People living with obstructive sleep apnoea (OSA) may experience more severe symptoms if they are exposed to higher levels of air pollution, according to new research presented at the European Respiratory Society (ERS) Congress in Amsterdam.
OSA is a common sleep disorder in which breathing repeatedly stops and starts during the night. Typical symptoms include loud snoring, disrupted sleep, and frequent awakenings, which can lead to excessive daytime sleepiness.
The condition also increases the risk of serious health issues such as high blood pressure, stroke, heart disease and type 2 diabetes. Many people with OSA remain undiagnosed.
The findings were presented by Martino Pengo, Associate Professor at the University of Milano-Bicocca and clinician at Istituto Auxologico Italiano IRCCS in Milan, Italy.
He explained: ‘We know that OSA is more common in people who are older or overweight, but there’s growing concern that air pollution also might make the condition worse. However, previous studies, mostly focused on just one country, have produced mixed results. We wanted to look at this on a larger scale, across several European cities, to better understand if and how air pollution affects OSA.’
The study analysed data from 19,325 patients diagnosed with OSA in 25 cities across 14 European countries. Patients contributed medical information including age, sex, body mass index, smoking history and detailed results from overnight sleep studies.
Researchers then linked this data with records of air quality, specifically measuring exposure to PM10 using data from the Copernicus Atmosphere Monitoring Service.
The analysis found that higher PM10 exposure was linked to worse OSA symptoms. For every one-unit increase in PM10, patients experienced on average an additional 0.41 respiratory events per hour of sleep. While this may appear modest at an individual level, researchers said the effect could be significant across large populations, pushing many into more severe OSA categories.
The study also found regional differences. Stronger associations were observed in cities such as Lisbon, Paris, and Athens, while other locations showed weaker or no associations. Researchers suggest factors such as local climate, pollution type, or differences in healthcare systems may explain these variations.
Professor Pengo said: ‘We confirmed a statistically significant positive association between average long-term exposure to air pollution, specifically fine particles known as PM10, and the severity of obstructive sleep apnoea. Even after we took account for other factors that we know have an effect on OSA, we still found an average increase in the number of respiratory events per hour of sleep of 0.41 for every one unit increase in PM10.
‘This effect may seem small for an individual, but across entire populations it can shift many people into higher-severity categories, making it meaningful from a public health perspective.
‘One of the most interesting findings was that the link between air pollution and OSA severity wasn’t the same in every European location. In some cities, the impact was stronger; in others, it was weaker or even absent. These regional differences might be due to things like local climate, the type of pollution or even how healthcare systems detect OSA.’
Professor Sophia Schiza, Head of the European Respiratory Society’s expert group on sleep disordered breathing was not involved in the research but said of it: ‘For people with OSA, especially those living in cities with high levels of air pollution, this study is important as it suggests pollution could be making their condition worse.
‘For doctors caring for people with OSA, this research highlights the need to consider environmental factors like air quality alongside other risk factors. This study strengthens the connection between environmental health and sleep medicine. It reminds us that tackling air pollution isn’t just good for the planet, it’s also vital for our lungs and our sleep quality too.’
Leave a Reply