Sleep problems mediate the association between outdoor nighttime light and symptoms of depression and anxiety: A cross-sectional, multi-city study in Bulgaria

Mostra el registre complet Registre parcial de l'ítem

  • dc.contributor.author Helbich, Marco
  • dc.contributor.author Burov, Angel
  • dc.contributor.author Dimitrova, Donka
  • dc.contributor.author Markevych, Iana
  • dc.contributor.author Nieuwenhuijsen, Mark J.
  • dc.contributor.author Dzhambov, Angel M.
  • dc.date.accessioned 2024-11-28T08:27:12Z
  • dc.date.available 2024-11-28T08:27:12Z
  • dc.date.issued 2024
  • dc.description.abstract Background: Nighttime light is a growing anthropogenic health threat, particularly in urban areas. Limited evidence suggests that exposure to outdoor artificial light at night (ALAN) may be associated with people's mental health by disrupting sleep-wake cycles. Aims: We assessed 1) the association between ALAN exposure and adults' symptoms of depression and anxiety, 2) whether the association was modified by sex, age, and income, and 3) the mediating role of sleep problems. Methods: We obtained cross-sectional data from 4,068 adults from the five largest Bulgarian cities. Depression and anxiety symptoms were measured using the 4-item Patient Health Questionnaire (PHQ-4). Sleep problems were self-reported based on three items. Outdoor ALAN at residential addresses was assessed using annual radiance levels obtained from satellite imagery. Regression models were adjusted for person-level characteristics, green space, and nitrogen dioxide (NO2). We also assessed effect modification by sex, age, and income. Using mediation analyses, we tested sleep problems as a mediator of the ALAN-PHQ-4 association. Results: Greater ALAN exposure in the fully adjusted model was marginally associated with higher PHQ-4 scores. We observed no effect modification. The mediator, sleep problems, was also positively associated with ALAN. The mediation of sleep problems was significantly positive. While the direct association was null, the total ALAN association was marginally and positively associated with PHQ-4 scores. Conclusions: Our findings suggest a positive association between outdoor nighttime light pollution and mental health. Poor sleep quality is a possible pathway relating ALAN exposure to mental health. Considering the increasing ubiquity and intensity of urban nighttime illumination, light pollution-reducing policies may provide significant health benefits for urban populations.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Helbich M, Burov A, Dimitrova D, Markevych I, Nieuwenhuijsen MJ, Dzhambov AM. Sleep problems mediate the association between outdoor nighttime light and symptoms of depression and anxiety: A cross-sectional, multi-city study in Bulgaria. Environ Res. 2024 Aug 31;263(Pt 1):119897. DOI: 10.1016/j.envres.2024.119897
  • dc.identifier.doi http://dx.doi.org/10.1016/j.envres.2024.119897
  • dc.identifier.issn 1096-0953
  • dc.identifier.uri http://hdl.handle.net/10230/68848
  • dc.language.iso eng
  • dc.publisher Elsevier
  • dc.relation.ispartof Environ Res. 2024 Aug 31;263(Pt 1):119897
  • dc.rights © 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Air pollution
  • dc.subject.keyword Anxiety
  • dc.subject.keyword Depression
  • dc.subject.keyword Eastern Europe
  • dc.subject.keyword Green space
  • dc.subject.keyword Insomnia
  • dc.subject.keyword Light at night
  • dc.subject.keyword Mental health
  • dc.title Sleep problems mediate the association between outdoor nighttime light and symptoms of depression and anxiety: A cross-sectional, multi-city study in Bulgaria
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion