Association between air pollution and sleep disordered breathing in children
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Updated: Jan 29, 2026

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Published on: April 26, 2024
Trinidad Sánchez1, David Gozal2, Dale L Smith3
1Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Air pollution, including ozone and sulfur dioxide, is linked to sleep disordered breathing symptoms in children. Environmental factors like humidity and temperature also impact respiratory sleep issues.
Area of Science:
- Environmental Health
- Pediatric Respiratory Medicine
- Sleep Science
Background:
- Sleep disordered breathing (SDB) may worsen with air contaminant exposure.
- Air pollution's impact on SDB incidence and severity in children is under investigation.
Purpose of the Study:
- To explore associations between air pollutant exposure and SDB symptoms in children.
- To investigate the role of environmental factors in pediatric sleep disturbances.
Main Methods:
- Cross-sectional study involving first-grade children in Chile.
- Data collection included clinical SDB risk factors, the Pediatric Sleep Questionnaire (PSQ), and air quality/meteorological data.
- Statistical analyses adjusted for demographic and household variables.
Main Results:
- A prevalence of 17.7% for SDB was identified via PSQ.
- Higher ozone (O3) and sulfur dioxide (SO2) levels correlated with increased odds of wheezing-related sleep disturbances.
- Increased humidity was associated with higher PSQ scores, while lower temperatures predicted snoring.
Conclusions:
- Pediatric sleep respiratory symptoms like wheezing and snoring are significantly associated with air pollutants (O3, SO2).
- Environmental conditions, including humidity and low temperatures, may also contribute to SDB symptoms in children.
Background And Objective:
Similar to other respiratory diseases, sleep disordered breathing (SDB) may be exacerbated by air contaminants. Air pollution may have an impact on incidence and severity of SDB in children. The aims of this study were to examine potential associations between the exposure to different air pollutants and SDB symptoms in children.
Methods:
In this cross-sectional study, parents from first grade children of elementary schools throughout Chile were included. Data about clinical and family-related SDB risk factors, and the pediatric sleep questionnaire (PSQ) were obtained. Air pollution and meteorological data were obtained from the Chilean online air quality database.
Results:
A total of 564 children (44.9% males) aged (median) 6 years (5-9 year) were included. Prevalence of SDB based on PSQ was 17.7%. When examining air pollutants and conditions, only higher humidity (β = 0.005, 95%CI 0.001-0.009, P = 0.011) was significantly associated with higher PSQ scores after adjusting for demographic and household variables. Higher ozone (O3 ) levels (OR = 1.693, 95%CI 1.409-2.035, P < 0.001), higher humidity (OR = 1.161, 95%CI 1.041-2.035, P = 0.008) and higher dioxide sulfur (SO2 ) levels (OR = 1.16, 95%CI 1.07-1.94, P < 0.001]) were associated with increased odds of wheezing-related sleep disturbances after adjusting for confounders. Lower temperature was a significant predictor of snoring at least >3 nights/week, following adjustment (OR = 0.865, 95%CI 0.751-0.997, P < 0.05).
Conclusion:
Sleep respiratory symptoms (wheezing and snoring) are significantly associated with air pollutants such as O3 and SO2 . In addition, meteorological conditions such as humidity and low temperatures may be also associated with SDB-related symptoms.
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