Kelton Minor：全球变暖影响睡眠质量（英）.pdf

Article Rising temperatures erode human sleep globally Graphical abstract Highlights d Warmer temperatures reduce sleep globally, amplifying the risk of insufficient sleep d The elderly,women,andresidents of lower-income countries are impacted most d Thoselivinginwarmerclimateslosemoresleepperdegreeof temperature rise d Climate change is projected to unequally erode sleep, widening global inequalities Authors Kelton Minor, Andreas Bjerre-Nielsen, Sigga Svala Jonasdottir, Sune Lehmann, Nick Obradovich Correspondence kmisamf.ku.dk K.M., obradovichmpib-berlin.mpg.de N.O. In brief estimate causal effect of nighttime temperature on sleep duration Tables S1 and S2; Figure 1C. Accelerometry-based sleep trackingdevices areincreasingly ubiquitous andparticularlywell suited for large-scale observational studies, 42 offering several empirical advantages over previous research designs. In situ sleep measures from sleep-tracking wristbands provide dy- namic spatial and temporal reference information for precise merging with meteorological data across diverse geographic re- gions, enabling the study of the effect of temperature on within- Article individual changes across the entire sleep period. Moreover, objective measures of total sleep duration can be used to inves- tigate whether temperature affects the probability of obtaining short sleep, following standard definitions. 14 To investigate whether ambient temperature alters sleep, we pair our sleep observations of nighttime sleep duration total sleep time and timing sleep onset, midsleep, and offset with geolocated meteorological and climate data Figures 1A and 1B; Experimental procedures. We specify multivariate fixed-ef- fects panel models 43 derived from the climate econometrics literature 44,45 with individual repeated measures, using as good as random variation in meteorological variables relative tolocalaveragestoestimatethetotaleffectofambientnighttime temperature on individual sleep outcomes Tables S6 and S7. An advance of the present study is that our dataset allows us to control for all stable individual characteristics and leverage within-person fluctuations in both weather exposures and sleep outcomes to isolate the plausibly causal effect of nighttime tem- perature on our person-level sleep outcomes while controlling for other potentially confounding individual-level, calendar- date-specific, and subnational administrative region-by-month spatiotemporal factors that might otherwise bias inference be- tweentemperature exposuresandsleepoutcomes.Importantly, this statistical model also controls for location-by-date historical climate normals and cloud-cover alterations in daylight, removing the potential confounding effect of seasonality from our analyses Tables S6–S8 and S30. Thus, whereas sleep lab- oratory research in this setting typically manipulates ambient room temperatures while limiting behavioral adaptation, the present study seeks to instead estimate the total effect of quasi-random changes in outside ambient temperatures on sleep patterns, allowing for habitual behavioral adjustments to temperature, including possible responses to the environmental information conveyed by outdoor conditions. This latter point is important for studying temperature-sleep relationships under ecologically valid circumstances, because even awareness of outdoor ambient conditions while indoors may impact sleep behavior at night. Summarizing our empirical results, we find that adults fall asleep later, rise earlier, and sleep less during hot nights. Devi- ating from the results of laboratory studies that constrained adaptive behavior, we show that increases in nighttime temper- ature reduce time slept across the global temperature distribu- tion, with effects increasing in magnitude as temperatures become hotter. The effect of a1 C14 C increase in minimum temper- atureamongtheelderlyisovertwicetheeffectobservedinother age groups. Further, the effect is nearly three times as large among globally poorer individuals as it is among individuals in richer nations and is significantly larger in females as compared with males. We do not find evidence of sleep adaptation to warmer temperatures within days, between days, across sum- mer months, or between climate regions. Indeed, the sleep impact per degree of temperature increase in warmer locations is significantly larger than in colder locations. Our results imply that suboptimal ambient temperatures likely already erode hu- man sleep considerably early in the 21 st century. Coupling our model estimates with downscaled climate model output, we project that climate change may exacerbate global environ- mental inequalities by disproportionately eroding sleep in the ll warmest regions, with differential societal sleep impacts scaling with future atmospheric greenhouse gas concentrations. We verifythat ourprimary conclusions arerobust toalternative sam- ple inclusion criteria, meteorological data, temporal controls, and outcome measures Tables S6–S20, S30, S31, S49, and S50; Figures S2 and S3. Further, our modeling framework One Earth 5, 534–549, May 20, 2022 535 GHCND weather stations A ll controls for any unobserved, fixed device characteristics, and weconfirmthattheperiodandfrequencyofsleep-trackingwrist- band use does not alter our primary results Experimental pro- cedures; Tables S32 and S33. RESULTS Effects on sleep duration and short sleep probability The results of our binned temperature regressions indicate that exogenous increases in nighttime ambient temperature reduce adult sleep duration across nearly the entire observed tempera- turedistributionFigures2AandS2.Climatechangeisprojected to continue to increase the magnitude and frequency of extreme nighttime temperatures beyond the recent historical record. Our data indicate that, on very warm nights 30 C14 C, sleep declines by 14.08 min C010.61 to C017.55 compared with nights with the lowest temperature-attributed sleep loss in our sample. Day of Year 2016 A v g. Individual Nightly Sleep Deviation in hours 28 -.4 -.2 0 .2 .4 .6 .8 56 84 112 140 168 196 224 252 280 308 336 364 C Figure 1. Global weather station and sleep data coverage A Plotted map of weather stations from the Global Historical Climatology Network-Daily B World map depicting the country-level count of accelerometry-based sleep-trac continents except for Antarctica. Countries with relatively more users appear as C Plot showing regular and dynamic temporal patterns in within-individual sleep daily measure corresponds to the mean of all within-individual nightly sleep deviations weekday valleys below zero reflect the imbalanced temporal structure of the compensated for on weekends with oversleep. D Annual total number of nighttime sleep observations collected over the 2-year 536 One Earth 5, 534–549, May 20, 2022 1000 10000 Fitness band count B Article Increasing nighttime temperatures amplify the estimated proba- bility of obtaining a short night of sleep, measured with multiple standard definitions for insufficient sleep. 14 The probability of sleeping less than 7 h increases gradually up to 10 C14 C, before increasing at an elevated rate. Nighttime minimum temperatures greaterthan25 C14 Cincreasetheprobabilityofgettinglessthan7h of sleep by 3.5 percentage points compared with the tempera- ture baseline of 5 C14 C–10 C14 CFigure 2D. However, our results show that the optimum nighttime ambient temperature for suffi- cient sleep may be considerably lower than this baseline, with nighttime heat inducing short sleep across most of the tempera- ture distribution. Providing scale for this estimated relationship, exposure to nighttime temperatures exceeding 25 C14 C, if extrapo- latedforanequivalentpopulationof100,000adultsacrossasin- gle night, would result in 4,600 additional individuals obtaining a short 15 C14 C, while C Nighttime temperature increases above C010 C14 C marginally delay midsleepthe higher temperatures is smaller than concomitant changes in sleep onset and offs D A plot of the predicted change in the probability of obtaining a short night of sleep 5 C14 C, the probability of obtaining a short night of sleepmeasured with three standard E Above C010 C14 C, increasing nighttime ambient temperatures delay sleep onset Sleep Offset min 2.5 5.0 7.5 ll sleep loss within our sample Tables S8 and S29. Moreover, constraining our sample to only include high-income countries does not alter our primary results Tables S49 and S50. Our finding that human sleep is unidirectionally sensitive to increasing ambient temperatures across the temperature distri- bution differs from previous experimental studies that found re- ductionsinsleepunderbothhighandlowenvironmentaltemper- atures. 37 Instead, our within-person global analysis uncovers a similarfunctionalrelationshipasthoseidentifiedbypriornational survey analyses using subjective measures of sleep. 11,13 In real- world settings, humans appear to be better at adapting theirsurroundings toobtain sufficientsleep undercooleroutside -2.5 0.0 2.5 Chang e in Midsleep min Chan ge i n Sleep Onset min Chang e in -2.5 0.0 2.5 5.0 7.5 -2.5 0.0 25 C Mar g inal Effect of 25C on slee p p eriod -10 0 10 20 Min. Nighttime Temperature in C theaverage within-individualchangeinsleep duration foreachtemperature decline when temperatures exceed 10 C14 C. Shaded regions represent 95 teredonthefirstadministrativedivisionlevel.Histogramsplotthedistribution sufficient observational support across all temperature bins Table S5. throughadelayinsleeponsetandamarginallysmalleradvanceinsleep very cold temperatures below C010 C14 C delay offset timing. midpoint of the human sleep periodalthough the magnitude of change at et. across each minimum temperature bin. As temperature increases above criteriaalso increases. across the observed temperature distribution. One Earth 5, 534–549, May 20, 2022 537 conditions, whereas sleep loss increases with rising ambient temperatures.Since othermeteorological factors may also influ- ence sleep, we use our primary flexible model specification Experimental procedures; Equation 1 to estimate the human sleep response to changes in weather. Sleep loss increases furtherasafunctionofthediurnaltemperaturerangethediffer- ence between daily maximum and minimum temperature. This result is directionally consistent with the diurnal temperature range attributed mortality response identified by a recent multi- country analysis. 47 Since our specified model controls for other weather variables, including cloud cover and relative humidity, two plausible explanations are that indoor environments may retain heat gained during the day or that daytime heat may impart physiological demands that extend into the sleep period. Importantly, diurnal temperature range is projected to increase annually over Europe 48 and separately across most other re- gions during summer months under a high-emissions, climate- change scenario. 47 By contrast, high levels of precipitation, wind speed, and cloud cover each marginally increase sleep duration Figure S1. Compared with moderate levels of relative humidity, both low and high levels reduce sleep, with the former producinggreatersleepreduction,providinginitialevidencethat dry conditions may curtail sleep. Effect on sleep onset, midsleep, and offset To investigate how the entire sleep period responds to tempera- ture-driven sleep loss, we construct separate flexible models to predict sleep onset, midsleep, and offset timing. Drawing on these combined estimates, we show that rising temperatures compress the human sleep period through both a larger delay in sleep onset and a moderate advance in sleep offset. As mini- mum temperatures rise above C010 C14 C, delays in sleep onset curtail sleep duration Figures 2A–2C and 2E and marginally delay midsleep. By contrast, nighttime temperature increases advance sleep offset timing when temperatures exceed 15 C14 C. Thus, larger declines in sleep duration at warmer nighttime tem- peratures are jointlydriven byboth delaysinsleep onset andad- vances in sleep offset, constricting the human sleep period and slightly delaying midsleep Tables S12–S14. Temperature effects by age group Individual and environmental demographic factors may modify the impact of temperature on sleep. Older adulthood is marked byanattenuatedthermoregulatoryresponsetosuboptimalenvi- ronmental temperatures, earlier sleep timing, and reduced total sleep duration. 49 Such age-related developments may increase the nocturnal sensitivity of the elderly to higher ambient temper- atures, possibly challenging sleep demand. We find that older adults65aremarkedlymoresensitivetoexogenousincreases in nighttime ambient temperature than mid-aged adults and youngadultsFigure3A.Theper-degreeeffectofnighttimetem- perature on lost sleep for older adults coefficient C00.61 is over two times p 2.3.co;2. 95. Menne, M.J., Durre, I., Vose, R.S., Gleason, B.E., and Houston, T.G. 2012. An overview of the global historical climatology network-daily database. J. Atmos. Ocean Technol. 29, 897–910. https//doi.org/10. 1175/jtech-d-11-00103.1. 96. 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