BACKGROUND Fluoride from environmental sources accumulates preferentially in the pineal gland which produces melatonin, the hormone that regulates the sleep-wake cycle. However, the effects of fluoride on sleep regulation remain unknown. This population-based study examined whether chronic low-level fluoride exposure is associated with sleep patterns and daytime sleepiness among older adolescents in the United States (US). METHOD This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2015-2016). We analyzed data from adolescents who had plasma fluoride (n = 473) and water fluoride (n = 419) measures and were not prescribed medication for sleep disorders. Relationships between fluoride exposure and self-reported sleep patterns or daytime sleepiness were examined using survey-weighted linear, binomial logistic or multinomial logistic regression after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons. RESULTS The average age of adolescents was 17 years (range = 16-19). Median (IQR) water and plasma fluoride concentrations were 0.27 (0.52) mg/L and 0.29 (0.19) μmol/L respectively. An IQR increase in water fluoride was associated with 1.97 times higher odds of reporting symptoms suggestive of sleep apnea (95% CI: 1.27, 3.05; p = 0.02), a 24 min later bedtime (B = 0.40, 95% CI: 0.10, 0.70; p = 0.05), a 26 min later morning wake time (B = 0.43, 95% CI: 0.13, 0.73; p = 0.04), and among males, a 38% reduction in the odds of reporting snoring (95% CI: 0.45, 0.87, p = 0.03). CONCLUSIONS Fluoride exposure may contribute to changes in sleep cycle regulation and sleep behaviors among older adolescents in the US. Additional prospective studies are warranted to examine the effects of fluoride on sleep patterns and determine critical windows of vulnerability for potential effects.

中文翻译：

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美国老年人中的氟化物暴露和睡眠方式：NHANES 2015-2016年的横断面研究。

背景技术来自环境的氟化物优先聚集在松果体中，该松果体产生褪黑激素，褪黑激素是调节睡眠-觉醒周期的激素。但是，氟化物对睡眠调节的影响仍然未知。这项基于人群的研究调查了美国（美国）青少年中长期低水平的氟化物暴露是否与睡眠方式和白天嗜睡有关。方法这项横断面研究利用了来自美国国家健康与营养检查调查（2015-2016）的数据。我们分析了青少年血浆中的氟化物（n = 473）和氟化氢（n = 419）的数据，但未针对睡眠障碍开处方。使用调查加权线性法检查了氟化物暴露与自我报告的睡眠方式或白天嗜睡之间的关系。协变量调整后的二项式logistic或多项式logistic回归。Holm-Bonferroni校正说明了多个比较。结果青少年的平均年龄为17岁（范围= 16-19）。中位数（IQR）水和血浆氟化物浓度分别为0.27（0.52）mg / L和0.29（0.19）μmol/ L。水中氟化物的IQR升高与报告有睡眠呼吸暂停症状的报告机率（1.9％，95％CI：1.27，3.05; p = 0.02）关联度高1.97倍，睡后24分钟（B = 0.40，95％CI：0.10， 0.70； p = 0.05），即早上醒后26分钟的时间（B = 0.43，95％CI：0.13，0.73； p = 0.04），而在男性中，打的几率降低了38％（95％CI ：0.45，0.87，p ＝ 0.03）。结论在美国，氟化物暴露可能会导致睡眠周期调节和睡眠行为发生变化。必须进行其他前瞻性研究，以检查氟化物对睡眠模式的影响，并确定潜在影响的脆弱性临界窗口。