睡眠状况与儿童青少年心理行为问题关联研究  

Sleep status associated with psychological and behavioral problems in adolescents and children

作　　者：汪倩玲 张新东[3] 伍晓艳[1] 张强[3] 张一 孙健[3] 张诗晨 王熙 宗巧 陶舒曼[1] 王仁杰 陶芳标[1] Wang Qianling;Zhang Xindong;Wu Xiaoyan;Zhang Qiang;Zhang Yi;Sun Jian;Zhang Shichen;Wang Xi;Zong Qiao;Tao Shuman;Wang Renjie;Tao Fangbiao(Population Health Across Life Cycle(Anhui Medical University),Ministry of Education of China/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract,National Health Commission of China,Hefei 230032,China;Department of Oncology,The First Hospital of Anhui Medical University,Hefei 230022,China;Baoan District Center for Disease Control and Prevention,Shenzhen 518101,China)

机构地区：[1]安徽医科大学出生人口健康教育部重点实验室国家卫生健康委配子及生殖道异常研究重点实验室,合肥230032 [2]安徽医科大学第一附属医院肿瘤内科,合肥230022 [3]深圳市宝安区疾病预防控制中心,518101

出　　处：《中华流行病学杂志》2021年第5期859-865,共7页Chinese Journal of Epidemiology

基　　金：睡眠时型、社会时差和生物钟关键基因遗传变异交互作用与青少年健康危险行为聚集现象的队列研究(82073578)。

摘　　要：目的:分析儿童青少年睡眠不足、周末睡眠社会时差等睡眠问题与心理行为问题之间的相关性,为预防和改善儿童青少年心理行为问题提供参考依据。方法:2019年4-5月采用立意抽样按照街道—学校类型—学校3个阶段在深圳市宝安区辖区内6个街道选取14所学校,对30188名1~12年级儿童青少年进行问卷调查。心理行为问题评定采用父母版与学生版困难与长处问卷进行,夜间睡眠时间、周末上床和起床推迟时间、午睡情况等采用自编的《中小学生成长轨迹及健康指数调查问卷》。调整性别、年龄、父母文化程度、学习成绩、学习负担和噪声等混杂因素,采用多因素logistic回归分析睡眠问题与心理行为问题之间的关联强度(OR值)及其95%CI。结果:小学低年级、小学高年级、初中和高中学生睡眠不足分别占90.4%、90.1%、98.2%和98.4%,有19.9%的学生不午睡,19.6%的学生周末推迟起床时间≥2 h,35.1%的学生晚上不固定时间睡觉,15.5%的学生每天不固定时间起床。与夜间睡眠时长8~9 h相比,小学低年级学生夜间睡眠时长≤7 h、7~8 h增加心理行为问题发生风险,睡眠时间>9 h与心理行为问题呈负向关联;小学高年级学生夜间睡眠时长≤7 h增加心理行为问题发生风险;初、高中生夜间睡眠≤6 h者心理行为问题增加,OR值(95%CI)分别为2.53(1.85~3.47)、2.41(1.11~5.25),而夜间睡眠>9 h者心理行为问题也增加,OR值(95%CI)分别为2.37(1.40~4.01)、5.38(1.79~16.1)。与午睡时间0.5~1 h相比,不午睡及午睡时间<0.5 h都是中小学生出现心理行为问题的危险因素,午睡时间1~2 h还是高中生出现心理行为问题的危险因素。早上不固定时间起床、晚上不固定时间睡觉、周末推迟起床≥2 h是中小学生出现心理行为问题的危险因素。周末夜间推迟入睡≥2 h,小学低年级和高年级、初中、高中学生出现心理行为问题的OR值(95%CI)分别为2.07(1Objective To examine whether sleep status and social jet lag are related to the mental health behaviors in children and adolescents,providing a reference for preventing and improving children and adolescents'mental health behaviors.Methods A large cross-section was conducted in Baoan District,Shenzhen,from April to May 2019.A total of 30188 adolescents and children in grades 1-12 in 14 schools were included.The growth trajectory and health index questionnaire of primary and secondary school students were designed to evaluate the sleep status.Mental health behavior problems among students were accessed using the parents'and students'versions of the Strengths and Difficulties Questionnaire.After controlling for confounding factors of demographic variables,including gender,age,parental education level,academic performance,learning burden,and noise impact,a multivariate logistic regression model was used for statistical analyses.Results The sleep duration of four grades students were 90.4%,90.1%,98.2%,and 98.4%,respectively.19.9%did not have a post-lunch nap.19.6%had a wake-up delay of more than or equal to 2 h weekend morning.35.1%had an inconsistent bedtime and 15.5%had an inconsistent awakening time.The multivariate logistic regression model showed that compared with 8-9 h,the sleep duration of elementary school juniors at night less than or equal to 7 h,7-8 h increased the risk of psychological behavior problems.The sleep time more than 9 h was negatively correlated with psychological behavior problems.The sleep duration of elementary school seniors less than or equal to 7 h increased the risk of psychological behavior problems.The sleep duration of middle school and high school students less than or equal to 6 h increased psychological behavior problems.The ORs(95%CI)appeared as 2.53(1.85-3.47),2.41(1.11-5.25),respectively.The ones with a sleep time more than 9 h also increased the risk,and ORs(95%CI)appeared as 2.37(1.40-4.01),5.38(1.79-16.1),respectively.Both the absence of post-lunch nap and the nap time less

关 键 词：睡眠 心理行为问题 儿童 青少年 

分 类 号：R179[医药卫生—妇幼卫生保健]