Association between blood ethylene oxide levels and trouble sleeping in U.S. adults: Data from NHANES 2013-2018

Environmental factors such as pollution have been reported to deteriorate sleep quality. Ethylene oxide (EO), a reactive cyclic oxide commonly used in manufacturing processes, has been associated with various health concerns such as cancer, metabolic syndrome, and inflammatory conditions. However, the relationship between EO exposure and self-reported troubled sleeping remains unclear. Using the National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018, 4310 participants with EO exposure histories were analyzed. Three groups of participants were categorized according to log2-transformed levels of hemoglobin adducts of the EO (HbEO). The risk of trouble sleeping was assessed using logistic regression, restricted cubic spline regression modeling, and subgroup analysis. Over the tertiles of HbEO levels, the prevalence of trouble sleeping prevalence increased from 28 % to 29 % to 35 %. Log2-transformed HbEO levels were significantly associated with an increased risk of trouble sleeping after adjusting for all covariates (Tertile 3 vs. Tertile 1 in model 4: OR = 1.41, 95 % CI: 1.07-1.86, P = 0.018, P for trend = 0.025). Additionally, a nonlinear J-shaped relationship was observed between HbEO levels and trouble sleeping. Furthermore, HbEO levels were positively correlated with trouble sleeping among different subgroups. Within the 40-60 age bracket, a distinct positive correlation emerged between HbEO levels and trouble sleeping (OR = 1.19, 95 % CI: 1.09-1.3, P = 0.0013). The results indicate a strong link between higher blood HbEO levels and an increased likelihood of sleep disturbances in U.S. adults, especially among those aged 40 to 60 years.