Effects of Air Pollution on Sleep in Postpartum Women in Rural Ghana

Résumé fourni par la source

Abstract Rationale: Air pollution exposure, particularly PM2.5, is linked to adverse health outcomes, yet its impact on sleep remains unclear. This study investigates the association between air pollution exposure and sleep-wake patterns in postpartum women using data from the Ghana Randomized Air Pollution and Health Study (GRAPHS). We hypothesize that higher PM2.5 exposure is associated with altered sleep-wake patterns in postpartum women from rural Ghana. Methods: The GRAPHS study enrolled pregnant women from 2013 to 2016. At 4 and 8 years postpartum, participants simultaneously wore personal PM2.5 exposure monitors and actigraphy devices. Personal PM2.5 monitors measured air pollution exposure over a 48-hour period, while actigraphy provided multi-night measures of sleep, including total sleep time (TST, primary outcome), and secondary outcomes including wake after sleep onset (WASO), time in bed (TIB), sleep efficiency, and nighttime awakenings. Sleep intervals were visually identified, and each 30-second epoch was scored as sleep vs wake using the Cole-Kripke algorithm. Linear regression models, adjusted for age, BMI, and household size, were used to assess associations between PM2.5 exposure and sleep outcomes. Results: There were 49 multi-night actigraphy at 4-years postpartum and 78 multi-night actigraphy at 8-years postpartum. On average, participants had mean ages of 33 and 35 years and BMIs of 24.1 and 24.2 at 4 and 8 years postpartum, respectively, with 3.1 nights of actigraphy at 4 years and 2.7 nights at 8 years. Average TST was 6.5 hours at 4 years and 6.0 hours at 8 years postpartum. Sleep onset latency was 18 minutes at 4 years and 4 minutes at 8 years, with WASO times of 81 and 72 minutes, respectively. No associations were identified between average PM2.5 levels over 48 hours and sleep outcomes, including TST, TIB, sleep efficiency, WASO, or number of nighttime awakenings (all p > 0.05). Conclusions: No association was found between average PM2.5 exposure and sleep outcomes, potentially due to limitations in sample size. Future analyses exploring associations with time-varying PM2.5 exposure concentrations may identify time-varying effects on actigraphy-derived sleep metrics that are not identified when averaging PM2.5 exposures. Additionally, incorporating sleep questionnaire responses available for the entire cohort may provide a more comprehensive view of sleep quality in this population. Further studies are needed to investigate objective sleep-wake patterns in relation to air pollution exposure to inform targeted interventions and policies that enhance sleep quality and public health globally.

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