Associations between reservoir bedroom dust allergen levels and sleep symptoms in school-age children

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OBJECTIVES: Exposure to allergens may trigger inflammatory pathways contributing to poor sleep. We investigated the associations between indoor allergen concentrations with multiple sleep dimensions in children. METHODS: Bedroom dust aeroallergens were collected in participants' homes. The outcomes were caregiver-reported sleep-related daytime impairment and sleep disturbance (pediatric PROMIS instruments), sleep-disordered breathing (SDB; apnea-hypopnea index or oxygen desaturation index >5), and actigraphy-based short sleep (<8 hours) duration and poor sleep continuity (sleep fragmentation index > 75th percentile). Logistic regression was used to examine associations between aeroallergens (>50% detectable levels) and sleep outcomes, adjusting for potential confounders (i.e., sociodemographic, environmental, and health-related). RESULTS: The sample included an urban cohort of 256 children (41% Hispanic, 29% Black; 43% female) aged 6-12 years. Mouse (Mus m 1), cat (Fel d 1), and dog (Can f 1) allergens were detected in 81%, 72%, and 53% of households, respectively. Elevated mouse allergen exposure (>0.55 μg/g-75th percentile) was associated with a 2.6-fold (95% CI: 1.34, 5.03) increased odds for sleep-related daytime impairment (PROMIS T-score > 55) after adjusting for demographic factors. This association persisted after further adjusting for inflammatory-related health factors (asthma, allergic rhinitis, obesity, and environmental tobacco smoke), neighborhood disadvantage, and SDB. There was attenuation of this association with poor sleep consolidation. Associations were not observed for other allergens or other sleep outcomes. CONCLUSIONS: Exposure to elevated mouse dust was associated with increased sleep-related daytime impairment symptoms. The role of household pest exposure as a potentially modifiable target for improving sleep health should be further studied.

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