夜间室外人造光对抑郁症患者执行功能的影响：睡眠时间的中介作用

IF 7.6 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environmental Pollution Pub Date : 2025-04-21 DOI:10.1016/j.envpol.2025.126274

Shanshan Shao , Tianqin Xie , Lei Zhang , Hui Kong , Jie Fang , Ting Wang , Yu Zhang , Jiakuai Yu , Peng Zhu , Daomin Zhu

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引用次数: 0

摘要

最近的证据强调了夜间室外人造光（ALAN）对睡眠的潜在影响，而晚睡时间可能是执行功能障碍的一个危险因素。抑郁症通常与执行功能障碍有关，这严重影响预后。然而，睡眠-觉醒阶段是否介导户外ALAN对执行功能的影响尚不清楚。我们评估了睡眠时间是否介导了抑郁症患者户外ALAN和执行功能之间的关联。2017年至2023年，合肥市第四人民医院招募了798名抑郁症住院患者。使用卫星图像估计患者的室外ALAN暴露。使用匹兹堡睡眠质量指数（PSQI）评估所有参与者的睡眠状况，使用执行功能行为评定量表-成人版（BRIEF-A）评估所有参与者的执行功能。我们采用多因素线性回归模型来研究户外ALAN暴露与执行功能之间的关系，并对潜在的混杂因素进行了调整。此外，我们利用中介模型来探讨睡眠时间在这种关联中的中介作用。我们的研究发现，更多的ALAN暴露与更高的执行功能得分显著相关。受试者在入组前12个月的暴露影响最大，户外ALAN暴露每增加四分位数范围（IQR 29.93nW/cm2/sr），全球执行综合（GEC）得分增加6.12（95%可信区间[CI]: 2.49, 9.74）。中介分析表明，睡眠中点显著中介户外ALAN与执行功能的关系，中介比例为22.39%。本研究提示，户外ALAN暴露对抑郁症患者的执行功能有不良影响，睡眠-觉醒阶段可能介导了户外ALAN暴露与执行功能之间的关联。

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Association between outdoor artificial light at night and executive function among depressive patients: the mediating effect of sleep timing

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Association between outdoor artificial light at night and executive function among depressive patients: the mediating effect of sleep timing

Recent evidence highlights the potential impact of outdoor artificial light at night (ALAN) on sleep, and later sleep timing may be a risk factor for executive dysfunction. Depression is commonly associated with executive dysfunction, which significantly compromise prognosis. However, it remains unclear whether sleep-wake phase mediate the effects of outdoor ALAN on executive function. We assessed whether sleep timing mediated the association between outdoor ALAN and executive function among depressed patients. Between 2017 and 2023, 798 inpatients with depression were enrolled from the Fourth People's Hospital of Hefei. The outdoor ALAN exposure of patients was estimated using satellite images. All participants were assessed for sleep conditions using the Pittsburgh Sleep Quality Index (PSQI) and for executive function using the Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A). We employed multifactor linear regression models to investigate the association between outdoor ALAN exposure and executive function, adjusted for potential confounders. Additionally, mediation models were utilized to explore the mediating role of sleep timing in this association. Our study found that greater ALAN exposure was significantly associated with higher executive function scores. The exposure of participants at 12 months prior to enrollment had the greatest effect, for each interquartile range (IQR 29.93 nW/cm²/sr) increase in outdoor ALAN exposure, the Global Executive Composite (GEC) scores increased by 6.12 (95 % confidence interval [CI]: 2.49, 9.74). Mediation analysis indicated that sleep midpoint significantly mediated the relationship between outdoor ALAN and executive function, with a mediated proportion of 22.39 %. The study suggested that outdoor ALAN exposure has adverse effects on executive function in depressed patients, and sleep-wake phase may mediate the association between outdoor ALAN exposure and executive function.

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来源期刊

Environmental Pollution 环境科学-环境科学

CiteScore

16.00

自引率

6.70%

发文量

2082

审稿时长

2.9 months

期刊介绍： Environmental Pollution is an international peer-reviewed journal that publishes high-quality research papers and review articles covering all aspects of environmental pollution and its impacts on ecosystems and human health. Subject areas include, but are not limited to: • Sources and occurrences of pollutants that are clearly defined and measured in environmental compartments, food and food-related items, and human bodies; • Interlinks between contaminant exposure and biological, ecological, and human health effects, including those of climate change; • Contaminants of emerging concerns (including but not limited to antibiotic resistant microorganisms or genes, microplastics/nanoplastics, electronic wastes, light, and noise) and/or their biological, ecological, or human health effects; • Laboratory and field studies on the remediation/mitigation of environmental pollution via new techniques and with clear links to biological, ecological, or human health effects; • Modeling of pollution processes, patterns, or trends that is of clear environmental and/or human health interest; • New techniques that measure and examine environmental occurrences, transport, behavior, and effects of pollutants within the environment or the laboratory, provided that they can be clearly used to address problems within regional or global environmental compartments.