空气质量与污染在阻塞性睡眠呼吸暂停中的作用：近期研究的启示

文献信息

中文摘要

引言： 空气污染是呼吸健康日益重要的环境决定因素，并且与阻塞性睡眠呼吸暂停（OSA）的相关性正在显现。尽管肥胖、衰老、性别、颅面解剖结构和神经肌肉因素仍是OSA的公认促成因素，但环境与室内污染物，以及气候相关和气象因素，可能通过多种生物学途径影响睡眠呼吸障碍。本综述总结了近期将环境暴露与OSA风险、症状和严重程度联系起来的流行病学和机制证据。
涵盖领域： 本叙述性综述综合了来自PubMed和Web of Science（数据库建库至2026年6月30日）关于环境暴露与OSA关系的证据，包括空气污染、室内外污染物、气候变化和气象因素。我们总结了当前将环境暴露与OSA风险、症状和严重程度联系起来的流行病学证据；来自脆弱人群的证据；以及涉及上气道炎症、氧化应激、自主神经功能障碍、间歇性缺氧和代谢失调的生物学机制。
专家意见： 尽管当前证据具有提示性，但仍存在异质性；因此未来研究应纳入标准化的暴露评估、客观睡眠测量、纵向和干预设计以及机制性生物标志物。对环境风险因素的认识可能有助于更全面的OSA预防、风险分层、咨询和公共卫生策略。

英文摘要

INTRODUCTION: Air pollution is an increasingly important environmental determinant of respiratory health and has emerging relevance for obstructive sleep apnea (OSA). Although obesity, aging, sex, craniofacial anatomy, and neuromuscular factors remain established contributors to OSA, ambient and indoor pollutants, together with climate-related and meteorological factors, may influence sleep-disordered breathing through multiple biological pathways. This review summarizes recent epidemiological and mechanistic evidence linking environmental exposures with OSA risk, symptoms, and severity.
AREAS COVERED: This narrative review synthesizes evidence from PubMed and Web of Science (database inception through 30 June 2026) on the relationship between environmental exposures and OSA, including air pollution, indoor and outdoor pollutants, climate change, and meteorological factors. We summarize current epidemiological evidence linking environmental exposures with OSA risk, symptoms, and severity; evidence from vulnerable populations; and biological mechanisms involving upper-airway inflammation, oxidative stress, autonomic dysfunction, intermittent hypoxia, and metabolic dysregulation.
EXPERT OPINION: Although current evidence is suggestive, it remains heterogeneous; future research should therefore incorporate standardized exposure assessment, objective sleep measurements, longitudinal and intervention designs, and mechanistic biomarkers. Recognition of environmental risk factors may support more comprehensive OSA prevention, risk stratification, counseling, and public health strategies.