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

Yaoyao Qian; Garun S Hamilton; Chamara V Senaratna; Caroline J Lodge; Michael J Abramson; Xin Dai; Dinh S Bui; Anurika P De Silva; Paul S Thomas; Bircan Erbas; Eugene H Walters; Jennifer L Perret; Shyamali C Dharmage

doi:10.1016/j.envres.2025.122068

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

Environ Res. 2025 Jun 3:282:122068. doi: 10.1016/j.envres.2025.122068. Online ahead of print.

Authors

Affiliations

¹ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
² Monash Lung, Sleep, Allergy & Immunology, Monash Health, Clayton, VIC, Australia; School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
³ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Institute for Health and Sport, Victoria University, Melbourne, Australia.
⁴ School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁵ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Methods and Implementation Support for Clinical and Health (MISCH) research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
⁶ Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
⁷ School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia.
⁸ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; School of Medicine, University of Tasmania, Hobart, TAS, Australia.
⁹ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep (IBAS), Melbourne, VIC, Australia.
¹⁰ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. Electronic address: s.dharmage@unimelb.edu.au.

PMID: 40473189
DOI: 10.1016/j.envres.2025.122068

Abstract

Study objectives: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: General population; Household air pollution; Obstructive sleep apnoea; Sleep disordered breathing.