# Ambient fine-particulate air pollution associates with short sleep duration among 2,082 community-dwelling older adults: findings from a large-scale questionnaire survey

## TL;DR

Long-term exposure to fine-particulate air pollution is linked to shorter sleep in older adults in China, suggesting air quality improvements could help sleep health.

## Contribution

This study identifies a dose-dependent association between PM₂.₅ and short sleep in older adults, highlighting air pollution as a modifiable sleep risk factor.

## Key findings

- Each 10 μg/m³ increase in PM₂.₅ raised short-sleep odds by 12%.
- PM₂.₅ levels above 50 μg/m³ were linked to 51% higher odds of short sleep.
- Reducing PM₂.₅ to ≤35 μg/m³ could prevent 24% of short-sleep cases.

## Abstract

Short sleep duration is widespread in China’s aging population, yet the contribution of ambient fine-particulate matter (PM₂.₅) remains uncertain. We investigated whether chronic PM₂.₅ exposure associates with habitual short sleep duration.

Within a hospital-based outreach program we surveyed 2082 community-dwelling adults aged ≥60 years in Nanchong and Chongqing (January–December 2024). Annual PM₂.₅ (1 km2 resolution) was estimated via a validated satellite–ground-fusion model; sleep duration was self-reported using the Chinese version of the Pittsburgh Sleep Quality Index, which has been culturally adapted and validated against actigraphy (ρ = 0.62). Short sleep duration was predefined as <6 h night−1. Mixed-effects logistic regression, adjusted for socioeconomic, lifestyle, cardiometabolic and environmental covariates, quantified associations per 10 μg m−3 increment and across exposure strata (<35, 35–50, and >50 μg m−3). Restricted cubic splines explored non-linearity, while population-attributable fractions and C-index shifts appraised public-health impact and predictive gain.

Mean PM₂.₅ was 44.1 ± 12.5 μg m−3; 27.3% of participants reported short sleep duration. Each 10 μg m−3 rise in PM₂.₅ increased short-sleep odds by 12% (adjusted OR 1.12, 95% CI 1.04–1.20). Compared with <35 μg m−3, exposure >50 μg m−3 conferred 51% higher odds (OR 1.51, 1.18–1.94). The relationship was monotonic and approximately log-linear. Achieving PM₂.₅ ≤ 35 μg m−3 could avert 24% of short-sleep cases; introducing PM₂.₅ improved discrimination from 0.55 to 0.57 (Δ 0.02).

Chronic PM₂.₅ exposure is a modifiable, dose-dependent driver of short sleep duration in older Chinese adults. Air-quality control may yield meaningful sleep-health dividends.