Association of Residential Greenness and Sleep Duration in Adults: A Prospective Cohort Study in China

Jiayi Li; Yaoyao Lin; Zongming Yang; Joachim Heinrich; Tianyu Zhao; Zhebin Yu; Wenqing Wang; Kaixuan Yang; Peng Shen; Hongbo Lin; Liming Shui; Jianbing Wang; Mingjuan Jin; Mengling Tang; Kun Chen

doi:10.1016/j.envres.2025.120767

Association of Residential Greenness and Sleep Duration in Adults: A Prospective Cohort Study in China

Environ Res. 2025 Jan 7:120767. doi: 10.1016/j.envres.2025.120767. Online ahead of print.

Authors

Jiayi Li¹, Yaoyao Lin², Zongming Yang³, Joachim Heinrich⁴, Tianyu Zhao⁵, Zhebin Yu⁶, Wenqing Wang¹, Kaixuan Yang⁷, Peng Shen⁸, Hongbo Lin⁸, Liming Shui⁹, Jianbing Wang¹⁰, Mingjuan Jin², Mengling Tang¹¹, Kun Chen¹²

Affiliations

¹ Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
² Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
³ Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
⁴ Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
⁵ Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany.
⁶ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁷ Department of Public Health, the Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, 322000, China.
⁸ Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315100, China.
⁹ Yinzhou District Health Bureau of Ningbo, Ningbo, 315040, China.
¹⁰ Department of Public Health, and Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
¹¹ Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China. Electronic address: tangml@zju.edu.cn.
¹² Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China. Electronic address: ck@zju.edu.cn.

PMID: 39788442
DOI: 10.1016/j.envres.2025.120767

Abstract

Background: Exposure to residential greenness has been linked with improved sleep duration; however, longitudinal evidence is limited, and the potential mediating effect of ambient fine particulate matter (PM_2.5) has yet to be assessed.

Methods: We obtained data for 19,567 participants across seven counties in a prospective cohort in Ningbo, China. Greenness was estimated using Normalized Difference Vegetation Index (NDVI) within 250-m, 500-m and 1000-m buffer zones, while yearly average PM_2.5 concentrations were measured using validated land-use regression models, both based on individual residential addresses. Sleep duration was assessed using structured questionnaires at baseline and during follow-up. The longitudinal associations between residential greenness and sleep duration were evaluated using linear mixed-effect models. Adjustments for PM_2.5 and county were implemented. To identify the effect of greenness exposure on age-related declines in sleep duration, we included an interaction term between NDVI and visit (baseline and follow-up). Additionally, half-longitudinal mediation analyses were conducted to evaluate the potential mediating role of PM_2.5 in this relationship.

Results: Each interquartile range (IQR) increase in NDVI within 250 m, 500 m and 1000 m was associated with increases in sleep duration of 0.044 hours (95% CI: 0.028,0.061), 0.045 hours (95% CI: 0.028,0.062), and 0.031 hours (95% CI: 0.013,0.049), respectively. Associations were attenuated after adjusting for PM_2.5. Farmers, homemakers, and short-nap individuals benefited the most from greenness exposure. Higher greenness exposure significantly lowered PM_2.5 levels, which was associated with a slower decline in sleep duration over the follow-up period.

Conclusion: Exposure to higher levels of residential greenness was associated with increased sleep duration and a slower decline in sleep over time. County-level heterogeneity in the effects of residential greenness on sleep duration was observed. PM_2.5 partially mediating this relationship.

Keywords: Air pollution; Fine particulate matter; Mediation; Residential greenness; Sleep duration.