| 摘要: | 研究緣起：睡眠呼吸障礙(sleep-disordered breathing, SDB)是在徹夜發生多次呼吸部分或完全停止，以中華民國胸腔疾病醫學會調查的鼾聲(snoring)盛行率推估40歲以上的國人至少有3.44%罹患阻塞型睡眠呼吸中止(obstructive sleep apnea, OSA)，但目前臺灣只有0.49%的就診率。而睡眠呼吸障礙及空氣污染分別會增加心血管疾病發生及死亡的風險，但目前兩者之間的相關性尚未被釐清。
研究目的：本研究利用臺北醫學大學附設醫院及衛生福利部雙和醫院的睡眠呼吸障礙患者來評估，是否空氣污染濃度上升會與26歲以上的睡眠呼吸障礙有相關性。
研究方法：利用2005年至2013年間經過整夜的睡眠多項生理檢查(polysomnography)得出的呼吸中止與淺呼吸指數(apnea and hypoxia index, AHI)及血氧飽和度降低指數(oxygen desaturation index, ODI)連結空氣污染監測站的逐時資料。空氣污染物指標包含粒徑小於等於10 μm之懸浮微粒（particles with aerodynamic diameters less than 10 μm, PM10）、粒徑小於等於2.5 μm之細懸浮微粒（particles with aerodynamic diameters less than 2.5 μm, PM2.5）、臭氧（ozone, O3）、一氧化碳（carbon monoxide, CO）、二氧化氮（nitrogen dioxide, NO2）、二氧化硫（sulfur dioxide, SO2）。所有的model分成短期：1-day, 3-day, 5-day average及長期：365-day average的空氣污染物濃度資料。
研究結果：呼吸中止與淺呼吸指數與短期及長期的污染物增加有相關性。而血氧飽和度降低指數除了長期臭氧外，皆與短期及長期的污染物增加有相關性。
結論：如果減少空氣污染的暴露會降低睡眠呼吸障礙的嚴重程度，並且可以改善心臟疾病的風險。
Background: Sleep disordered breathing is the intermittent occurrence of a partial or complete cessation of breathing during sleep. An investigation conducted by the Taiwan Society of Pulmonary Medicine estimated the prevalence of obstructive sleep apnea (OSA) among snoring Taiwanese 40 years of age and older to be at least 3.44%. However, currently only 0.49% of Taiwanese have sought medical attention for OSA. While sleep disordered breathing and air pollution have been well-established to independently increase the risk of cardiovascular disease and death, to date the interplay between these two factors remains to be elucidated.
Objective: This study utilized sleep disordered breathing patients sourced from Taipei Medical University Hospital and Shuang Ho Hospital to explore the association between air pollution and sleep disordered breathing among Taiwanese aged over 26 years.
Methods: This study ascertained sleep disordered breathing, the apnea and hypoxia index (AHI), as well as the oxygen desaturation index (ODI) among sleep disordered breathing patients undergoing overnight polysomnography and linked this data to that gathered by air pollution monitoring stations scattered across Taiwan. The air pollutants measured and analyzed in this study included particles with aerodynamic diameters less than 10μm (PM10), particles with aerodynamic diameters less than 2.5μm (PM2.5), ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2). All models were stratified by exposure time. Short-term exposure analyses consisted of 1-day, 3-day, and 5-day average models. The effects of long-term exposure were assessed by a 365-day average.
Results: AHI were associated with both short- and long-term increases in air pollution. Furthermore, apart from long-term exposure to ozone, ODI was associated with all the other short- and long-term air pollution parameters investigated.
Conclusion: If decreasing air pollution exposure mitigates the severity of sleep disordered breathing, it will concomitantly reduce heart disease risk. |
