Long-term exposure to major constituents of fine particulate matter and sleep disorders among children and adolescents: a population-based survey in Guangdong province, China

Long-term exposure to PM_2.5 is associated with sleep health in adults, but its impact on children and adolescents remains unclear. This cross-sectional study analyzed 64,203 children and adolescents (6 - 18 years) from four cities in Guangdong, China, to assess the impact of PM_2.5 and its major constituents on sleep disorders. Sleep disorders were assessed using the Sleep Disturbance Scale for Children. Generalized linear mixed models and weighted quantile sum regression were applied to assess the joint effects of PM_2.5 constituents. The results indicated a positive association between PM_2.5 and sleep disorders. For example, the odds of sleep disorder increased with per interquartile range (IQR) increase in PM_2.5 concentrations [odds ratio (OR): 1.15, 95% confidence interval (CI):1.06, 1.26). Black carbon (BC) and organic matter (OM) increase the odds by 16% (95% CI: 9, 24%) and 23% (95% CI: 9, 39%), respectively. Notably, combustion-related BC (44.3%) and OM (24.3%) contributed the key contributors to the mixture risk. Children and adolescents with limited outdoor activity (< 2 hours/day) were more vulnerable to PM_2.5 exposure (P for interaction = 0.028). These findings highlight that stricter air pollution regulations and targeted measures to reduce children’s exposure to combustion-derived pollutants are essential for protecting sleep health and overall well-being.