Sleep apnea can be tied to air pollution, suggests new study

New delhi: Can air pollution add to the risk and severity of obstructive sleep apnea (OSA), a potentially serious sleep disorder in which breathing repeatedly stops and starts? A new study published in the journal Neuro Toxicology suggests so.

It claims that though there is no conclusive evidence, there are several plausible pathways to link the two. For example, the Neuro Toxicology study says, exposure to persistently high levels of air pollution can cause systemic inflammation or inflammation throughout the body, oxidative stress, potentially leading to or worsening upper airway dysfunction during sleep.

"It is important to note that effects of air pollutants may vary based on the type of pollutant, duration of exposure, and individual susceptibility factors, including age, gender, and underlying health conditions," it adds. The study was led by Bijaya Kumar Padhi from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh.

The researchers carried out a systematic review and meta-analysis of 12 studies to consolidate and examine data on the relationship between air pollution and OSA's risk and severity.

They found that air pollutants, especially nitrogen oxide (NO2), might play a role in worsening OSA risk and severity, but the evidence isn't definitive. NO2 is part of a group of gaseous air pollutants produced because of road traffic and other fossil fuel combustion processes.

The potential association between air pollution and OSA severity has significant implications for clinical practice, say researchers.

"Healthcare providers may need to consider environmental factors in OSA risk assessment and management. In high-pollution areas, clinicians could be advised to monitor patients more closely for OSA symptoms and consider environmental factors in the condition's severity," they add, in the Neuro Toxicology study.

OSA is caused by repetitive collapse of the upper airway during sleep. It is estimated that 11 per cent Indians (adults) suffer from OSA with men at higher risk (13 per cent) compared to women (5 per cent).

Dr J C Suri, director of pulmonology, critical care and sleep medicine at Fortis Hospital, Vasant Kunj, said OSA can affect any age or gender, but elderly and overweight individuals are at increased risk. "The above mentioned study doesn't give out any direct evidence of a link between air pollution and OSA. We need more data to comment or act on its implications," he added.

Some of the key signs of obstructive sleep apnea include loud snoring and choking or gasping during sleep. Restless sleep leads to daytime sleepiness, which decreases workplace productivity and increases the risk of road traffic accidents.

After many years of untreated OSA, patients develop an increased risk of hypertension, heart disease, stroke, and metabolic disorders, according to doctors.

Dr Suri said lifestyle changes such as weight reduction, quitting smoking and avoiding alcohol can help manage or even reduce the risk of OSA. But those suffering from moderate and severe sleep apnea may need medical intervention.