0952 Association of Air Quality with Sleep Disorders in Normally Developing 2-18-Year-Olds: Real World Data from an Ongoing Observational Study

Abstract Introduction Majority of world population resides in areas with air quality index (AQI) exceeding the acceptable standards set by World Health Organization. Research from areas with poor AQI have shown association of sleep disorders with air pollutants (particulate matter [PM10 and PM2.5], ozone, carbon monoxide, nitrogen dioxide and sulphur dioxide) that contribute towards air quality index (AQI). This ongoing study of 18 months duration from June 2025 is evaluating the association between AQI and sleep disorders in normally developing 2-18-year-olds from New Delhi, India. Methods Subjects are being screened for sleep disorders using the Childhood and Adolescent Sleep Evaluation Questionnaire (CASEQ) at a tertiary-care teaching hospital by systematic random sampling. Screen-positives for sleep disorders are evaluated by overnight polysomnography and assigned an ICSD-3 based diagnosis. Daily AQI and the predominant air pollutant are noted from SAMEER, the official mobile application of Indian Central Pollution Control Board. Monthly prevalence of sleep disorders is being correlated with the combined mean AQI of Delhi for that month and the preceding month. Results Overall, 212 cases have been enrolled from June till November 2025 (mean age 9.1 ± 3.5 years; 62.1% males, 59/212 [27.8%] with final diagnosis of sleep disorder). The most common ICSD-3 diagnoses are periodic limb movement disorders (75%) and obstructive sleep apnea (54.5%). Multiple diagnoses were seen in 63.6%. The most common symptoms on initial CASEQ screening are sleep related movement disorder (77.8%) and insomnia (59.3%). The prevalence of sleep disorders is higher during June (29.3%), October (42.9%) and November (48.5%) with higher combined mean AQI noted for the corresponding time periods (May-June:155.4, September-October:165.3, and October-November:287.7) and lower during July, August and September with corresponding lower AQIs (11.8%,109; 17.4%, 83.5; 96.8, 25%) (r=0.86). The predominant pollutants during higher AQI months are PM10 and ozone whereas carbon monoxide predominates lower AQI months. Conclusion Significant correlation exists between prevalence of sleep disorders and AQI. PM10 and ozone may be central to health hazards of air pollution. Future studies should focus on causality establishment exploring biological pathways, longitudinal follow-ups, and controlling for multiple environmental determinants. Support (if any)