Jiayue Xu1, Junmin Zhou1, Peng Luo2, Deqiang Mao3, Wen Xu4, Qucuo Nima5, Chaoying Cui6, Shujuan Yang1, Linjun Ao7, Jialong Wu1, Jing Wei8, Gongbo Chen9, Shanshan Li10, Yuming Guo11, Juying Zhang12, Zhu Liu13, Xing Zhao14. 1. West China School of Public Health and West China Fourth Hospital, Sichuan University, China. 2. School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China. Electronic address: luopeng@gmc.edu.cn. 3. Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China. 4. Yunnan Center for Disease Control and Prevention, Kunming 650022, China. 5. Tibet Center for Disease Control and Prevention CN, Lhasa 850000, China. 6. Tibet University, Lhasa 850000, China. 7. West China School of Public Health and West China Fourth Hospital, Sichuan University, China. Electronic address: aolinjun@stu.scu.edu.cn. 8. Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA, USA. 9. Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address: chengb36@mail.sysu.edu.cn. 10. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: Shanshan.Li@monash.edu. 11. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: yuming.guo@monash.edu. 12. West China School of Public Health and West China Fourth Hospital, Sichuan University, China. Electronic address: juying109@163.com. 13. Chengdu Center for Disease Control and Prevention, Chengdu 610041, China. Electronic address: 137949813@qq.com. 14. West China School of Public Health and West China Fourth Hospital, Sichuan University, China. Electronic address: xingzhao@scu.edu.cn.
Abstract
BACKGROUND: Air pollution is a potential environmental risk for sleep disturbance. However, the evidence is very limited in China. On the other hand, physical activity (PA) is a preventive behavior that can improve insomnia, but whether PA mitigates the negative impact of air pollution on insomnia is unknown. METHODS: We obtained data from the baseline of China Multi-Ethnic Cohort (CMEC) survey, and examined the association between air pollution and insomnia, as well as PA's modification effect of on this association. We included 70,668 respondents and assessed insomnia by self-reported symptoms collected using electronic questionnaires. Using satellite data, we estimated the residence-specified, three-year average PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters of ≤1 μm, ≤2.5 μm and 10 μm, respectively), O3 (ozone), and NO2 (nitrogen dioxide) concentrations. We established the associations between air pollutants and insomnia through logistic regression. We evaluated the modification impact of total and domain-specific PA (leisure, occupation, housework, transportation) by introducing an interaction term. RESULTS: Positive associations were observed between long-term exposure to PM1, PM2.5, PM10, and O3 and insomnia symptoms, with ORs (95% CI) of 1.09 (1.03-1.16), 1.11 (1.07-1.15), 1.07 (1.05-1.10) and 1.15 (1.11-1.20), respectively. As total PA increased, the ORs of air pollution for insomnia tended to decrease and then rise. We observed varying modification effects of domain-specific PA. With an increase in leisure PA, the ORs for PM2.5 and PM10 significantly declined. However, increased ORs of air pollutants were related to insomnia among participants with higher levels of occupational and housework PA. CONCLUSION: Long-term exposure to higher concentrations of PM1, PM2.5, PM10, and O3 increases the risk of insomnia symptoms. Moderate to high levels of leisure PA alleviate the harmful effects of air pollution on insomnia, while high levels of occupation and housework PA intensify such effects.
BACKGROUND: Air pollution is a potential environmental risk for sleep disturbance. However, the evidence is very limited in China. On the other hand, physical activity (PA) is a preventive behavior that can improve insomnia, but whether PA mitigates the negative impact of air pollution on insomnia is unknown. METHODS: We obtained data from the baseline of China Multi-Ethnic Cohort (CMEC) survey, and examined the association between air pollution and insomnia, as well as PA's modification effect of on this association. We included 70,668 respondents and assessed insomnia by self-reported symptoms collected using electronic questionnaires. Using satellite data, we estimated the residence-specified, three-year average PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters of ≤1 μm, ≤2.5 μm and 10 μm, respectively), O3 (ozone), and NO2 (nitrogen dioxide) concentrations. We established the associations between air pollutants and insomnia through logistic regression. We evaluated the modification impact of total and domain-specific PA (leisure, occupation, housework, transportation) by introducing an interaction term. RESULTS: Positive associations were observed between long-term exposure to PM1, PM2.5, PM10, and O3 and insomnia symptoms, with ORs (95% CI) of 1.09 (1.03-1.16), 1.11 (1.07-1.15), 1.07 (1.05-1.10) and 1.15 (1.11-1.20), respectively. As total PA increased, the ORs of air pollution for insomnia tended to decrease and then rise. We observed varying modification effects of domain-specific PA. With an increase in leisure PA, the ORs for PM2.5 and PM10 significantly declined. However, increased ORs of air pollutants were related to insomnia among participants with higher levels of occupational and housework PA. CONCLUSION: Long-term exposure to higher concentrations of PM1, PM2.5, PM10, and O3 increases the risk of insomnia symptoms. Moderate to high levels of leisure PA alleviate the harmful effects of air pollution on insomnia, while high levels of occupation and housework PA intensify such effects.