Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study

Abstract Background While there are many well understood clinical risk factors on sleep patterns, the associations of environmental factors, specifically air pollution on insufficient sleep remains understudied. This study investigates the association between insufficient sleep and particulate matte...

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Main Authors: Haris Majeed, Daniyal Zuberi
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23316-9
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author Haris Majeed
Daniyal Zuberi
author_facet Haris Majeed
Daniyal Zuberi
author_sort Haris Majeed
collection DOAJ
description Abstract Background While there are many well understood clinical risk factors on sleep patterns, the associations of environmental factors, specifically air pollution on insufficient sleep remains understudied. This study investigates the association between insufficient sleep and particulate matter 2.5 (PM2.5) among adults in the United States. There is also a need to determine whether various El Niño Southern Oscillation (ENSO) phases are effect modifiers in this relationship. Method A cross-sectional observational analysis using annual survey data from 3100 United States counties for adult (≥ 18 years) age-adjusted insufficient sleep prevalence from 2017 to 2024. Annual average county-specific PM2.5 data was categorized into three categories [low (< 5 µg/m3), moderate (5–11 µg/m3), extreme (≥ 11 µg/m3)]. The annual average ENSO index was used to determine if the year was either El Niño, La Niña, or neutral. Adjusted associations were conducted using Poisson regression and were stratified by various phases of ENSO. Adjusted associations were reported as rate ratio (RR). Results From 2017 to 2024, the United States annual insufficient sleep is 34% [range min to max: 23–49%]. With respect to low PM2.5; moderate and extreme PM2.5 levels were associated with an increased risk of insufficient sleep by 1.03 (95% CI 1.02–1.05, P < 0.001) and 1.11 (95% CI 1.09–1.12, P < 0.001), respectively. The interaction between PM2.5 and ENSO was significant (P < 0.001) on insufficient sleep. The magnitude in associations between extreme PM2.5 and insufficient sleep differed by various ENSO phases. Conclusion Long-term (i.e. annual) effects of air pollution can pose a risk on adult sleep. While El Niño and La Niña phases were found to be a significant effect modifier, yet during the neutral phase the risks for extreme PM2.5 were observed to be the strongest on insufficient sleep. Further investigations are needed to recognize the environmental effects on sleep deprivation.
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spelling doaj-art-1b75946385e946fcbbce51a6617a74782025-08-20T03:10:32ZengBMCBMC Public Health1471-24582025-06-012511710.1186/s12889-025-23316-9Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional studyHaris Majeed0Daniyal Zuberi1University of TorontoUniversity of TorontoAbstract Background While there are many well understood clinical risk factors on sleep patterns, the associations of environmental factors, specifically air pollution on insufficient sleep remains understudied. This study investigates the association between insufficient sleep and particulate matter 2.5 (PM2.5) among adults in the United States. There is also a need to determine whether various El Niño Southern Oscillation (ENSO) phases are effect modifiers in this relationship. Method A cross-sectional observational analysis using annual survey data from 3100 United States counties for adult (≥ 18 years) age-adjusted insufficient sleep prevalence from 2017 to 2024. Annual average county-specific PM2.5 data was categorized into three categories [low (< 5 µg/m3), moderate (5–11 µg/m3), extreme (≥ 11 µg/m3)]. The annual average ENSO index was used to determine if the year was either El Niño, La Niña, or neutral. Adjusted associations were conducted using Poisson regression and were stratified by various phases of ENSO. Adjusted associations were reported as rate ratio (RR). Results From 2017 to 2024, the United States annual insufficient sleep is 34% [range min to max: 23–49%]. With respect to low PM2.5; moderate and extreme PM2.5 levels were associated with an increased risk of insufficient sleep by 1.03 (95% CI 1.02–1.05, P < 0.001) and 1.11 (95% CI 1.09–1.12, P < 0.001), respectively. The interaction between PM2.5 and ENSO was significant (P < 0.001) on insufficient sleep. The magnitude in associations between extreme PM2.5 and insufficient sleep differed by various ENSO phases. Conclusion Long-term (i.e. annual) effects of air pollution can pose a risk on adult sleep. While El Niño and La Niña phases were found to be a significant effect modifier, yet during the neutral phase the risks for extreme PM2.5 were observed to be the strongest on insufficient sleep. Further investigations are needed to recognize the environmental effects on sleep deprivation.https://doi.org/10.1186/s12889-025-23316-9SleepEnvironmentAir pollutionEl Niño Southern Oscillation
spellingShingle Haris Majeed
Daniyal Zuberi
Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study
BMC Public Health
Sleep
Environment
Air pollution
El Niño Southern Oscillation
title Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study
title_full Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study
title_fullStr Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study
title_full_unstemmed Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study
title_short Effects of extreme air pollution and El Niño Southern Oscillation on insufficient sleep: a cross-sectional study
title_sort effects of extreme air pollution and el nino southern oscillation on insufficient sleep a cross sectional study
topic Sleep
Environment
Air pollution
El Niño Southern Oscillation
url https://doi.org/10.1186/s12889-025-23316-9
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AT daniyalzuberi effectsofextremeairpollutionandelninosouthernoscillationoninsufficientsleepacrosssectionalstudy