Associations between indoor fine particulate matter (PM2.5) and sleep-disordered breathing in an urban sample of school-aged children.

Objectives: Environmental risk factors may contribute to sleep-disordered breathing. We investigated the association between indoor particulate matter ≤2.5µm in aerodynamic diameter (PM_2.5) and sleep-disordered breathing in children in an urban US community.

Methods: The sample consisted of children aged 6-12years living in predominantly low-income neighborhoods in Boston, Massachusetts. Indoor PM_2.5 was measured in participants' main living areas for 7days using the Environmental Multipollutant Monitoring Assembly device. High indoor PM_2.5 exposure was defined as greater than the sample weekly average 80th percentile level (≥15.6 μg/m³). Sleep-disordered breathing was defined as an Apnea-Hypopnea-Index (AHI) or Oxygen-Desaturation-Index (ODI) (≥3% desaturation) of ≥5 events/hour. Habitual loud snoring was defined as caregiver-report of loud snoring (most or all the time each week) over the past 4weeks. We examined the associations of PM_2.5 with sleep-disordered breathing or snoring using logistic regression adjusting for potential confounders.

Results: The sample included 260 children (mean age 9.6years; 41% female), with 32% (n = 76) classified as having sleep-disordered breathing. In a logistic regression model adjusted for socioeconomics and seasonality, children exposed to high indoor PM_2.5 levels (n = 53) had a 3.53-fold increased odds for sleep-disordered breathing (95%CI: 1.57, 8.11, p = .002) compared to those with lower indoor PM_2.5. This association persisted after additional adjustments for physical activity, outdoor PM_2.5, environmental tobacco smoke, and health characteristics. Similar associations were observed for snoring and indoor PM_2.5. CONCLUSIONS: Children with higher indoor PM_2.5 exposure had greater odds of sleep-disordered breathing and habitual loud snoring, suggesting that indoor air quality contributes to sleep disparities.