中国老年人午睡时长和夜间睡眠与抑郁症状的关联:基于2020年CHARLS数据的实证分析  

The Association between Nap Duration,Nighttime Sleep,and Depressive Symptoms among Elderly People in China:an Empirical Analysis based on 2020 CHARLS Data

作　　者：周梅[1] 杨爱琼[1] 邢英[1] 王玉玲[1] ZHOU Mei;YANG Aiqiong;XING Ying;WANG Yuling(Cadre Health Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院干部保健中心,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《中国全科医学》2025年第5期560-567,共8页Chinese General Practice

基　　金：新疆维吾尔自治区科技支疆项目计划(2021E02068);新疆维吾尔自治区卫生健康保健科研专项项目(BG202403)。

摘　　要：背景随着我国进入中度老龄化社会,老年人心理健康问题逐年增加,而生活习惯与老年人的心理健康密切相关。目的探讨我国老年人午睡时长、夜间睡眠与抑郁症状的关系,基于生活习惯角度推荐睡眠时间,为老年人抑郁早期防控提供科学依据。方法基于2023-11-16公开发布第五轮(2020年)中国健康与养老追踪调查项目(CHARLS),纳入符合研究标准的8233名为研究对象。采用抑郁评定量表(CSE-D10)评估老年人抑郁症状,午睡时长划分5级:不午睡、<30 min、30~59 min、60~89 min、≥90 min,夜间睡眠分为5级:≥8 h、7~<8 h、6~<7 h、5~<6 h、<5 h。采用多因素Logistic回归分析探究影响老年人发生抑郁症状的因素,随机森林模型分析午睡时长、夜间睡眠在老年人发生抑郁症状中的重要程度,限制性立方样条曲线进一步探索午睡时长、夜间睡眠时长与抑郁症状发生风险之间的剂量-反应关系。结果2020年调查期间,中国老年人抑郁症状的发生率为24.84%(2045/8233)。多因素Logistic回归分析结果显示,午睡时长30~59 min是老年人发生抑郁症状的保护因素(OR=0.814,95%CI=0.673~0.985,P=0.034),夜间睡眠时间<5 h是老年人发生抑郁症状的危险因素(OR=1.705,95%CI=1.435~2.027,P<0.001)。女性、未婚/分居/离异/丧偶、失能、身体疼痛、强度体力活动、自评健康状况下降、生活满意度下降、卒中、帕金森病会增加老年人发生抑郁症状的风险(P<0.05)。随机森林模型显示,午睡时长、夜间睡眠时间对抑郁症状影响的重要性较高。午睡时长与发生抑郁症状之间存在非线性关系(P_(nonlinear)<0.05),老年人发生抑郁症的风险在午睡时长30 min后随着时间的增加而持续降低,最低水平约为50 min,午睡时长超过75 min后抑郁症状的发生风险会增加。老年人患抑郁症状的发生风险在夜间睡眠6 h后随着时间的增加而持续降低,最低水平约为7 h,睡眠时间超过9 hBackground As China enters a moderately aging society,the mental health problems of the elderly are increasing year by year,and lifestyle habits are closely related to the mental health of the elderly.Objective Exploring the relationship between nap time,nighttime sleep,and depressive symptoms among elderly people in China,and determining recommended sleep time based on lifestyle habits,providing scientific basis for early prevention and control of depression in the elderly.Methods Based on the publicly released fifth round(2020)of the China Health and Retirement Longitudinal Study(CHARLS)on November 16,2023,8233 eligible individuals were included as research subjects.The Depression Rating Scale(CSE-D10)was used to assess depressive symptoms in elderly individuals,with nap duration divided into 5 levels:no nap,<30 min,30-59 min,60-89 min,≥90 min.Nighttime sleep was divided into 5 levels:≥8 h,7-<8 h,6-<7 h,5-<6 h,<5 h.Multivariate Logistic regression analysis was used to explore the factors that affect the occurrence of depression symptoms in elderly people.Random forest model was used to analyze the importance of nap duration and nighttime sleep in the occurrence of depression symptoms in elderly people.Restrictive cubic spline curves were used to further explore the dose-response relationship between nap duration,nighttime sleep duration,and the risk of depression symptoms.Results During the 2020 survey period,the incidence of depressive symptoms among elderly people in China was 24.84%(2045/8233).The results of multivariate Logistic regression analysis showed that a nap duration of 30-59 minutes was a protective factor for depression symptoms in the elderly(OR=0.814,95%CI=0.673-0.985,P=0.034),and a nighttime sleep duration of less than 5 hours was a risk factor for depression symptoms in the elderly(OR=1.705,95%CI=1.435-2.027,P<0.001).Women,unmarried/separated/divorced/widowed,disabled,physically painful,physically active,self-rated health status decreased,life satisfaction decreased,stroke,and Parkinson's

关 键 词：抑郁 老年人 午睡时长 夜间睡眠 中国健康与养老追踪调查项目 

分 类 号：R749.4[医药卫生—神经病学与精神病学]