Effects of Bedroom Environmental Conditions on the Severity of Obstructive Sleep Apnea

Abstract

Study objectives: Epidemiological associations have demonstrated the effects of long-term air pollution to obstructive sleep apnea (OSA) through a physiological mechanism linking particulate matter exposure to OSA. This study aimed to determine the relationship between bedroom environmental conditions, OSA severity, and sleep quality.

Methods: Sixty-three participants were enrolled for an overnight polysomnography; OSA was diagnosed between May to August 2016. Personal characteristics and sleep quality were obtained by a face-to-face interview. Bedroom environments, including data on particulate matter with an aerodynamic diameter less than 10 μm (PM₁₀), temperature, and relative humidity, were collected by personal air sampling and a HOBO tempt/RH data logger.

Results: Sixty-eight percent of the participants experienced poor sleep. An elevation in 1-year mean PM₁₀ concentration was significantly associated with an increase in apnea-hypopnea index (beta = 1.04, P = .021) and respiratory disturbance index (beta = 1.07, P = .013). An increase of bedroom temperature during sleep was significantly associated with poorer sleep quality (adjusted odds ratio 1.46, 95% confidence interval 1.01-2.10, P = .044). Associations between PM₁₀ concentration and respiratory disturbance index were observed in the dry season (beta = 0.59, P = .040) but not in the wet season (beta = 0.39, P = .215). PM₁₀ was not associated with subjective sleep quality.

Conclusions: Elevation of PM₁₀ concentration is significantly associated with increased OSA severity. Our findings suggest that reduction in exposure to particulate matter and suitable bedroom environments may lessen the severity of OSA and promote good sleep.

Keywords: bedroom environments; obstructive sleep apnea; particulate matter; sleep quality.

Figure 1. Beta coefficients with 95% CI for the association of bedroom environmental conditions (stratified by seasons) and AHI.

AHI = apnea-hypopnea index, CI = confidence interval, PM₁₀ = particulate matters with an aerodynamic diameter of less than 10 μm, RH = relative humidity, Tempt = temperature.

Figure 2. Beta coefficients with 95% CI for the association of bedroom environmental conditions (stratified by seasons) and RDI.

CI = confidence interval, PM₁₀ = particulate matters with an aerodynamic diameter of less than 10 μm, RDI = respiratory disturbance index, RH = relative humidity, Tempt = temperature.