Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015-2016
Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015-2016
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DOI：
10.1186/s12940-019-0546-7
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发表时间：
2019-12-09
影响因子：
6
通讯作者：
Arora, Manish
中科院分区：
文献类型：
--
作者：
Malin, Ashley J.;Bose, Sonali;Arora, Manish
背景资料：环境中的氟化物会优先在松果体中积累，松果体会产生褪黑激素，这是一种调节睡眠-觉醒周期的激素。然而，氟化物对睡眠调节的影响仍然未知。这项基于人群的研究探讨了慢性低水平氟化物暴露是否与美国（US）年龄较大的青少年的睡眠模式和白天嗜睡有关。方法：这项横断面研究利用了国家健康和营养调查（2015-2016）的数据。我们分析了来自青少年的数据，这些青少年有血浆氟（n = 473）和水氟（n = 419）的测量结果，并且没有为睡眠障碍开处方药。氟暴露和自我报告的睡眠模式或白天嗜睡之间的关系进行了检查，使用调查加权线性，二项逻辑或多项逻辑回归协变量调整后。A Holm-Bonferroni校正占多重comparation.Results：青少年的平均年龄为17岁（范围= 16-19）。水和血浆氟浓度中位数分别为0.27（0.52）mg/L和0.29（0.19）μ mol/L。水氟化物的IQR增加与报告提示睡眠呼吸暂停症状的几率增加1.97倍相关（95% CI：1.27，3.05; p = 0.02），睡前24分钟（B = 0.40，95% CI：0.10，0.70; p = 0.05），26分钟后早晨醒来时间（B = 0.43，95% CI：0.13，0.73; p = 0.04），在男性中，报告打鼾的几率降低38%结论：氟暴露可能导致美国大龄青少年睡眠周期调节和睡眠行为的改变。另外的前瞻性研究是必要的，以检查氟化物对睡眠模式的影响，并确定潜在影响的脆弱性的关键窗口。
Background: Fluoride from environmental sources accumulates preferentially in the pineal gland which produces melatonin, the hormone that regulates the sleep-wake cycle. However, the effects of fluoride on sleep regulation remain unknown. This population-based study examined whether chronic low-level fluoride exposure is associated with sleep patterns and daytime sleepiness among older adolescents in the United States (US).Method: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2015-2016). We analyzed data from adolescents who had plasma fluoride (n = 473) and water fluoride (n = 419) measures and were not prescribed medication for sleep disorders. Relationships between fluoride exposure and self-reported sleep patterns or daytime sleepiness were examined using survey-weighted linear, binomial logistic or multinomial logistic regression after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons.Results: The average age of adolescents was 17 years (range = 16-19). Median (IQR) water and plasma fluoride concentrations were 0.27 (0.52) mg/L and 0.29 (0.19) mu mol/L respectively. An IQR increase in water fluoride was associated with 1.97 times higher odds of reporting symptoms suggestive of sleep apnea (95% CI: 1.27, 3.05; p = 0.02), a 24 min later bedtime (B = 0.40, 95% CI: 0.10, 0.70; p = 0.05), a 26 min later morning wake time (B = 0.43, 95% CI: 0.13, 0.73; p = 0.04), and among males, a 38% reduction in the odds of reporting snoring (95% CI: 0.45, 0.87, p = 0.03).Conclusions: Fluoride exposure may contribute to changes in sleep cycle regulation and sleep behaviors among older adolescents in the US. Additional prospective studies are warranted to examine the effects of fluoride on sleep patterns and determine critical windows of vulnerability for potential effects.