Ten-year exposure to household air pollution is associated with obstructive sleep apnoea

The impact of household air pollution (HAP) on obstructive sleep apnoea (OSA) was unclear from the literature. We aimed to investigate the associations between HAP exposure over 10 years and OSA in middle-aged adults.

Using the Tasmanian Longitudinal Health Study (TAHS), seven longitudinal HAP profiles were previously identified using information on household heating, cooking, mould, active and passive smoking exposure collected at two ages spanning 10 years (at mean ages 43 and 53 years). Probable OSA was only measured at 53 years using validated STOP-Bang, Berlin and OSA-50 questionnaires. Medically diagnosed OSA was self-reported. Multivariable logistic regression was used to assess the associations between HAP profiles and each definition of OSA, adjusting for age, sex, socioeconomic status and ambient air pollution.

Compared with the "Least exposed" profile, characterised by reverse-cycle air conditioning, electric cooking and no smoking exposure, the "Wood and gas heating/gas cooking/smoking" profile was associated with both probable OSA defined using OSA-50 (aOR = 2.39, 95 %CI 1.61-3.53) and medically diagnosed OSA (aOR = 2.31, 1.06-5.05). The "All gas" and "Wood heating/smoking" profiles were associated with OSA-50-defined probable OSA (aOR = 1.35, 1.01-1.79; aOR = 1.47, 1.10-1.96 respectively). Additionally, the "All gas" profile was associated with incident medically diagnosed OSA (aOR = 2.15, 1.06-4.38).

Sustained exposure to wood and gas heating and gas cooking especially when combined with tobacco smoke increased the risk of OSA over 10 years in middle age. Our study strengthens the rationale for including the potential adverse effects of HAP on mid-life OSA within public educational programs and guidelines.