睡眠类型与睡眠时间对医学生自评健康的独立与联合效应研究  

Independent and joint effect of chronotype and sleep duration on self-rated health in medical students

作　　者：丁攀 李缙永 叶晓丽 尹筱晗 钱丹妮 钟崇洲 施红英 Ding Pan;Li Jinyong;Ye Xiaoli;Yin Xiaohan;Qian Danni;Zhong Chongzhou;Shi Hongying(Department of Preventive Medicine,School of Public Health and Management,Wenzhou Medical University,Wenzhou 325035,China;Renji College,Wenzhou Medical University,Wenzhou 325035,China;Publicity Department,Wenzhou Medical University,Wenzhou 325035,China)

机构地区：[1]温州医科大学公共卫生与管理学院预防医学系,温州325035 [2]温州医科大学仁济学院,温州325035 [3]温州医科大学宣传部,温州325035

出　　处：《中华流行病学杂志》2022年第11期1796-1803,共8页Chinese Journal of Epidemiology

基　　金：国家社会科学基金(21BRK021);浙江省哲学社会科学规划课题重点项目(21NDJC013Z);国家级大学生创新创业训练计划(202010343008);浙江省大学生科技创新活动计划(2022R413C079)。

摘　　要：目的:探讨睡眠类型、睡眠时间对医学生自评健康状况较差的独立及联合效应。方法:本研究为横断面调查。采用按比例分层整群随机抽样的方法在浙江省某医科大学选取1 526名在校医学生作为研究对象。调查内容主要包括基本人口学特征、睡眠类型、睡眠时间、夜宵、久坐时间和体力活动时间等生活方式信息以及自评健康状况。采用logistic回归模型控制可疑混杂变量后评价睡眠类型、睡眠时间与自评健康的关联性。结果:医学生睡眠类型为晚睡晚起型者最多(664人,43.5%),其次为中间型(442人,29.0%)、早睡早起型(420人,27.5%)。自评健康状况较差的报告人数占42.8%(653人)。不同睡眠类型医学生自评健康状况较差报告率不等:与早睡早起型相比,中间型、晚睡晚起型者自评健康状况较差比例更高,调整 OR值(95% CI)分别为1.69(1.23~2.31)、2.43(1.81~3.26),趋势检验 P<0.001。与每晚睡眠时间≥8 h者相比,睡眠时间为7、≤6 h者自评健康状况较差的 OR值(95% CI)分别为1.40(1.07~1.84)、2.38(1.69~3.37),趋势检验 P<0.001。睡眠类型与睡眠时间存在联合效应,调整各种混杂因素后,与早睡早起型且每晚睡眠时间≥8 h的医学生相比,晚睡晚起型且睡眠时间≤6 h者自评健康状况较差的 OR值最大, OR值(95% CI)为6.53(3.53~12.09)。 结论:晚睡晚起型及睡眠不足均与医学生自评健康状况较差的 OR值增加有关联,且两者具有联合效应。建议医学生应尽量早睡早起,并保持充足睡眠,促进健康。Objective To investigate the independent and joint effects of chronotype and sleep duration on self-rated health in medical students.Methods A cross-sectional study was conducted in 1526 medical students selected through proportional stratified cluster random sampling from a medical university in Zhejiang province.A questionnaire survey was conducted to collect the information about their basic demographic characteristics,chronotype,sleep duration,and other lifestyle factors such as midnight snack,sedentary behavior,physical activity,meal time,and self-rated health.The independent and joint effects of chronotype and sleep duration on self-rated health were assessed by logistic regression model after controlling for confounding variables.Results The numbers of the students with evening chronotype,neutral chronotype,and morning chronotype were 664(43.5%),442(29.0%),and 420(27.5%),respectively.Among the medical students,42.8%(653)had poor self-rated health.Compared with those with the morning chronotype,the adjusted ORs for those with neutral chronotype and evening chronotype were 1.69(95%CI:1.23-2.31)and 2.43(95%CI:1.81-3.26),respectively,trend test P<0.001.Compared with those with sleep duration of 8 h or above per night,the adjusted ORs for those with sleep duration of 7 and≤6 h per night were 1.40(95%CI:1.07-1.84)and 2.38(95%CI:1.69-3.37),respectively,trend test P<0.001.In the joint effect,compared with those with the morning chronotype and sleep duration of 8 h or above per night,the adjusted OR for those with evening chronotype and sleep duration of≤6 h per night was 6.53(95%CI:3.53-12.09).Conclusions Both evening chronotype and insufficient sleep were associated with increased odds of poor self-rated health in medical students,and they had joint effects.Therefore,it is necessary to promote early to bed,early to rise and adequate sleep in medical student to maintain their health.

关 键 词：睡眠类型 睡眠时间 自评健康 医学生 

分 类 号：R179[医药卫生—妇幼卫生保健]