Dataset Information

Association of Outdoor Artificial Light at Night With Mental Disorders and Sleep Patterns Among US Adolescents.

ABSTRACT:

Importance

Indoor nighttime light exposure influences sleep and circadian rhythms and is known to affect mood-associated brain circuits in animals. However, little is known about the association between levels of nighttime outdoor light and sleep and mental health in the population, especially among adolescents.

Objective

To estimate associations of outdoor artificial light at night (ALAN) with sleep patterns and past-year mental disorder among US adolescents.

Design, setting, and participants

This population-based, cross-sectional study of US adolescents used the National Comorbidity Survey-Adolescent Supplement, a nationally representative cross-sectional survey conducted from February 2001 through January 2004. A probability sample of adolescents aged 13 to 18 years was included. Analyses were conducted between February 2019 and April 2020.

Exposures

Levels of outdoor ALAN, measured by satellite, with means calculated within census block groups. ALAN values were transformed into units of radiance (nW/cm2/sr).

Main outcomes and measures

Self-reported habitual sleep patterns (weeknight bedtime, weeknight sleep duration, weekend bedtime delay, and weekend oversleep) and past-year mood, anxiety, behavior, and substance use disorders, measured via an in-person structured diagnostic interview. Parent-reported information was included in behavior disorder diagnoses.

Results

Among 10 123 adolescents (4953 boys [51.3%]; mean [SE] age, 15.2 [0.06] years [weighted]; 6483 for behavior disorder outcomes), ALAN was positively associated with indicators of social disadvantage, such as racial/ethnic minority status (median [IQR] ALAN: white adolescents, 12.96 [30.51] nW/cm2/sr; Hispanic adolescents: 38.54 [47.84] nW/cm2/sr; non-Hispanic black adolescents: 37.39 [51.88] nW/cm2/sr; adolescents of other races/ethnicities: 30.94 [49.93] nW/cm2/sr; P < .001) and lower family income (median [IQR] ALAN by family income-to-poverty ratio ≤1.5: 26.76 [52.48] nW/cm2/sr; >6: 21.46 [34.38] nW/cm2/sr; P = .005). After adjustment for several sociodemographic characteristics, as well as area-level population density and socioeconomic status, this study found that higher ALAN levels were associated with later weeknight bedtime, and those in the lowest quartile of ALAN reported the longest weeknight sleep duration. Those in the highest quartile of ALAN went to bed 29 (95% CI, 15-43) minutes later and reported 11 (95% CI, 19-2) fewer minutes of sleep than those in the lowest quartile. ALAN was also positively associated with prevalence of past-year mood and anxiety disorder: each median absolute deviation increase in ALAN was associated with 1.07 (95% CI, 1.00-1.14) times the odds of mood disorder and 1.10 (95% CI, 1.05-1.16) times the odds of anxiety disorder. Further analyses revealed associations with bipolar disorder (odds ratio [OR], 1.19 [95% CI, 1.05-1.35]), specific phobias (OR, 1.18 [95% CI, 1.11-1.26]), and major depressive disorder or dysthymia (OR, 1.07 [95% CI, 1.00-1.15]). Among adolescent girls, differences in weeknight bedtime by ALAN (third and fourth quartiles vs first quartile) were greater with increasing years since menarche (F3, 8.15; P < .001).

Conclusions and relevance

In this study, area-level outdoor ALAN was associated with less favorable sleep patterns and mood and anxiety disorder in adolescents. Future studies should elucidate whether interventions to reduce exposure to ALAN may positively affect mental and sleep health.

SUBMITTER: Paksarian D

PROVIDER: S-EPMC7344797 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveTo analyze the association between outdoor artificial light-at-night (ALAN) exposure and overweight and obesity among children and adolescents aged 9 to 18 years in China.MethodsUsing follow-up data of 5 540 children and adolescents aged 9 to 18 years conducted from November 2019 to November 2020 in eight provinces of China, latitude and longitude were determined based on school addresses, and the mean monthly average nighttime irradiance at the location of 116 schools was extracted by the nearest neighbor method to obtain the mean outdoor ALAN exposure [unit: nW/(cm2·sr)] for each school. Four indicators of overweight and obesity outcomes were included: Baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. Mixed effects Logistic regression was used to explore the association between ALAN exposure levels (divided into quintiles Q1-Q5) and baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. In addition, a natural cubic spline function was used to explore the exposure response association between ALAN exposure (a continuous variable) and the outcomes.ResultsThe prevalence of baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence among the children and adolescents in this study were 21.6%, 16.3%, 2.9% and 12.8%, respectively. The OR value for the association between ALAN exposure and baseline overweight and obesity was statistically significant when ALAN exposure levels reached Q4 or Q5, 1.90 (95%CI: 1.26-2.86) and 1.77 (95%CI: 1.11-2.83), respectively, compared with the children and adolescents in the Q1 group of ALAN exposure. Similar to the results for baseline overweight and obesity, the OR values for the association with persistent overweight and obesity were 1.89 (95%CI: 1.20-2.99) and 1.82 (95%CI: 1.08-3.06) when ALAN exposure levels reached Q4 or Q5, respectively, but none of the OR values for the association between ALAN and overweight and obesity progression and overweight and obesity incidence were statistically significant. Fitting a natural cubic spline function showed a non-linear trend between ALAN exposure and persistent overweight and obesity.ConclusionThere is a positive association between ALAN exposure and overweight and obesity in children and adolescents, and the promotion of overweight obesity in children and adolescents by ALAN tends to have a cumulative effect rather than an immediate effect. In the future, while focusing on the common risk factors for overweight and obesity in children and adolescents, there is a need to improve the overweight and obesity-causing nighttime light exposure environment.

Project description:BackgroundEvidence in adults suggests that exposure to artificial light-at-night (ALAN) leads to obesity. However, little is known about whether this effect exists in children and adolescents. We aimed to investigate whether ALAN exposure was associated with overweight and obesity in school-aged children and adolescents and whether this association varied with socioeconomic status.MethodsData on the height and weight of 129,500 children and adolescents aged 10-18 years from 72 cities were extracted from the 2014 Chinese National Survey on Students' Constitution and Health (CNSSCH). The ALAN area percentage and average ALAN intensity were calculated using the Visible/Infrared Imager/Radiometer Suite. The subjects were separated into three categories based on the cities' gross domestic product per capita (GDPPC). A mixed-effect logistic regression model and generalized additive model (GAM) were utilized to evaluate the association between ALAN exposure and overweight and obesity in children and adolescents stratified by municipal GDPPC.ResultsBoth ALAN area (OR = 1.194, 95% CI: 1.175-1.212) and ALAN intensity (OR = 1.019, 95% CI: 1.017-1.020) were positively associated with overweight and obesity in children and adolescents, and the associations remained robust after adjusting for covariates. ORs for overweight and obesity and ALAN area decreased as GDPPC level increased (first tertile: OR = 1.457, 95% CI: 1.335-1.590; second tertile: OR = 1.350, 95% CI: 1.245-1.464; third tertile: OR = 1.100, 95% CI: 1.081-1.119). Similar results were observed for ALAN intensity. In the GAM models, thresholds existed in almost all these spline trends, indicating that ALAN might have a nonlinear association with overweight and obesity.ConclusionsALAN contributed to the development of overweight and obesity in children and adolescents and this effect differed with GDPPC. Future longitudinal studies should confirm the causal relationship between ALAN and obesity. Moreover, reducing unnecessary exposure to artificial light at night may have beneficial implications for controlling childhood and adolescent obesity, particularly in low-income areas.