Residential environments and sleep-disordered breathing in Bangkok Thailand: a repeated cross-sectional study

Abstract

Since epidemiological associations have demonstrated the effects of long-term air pollution to OSA through a physiological mechanism linking particulate matter exposure to OSA. We enrolled 81 participants from the Excellence Center for Sleep Disorders at King Chulalongkorn Memorial hospital, Bangkok, Thailand. This study consists of two seasons (the wet and the dry seasons), which it started during the period of January in 2016 to April in 2017. Personal information, bedroom environmental characteristics, subjective sleep quality, underlying diseases, bedroom environmental conditions (PM10, temperature, and relative humidity), and urinary melatonin were obtained by a face-to-face interview, medical record, field analysis, and laboratory analysis respectively. A big proportion of participants experienced poor sleep and was suffered from severe OSA. An elevation in 1-year mean PM10 concentration was significantly associated with an increase in an apnea-hypopnea index (Beta = 1.04, p value = 0.021), and respiratory disturbance index (Beta = 1.07, p value = 0.013). An increase of bedroom temperature during sleep was significantly associated with poorer sleep quality (AOR = 1.46, 95% CI; 1.01, 2.10; p value = 0.044). Associations between PM10 concentration and respiratory disturbance index were observed in the dry season (Beta = 0.59, p value = 0.040) but not in the wet season (Beta =0.39, p value = 0.215). PM10 was not associated with subjective sleep quality. A significant association between PM10 concentrations and low levels of urinary melatonin was found (AOR = 1.06, 95% CI; 1.00, 1.11; p value = 0.048), and participants whose bedroom had an elevation of PM10 concentrations, it has a statistically significant 1.07-fold increased odds of low melatonin concentrations (≤ 15.24 ng/mg) (95% CI; 1.01-1.13; p value = 0.034). This research suggests that lowering in exposure to particulate matter and suitable bedroom environments may lessen the severity of OSA, promote good sleep, and improve or maintain melatonin level.