关注健康老龄化，体力活动减弱中国农村老年人长期暴露于二氧化氮对睡眠质量及其维度的有害影响

Physical activity attenuates the association of long-term exposure to nitrogen dioxide with sleep quality and its dimensions in Chinese rural older adults

体力活动减弱中国农村老年人长期暴露于二氧化氮与睡眠质量及其维度的相关性

Authors: Hongli Wang, Junzhe Li, Qiang Liu, Yan Zhang, Yuan Wang, Huaibiao Li, Liang Sun, Bing Hu, Dongmei Zhang, Chunmei Liang, Jingyuan Lei, Panpan Wang, Jie Sheng, Fangbiao Tao, Guimei Chen, Linsheng Yang

Source: Journal of Affective Disorders. 15 March 2024, Pages 187-196.

Doi: 10.1016/j.jad.2024.01.036.

Abstract

Background: Joint impacts of air pollution and physical activity (PA) on sleep quality remain unaddressed. We aimed to investigate whether PA attenuates the association of long-term exposure to nitrogen dioxide (NO₂) with sleep quality and its dimensions in older adults.

Methods: This study included 3408 Chinese rural older adults. Annual NO₂ was estimated using the Space-Time Extra-Trees model. PA was assessed by International Physical Activity Questionnaire. Sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI) scale. Linear regression models were used to assess the associations of long-term NO₂ exposure and PA with sleep quality and its dimensions, and interaction plots were used to depict the attenuating effect of PA on associations of NO₂ with sleep quality and its dimensions.

Results: Three-year (3-y) average NO₂ (per 0.64-μg/m³ increment) was positively associated with global PSQI (b=0.41, 95% CI: 0.23, 0.59), sleep duration (b=0.16, 95% CI: 0.11, 0.21), and habitual sleep efficiency (b=0.22, 95% CI: 0.17, 0.27), while PA was negatively associated with global PSQI (b=-0.33, 95% CI: -0.46, -0.20) and five domains of PSQI other than sleep duration and sleep disturbances. The associations of NO₂ with global PSQI, sleep duration, and habitual sleep efficiency were attenuated with increased PA (P_interaction were 0.037, 0.020, and 0.079, respectively). 

Conclusions:PA attenuates the adverse impacts of long-term NO₂ exposure on sleep quality, especially on sleep duration, and habitual sleep efficiency, in Chinese rural elderly people. Participating in PA should be encouraged in this population, and continued efforts are still needed to reduce air pollution.

Keywords: nitrogen dioxide; sleep quality; physical activity; rural older adults

摘要

背景 空气污染和体力活动（PA）对睡眠质量的共同影响仍未得到解决。我们的目的是研究长期暴露于二氧化氮（NO₂）环境中的老年人，PA是否会减轻其与睡眠质量及其维度的关联。

方法 本研究纳入3408 名中国农村老年人。采用时空外树模型估算每年NO₂含量。PA通过国际体力活动问卷进行评估。睡眠质量采用匹兹堡睡眠质量指数（PSQI）量表进行评估。采用线性回归模型评估长期暴露于NO₂和PA与睡眠质量及其各维度之间的关联，并采用交互图描述PA对NO₂与睡眠质量及其各维度间关联的减弱作用。

结果 三年平均NO₂（每 0.64-μg/m³增量）与总PSQI（b=0.41，95%CI：0.23，0.59）、睡眠持续时间（b=0.16，95% CI：0.11，0.21）和习惯性睡眠效率（b=0.22，95%CI：0.17，0.27）呈正相关，而PA与总PSQI（b=-0.33，95%CI：-0.46，-0.20）以及除睡眠时间和睡眠障碍之外的5个PSQI维度呈负相关。随着 PA 的增加，NO₂与总体PSQI、睡眠时间和习惯性睡眠效率的相关性减弱（交互作用P值分别为 0.037、0.020和0.079）。

结论 PA能减轻长期暴露于NO₂对中国农村老年人睡眠质量的不良影响，尤其是对睡眠时间和习惯性睡眠效率的影响。应鼓励老年人群参加PA，同时仍需继续努力减少空气污染。

关键词 二氧化氮 睡眠质量 体力活动 农村老年人