{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:15:33Z","timestamp":1794244533876,"version":"4.9.0"},"reference-count":48,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Taiwan National Science and Technology Council","award":["NSTC 111-2634-F-002-021"],"award-info":[{"award-number":["NSTC 111-2634-F-002-021"]}]},{"DOI":"10.13039\/501100004663","name":"Taiwan Ministry of Science and Technology","doi-asserted-by":"crossref","award":["MOST 110\u20132634\u2013F"],"award-info":[{"award-number":["MOST 110\u20132634\u2013F"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2023,10,27]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Air pollution may alter body water distribution, it may also be linked to low-arousal-threshold obstructive sleep apnoea (low-ArTH OSA). Here, we explored the mediation effects of air pollution on body water distribution and low-ArTH OSA manifestations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective study, we obtained sleep centre data from healthy participants and patients with low-ArTH OSA (N=1924) in northern Taiwan. Air pollutant exposure at different time intervals (1, 3, 6 and 12 months) was estimated using the nearest station estimation method, and government air-quality data were also obtained. Regression models were used to assess the associations of estimated exposure, sleep disorder indices and body water distribution with the risk of low-ArTH OSA. Mediation analysis was performed to explore the relationships between air pollution, body water distribution and sleep disorder indices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>First, exposure to particulate matter (PM) with a diameter of \u226410\u2009\u00b5m (PM<jats:sub>10<\/jats:sub>) for 1 and 3 months and exposure to PM with a diameter of \u22642.5\u2009\u00b5m (PM<jats:sub>2.5<\/jats:sub>) for 3 months were significantly associated with the Apnoea\u2013Hypopnoea Index (AHI), Oxygen Desaturation Index (ODI), Arousal Index (ArI) and intracellular-to-extracellular water ratio (I-E water ratio). Significant associations were observed between the risk of low-ArTH OSA and 1-\u2009month exposure to PM<jats:sub>10<\/jats:sub> (OR 1.42, 95% CI 1.09 to 1.84), PM<jats:sub>2.5<\/jats:sub> (OR 1.33, 95%\u2009CI 1.02 to 1.74) and ozone (OR 1.27, 95%\u2009CI 1.01 to 1.6). I-E water ratio alternation caused by 1-month exposure to PM<jats:sub>10<\/jats:sub> and 3-month exposure to PM<jats:sub>2.5<\/jats:sub> and PM<jats:sub>10<\/jats:sub> had partial mediation effects on AHI and ODI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Air pollution can directly increase sleep disorder indices (AHI, ODI and ArI) and alter body water distribution, thus mediating the risk of low-ArTH OSA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2023-001802","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T11:52:55Z","timestamp":1699444375000},"page":"e001802","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Association between air pollutant exposure, body water distribution and sleep disorder indices in individuals with low-arousal-threshold obstructive sleep apnoea"],"prefix":"10.1136","volume":"10","author":[{"given":"Cheng-Yu","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Civil and Environmental Engineering, Imperial College London, London, UK"},{"name":"Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huei-Tyng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hua","family":"Hsu","sequence":"additional","affiliation":[{"name":"School of Respiratory 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