Ultrafine particles, psychosocial stress, and sleep: new epidemiological links?

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Introduction: Insufficient or poor-quality sleep during childhood is common and can have lifelong adverse health effects. Ultrafine particle (UFP) exposure and psychosocial stress can impact cardiovascular, respiratory, and neurological health but the effects of UFPs, particularly among children experiencing psychosocial stress, on sleep outcomes are unknown.Methods: This study includes 118 adolescents from the Ecologocial Momentary Assessment and Personal particle Exposure (EcoMAPPE) Study. A seven-day sampling period using a personal UFP monitor was completed and average daily concentrations of UFP were calculated. PROMIS® pediatric self-report measures were used to assess elevated levels (T-scores ≥ 60) of anxiety and depression symptoms over the sampling period. At the end of the sampling period, the child completed the Sleep Habits Questionnaire (SHQ); outcomes included sleep duration and frequency of night waking. Regression models were used to assess the associations between an IQR increase in UFP exposure and sleep outcomes and explore effect modification by concurrent psychosocial stress.Results: Increased UFP exposure was marginally associated with shorter weekend sleep duration (β = -0.43, SE 0.23, p=0.07); UFP exposure was not associated with night waking. Among children reporting elevated anxiety symptoms, UFP exposure was associated with reduced sleep duration during the week (β=-1.01, SE=0.49, pUFP*anxiety=0.04) and weekend (β=-1.65, SE=0.71, pUFP*anxiety=0.01). Among children experiencing elevated depression symptoms, increased UFP exposure was significantly associated with reduced sleep duration during the weekend (β=-2.09, SE=0.81, pUFP*depression=0.009). All models controlled for child’s age, race, gender, asthma status, maternal education, and exposure to environmental tobacco smoke.Conclusions: Exposure to UFPs alone does not result in poor quality sleep; however, concurrent UFP exposure and symptoms of anxiety/depression may have a negative impact on sleep outcomes. Understanding the potential synergistic effects between psychosocial factors and environmental toxins (e.g., UFP) will help inform health risks related to poor sleep outcomes among adolescents.