Associations of long-term exposure to ambient air pollution and physical activity with insomnia in Chinese adults

Jiayue Xu; Junmin Zhou; Peng Luo; Deqiang Mao; Wen Xu; Qucuo Nima; Chaoying Cui; Shujuan Yang; Linjun Ao; Jialong Wu; Jing Wei; Gongbo Chen; Shanshan Li; Yuming Guo; Juying Zhang; Zhu Liu; Xing Zhao; China Multi-Ethnic Cohort (CMEC) collaborative group

doi:10.1016/j.scitotenv.2021.148197

Associations of long-term exposure to ambient air pollution and physical activity with insomnia in Chinese adults

Sci Total Environ. 2021 Oct 20:792:148197. doi: 10.1016/j.scitotenv.2021.148197. Epub 2021 Jun 1.

Authors

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; China Multi-Ethnic Cohort (CMEC) collaborative group

Affiliations

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.

PMID: 34144234
DOI: 10.1016/j.scitotenv.2021.148197

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, PM_2.5, 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, PM_2.5, 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 PM_2.5 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, PM_2.5, 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.

Keywords: Air pollution; China multi-ethnic cohort; Insomnia; Physical activity.

MeSH terms

Adult
Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
China / epidemiology
Environmental Exposure / analysis
Exercise
Humans
Nitrogen Dioxide / analysis
Particulate Matter / adverse effects
Particulate Matter / analysis
Sleep Initiation and Maintenance Disorders* / epidemiology

Substances

Air Pollutants
Particulate Matter
Nitrogen Dioxide