A cross-sectional field study of bedroom ventilation and sleep quality in Denmark during the heating season.

Parameters describing the bedroom environment and sleep quality were measured overnight for one week in 84 randomly selected actual bedrooms in Denmark from September to December 2020. The median age of participants was 26 years (interquartile range (IQR) [24-32] years); 41 were males. Carbon dioxide (CO 2), temperature, and relative humidity were measured continuously. Sleep quality was assessed by the Groningen Sleep Quality Scale (GSQS) on two mornings and was assessed using wrist-worn sleep trackers. Skin temperature was monitored continuously. Bedroom indoor air quality (IAQ) was rated by participants on two occasions just before sleep in the evening and upon waking up in the morning. Measurements from 75 bedrooms were complete. The median [IQR] of mean CO 2 , air temperature and relative humidity measured during sleep were 1,120 [741–4,804] ppm, 23.4 [22.3–24.4]°C, and 48.6 [44.7–55.4]%. The median [IQR] of GSQS was 4.0 [1.0–6.0] suggesting medium to poor subjectively rated sleep quality; the objectively measured sleep efficiency, and percentage of light, deep and REM sleep were in normal ranges: 88.1 [86.1–89.5]%, 59.4 [54.9–64.5]%, 18.3 [15.0–21.7]%, and 23.0 [18.4–26.4]%. The subjectively-assessed sleep quality decreased when perceived IAQ was reduced. Opening the bedroom door or window, which is a proxy for enhanced ventilation, also improved subjectively-assessed sleep quality and IAQ. The cross-sectional nature of the study prompts the validation of the present results with protocols that include measurements of other pollutants besides CO 2 as well as the examination of underlying mechanisms. Nevertheless, they strongly suggest that keeping high bedroom IAQ is essential. • Sleeping with either windows or doors open improved subjective-rated sleep quality. • Poorer perceived air quality decreased subjective-rated sleep quality. • Higher CO 2 levels increased the drop in skin temperature during sleep. • A higher drop in skin temperature increased the fraction of deep sleep. [ABSTRACT FROM AUTHOR]