睡眠时间和睡眠质量对我国中老年人高血压发病率的影响

  目的   了解我国中老年人高血压发病情况, 并探讨睡眠时间和睡眠质量与我国中老年人高血压发病率之间的关系。   方法   运用2011年和2015年中国健康与养老追踪调查数据(China health and retirement longitudinal study, CHARLS), 共纳入45岁及以上中老年6 047人。睡眠时间被定义为过去1个月平均每晚的实际睡眠时间, 睡眠质量应用自编问卷进行评估。睡眠时间和睡眠质量对高血压发病率的影响采用多因素Logistic回归模型分析。   结果   经过4年随访, 1 151人发生了高血压, 累积发病率为19.03%。多因素Logistic回归模型分析结果显示, 单纯睡眠时间异常或睡眠质量不佳均对高血压发病率无影响, 在性别、年龄的亚组分析中结果保持不变。进一步研究不同组合的睡眠时间和睡眠质量与高血压的关系, 结果显示睡眠时间和睡眠质量与高血压的联合效应差异均无统计学意义(均有P > 0.05)。   结论   无充分证据显示睡眠时间和睡眠质量与我国中老年高血压发病率有关且年龄、性别对该相关性无影响。     

大学生饮料消费睡眠质量和抑郁症状的关系

研究睡眠质量在饮料消费与大学生抑郁症状关联中的中介作用,为预防和减轻大学生抑郁症状提供理论依据.方法 采用横断面研究的方法,从安徽省和江西省2所大学整群抽取大一至大三4 624名大学生进行问卷调查.应用9项患者健康问卷(Patient Health Questionnaire-9 items,PHQ-9)评估抑郁症状,采用匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评估睡眠质量,使用自我报告的饮食频率调查表评估饮料的消费.使用分位数回归模型进行关联分析,应用潜变量中介效应模型分析中介效应.结果 大学生轻度、中度、中重度和重度抑郁检出率分别为31.4%,7.5%,4.1%和2.0%.饮料消费评分、PSQI评分和PHQ-9评分之间的关联有统计学意义(P值均<0.01).饮料消费和PSQI评分的分位数越高,回归系数更大,呈现明显的剂量反应关系(P<0.01).在饮料消费与大学生抑郁症状关联的潜变量中介效应模型中,睡眠质量的中介效应值为0.12,中介效应占总效应的比例为71.3%.结论 大学生较差的睡眠质量在饮料消费与抑郁症状之间起部分中介作用.     

Perceived quality of life in schizophrenia: Relationships to sleep quality

We examined the relationship between perceived quality of life (QOL) and subjective quality of sleep among schizophrenia patients, and its relation to symptom severity, side effects and emotional distress. One hundred and forty five schizophrenia patients were comprehensively evaluated with standardized measures of symptom severity, adverse effects, emotional distress, QOL, and sleep quality (the Pittsburgh Sleep Quality Index, PSQI). Partial correlation and multiple regression analyses were performed. Poor sleepers reported lower mean scores on all QOL domains, they were more depressed and distressed, and had more adverse effects to medications with concomitant distress than good sleepers. The negative relationship between complaints of poor sleep quality and QOL measures remained significant when the confounding effect of depression, side effects, and distress was partialled from the correlation matrix. Daytime dysfunction (a component of the PSQI) accounted for 12.6% of the variance in QOL index scores. Thus, poor QOL reported by schizophrenia patients is substantially associated with poor sleep quality. This association appears both independently and synergistically with depression, distress and side effects of medications.     

病房护士的睡眠质量对日周性作业疲劳的影响

目的 探讨病房护士的睡眠质量对日周性作业疲劳的影响.方法 利用整群抽样的方法,调查了浙江省杭州市的3所三等甲级医院479名病房护士(非孕期、非病假)的睡眠质量及其日周性作业疲劳情况.采用匹茨堡睡眠质量指数量表(PSQI)评定睡眠质量;使用作业疲劳症状自评量表(2002)评定被调查对象1天的疲劳情况;自拟一般资料问卷收集护士的一般资料.结果 病房护士的睡眠质量普遍较差:PSQI总均分为7.31±3.45,PSQI7分的病房护士有200位(41.75%),睡眠总分与学历呈负相关(r=-0.11,P＜0.01),学历与睡眠质量、入睡时间和睡眠时间呈负相关;睡眠与婚姻、工龄、职称、职务无相关性.病房护士的睡眠质量与作业疲劳存在密切的关联:(1)睡眠总分与1天4个时间点的疲劳均分呈正相关(r值分别为0.42,0.34,0.25,0.33,P值均0.01).(2)睡眠总分与4个时间点疲劳的5个因子有相关性.(3)睡眠的7个因子之间以及4个时间点的疲劳均分之间也呈明显的相关.(4)睡眠质量与作业疲劳的多元回归分析结果显示,睡眠质量、日间功能、睡眠障碍以及催眠药物的使用是导致工作疲劳的重要因素.(5)睡眠质量与延迟下班无相关(r=0.06,P=-0.17).结论 应重视病房护士的睡眠质量,了解护士的工作疲劳程度,科学地安排工作任务和流程,合理地进行人力资源管理,注重睡眠卫生的宣传和教育,劳逸结合,提高病房护士的睡眠质量,降低工作疲劳感.     

社会资本与征地农转非城市新移民睡眠时长及睡眠质量相关性研究

目的 探讨社会资本与征地农转非城市新移民睡眠时长及睡眠质量的关系,为改善征地农转非城市新移民的睡眠状况提供参考依据。方法 采用多阶段随机抽样的方法,通过面对面问卷调查的方法收集资料,研究对象为15岁及以上征地农转非城市新移民。采用自行设计的量表测量社会资本,包括微观（个体、家庭）、中观（社区）和宏观3个层次。运用logistic回归分析探讨社会资本对睡眠时长和睡眠质量的影响。结果 本研究共纳入816名征地农转非城市新移民进行分析,调查居民平均睡眠时长（6.83±1.66）h,30.1%的居民睡眠质量差。控制性别、年龄、婚姻状况、文化程度、就业状况、患病情况等因素后,低家庭社会资本与睡眠时长＜6h相关（OR=1.624,95%CI:1.054~2.503）,低个体社会资本与睡眠质量差相关（OR=1.781,95%CI:1.253~2.530）。结论 微观社会资本与征地农转非城市新移民睡眠时长及睡眠质量相关。可以通过维持或扩展自身的社交网络、社区积极支持新移民社区参与和家庭建设以提高新移民微观社会资本,从而改善睡眠状况。     

Sleep duration,mortality and the influence of age

Prior work has shown that both short and long sleep predict mortality. However, sleep duration decreases with age and this may affect the relationship of sleep duration with mortality. The purpose of the present study was to assess whether the association between sleep duration and mortality varies with age. Prospective cohort study. 43,863 individuals (64% women), recruited in September 1997 during the Swedish National March and followed through record-linkages for 13 years. Sleep duration was self-reported and measured using the Karolinska Sleep Questionnaire, and grouped into 4 categories: ≤5, 6, 7 (reference) and ≥8 h. Up to 2010 3548 deaths occurred. Multivariable Cox proportional hazards regression models with attained age as time scale were fitted to estimate mortality rate ratios. Among individuals <65 years, short (≤5 h) and long (≥8 h) sleep duration showed a significant relationship with mortality (HR 1.37, 95% CI 1.09–1.71, and HR 1.27, 95% CI 1.08–1.48). Among individuals 65 years or older, no relationships between sleep duration and mortality were observed. The effect of short and long sleep duration on mortality was highest among young individuals and decreased with increasing age. The results suggest that age plays an important role in the relationship between sleep duration and mortality.     

Interaction of Sleep Duration and Sleep Quality on Hypertension Prevalence in Adult Chinese Males

Background

Previous studies demonstrated conflicting results about the association of sleep duration and hypertension. Given the potential relationship between sleep quality and hypertension, this study aimed to investigate the interaction of self-reported sleep duration and sleep quality on hypertension prevalence in adult Chinese males.

Methods

We undertook a cross-sectional analysis of 4144 male subjects. Sleep duration were measured by self-reported average sleep time during the past month. Sleep quality was evaluated using the standard Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure level ≥140/90 mm Hg or current antihypertensive treatment. The association between hypertension prevalence, sleep duration, and sleep quality was analyzed using logistic regression after adjusting for basic cardiovascular characteristics.

Results

Sleep duration shorter than 8 hours was found to be associated with increased hypertension, with odds ratios and 95% confidence intervals (CIs) of 1.25 (95% CI, 1.03–1.52) for 7 hours, 1.41 (95% CI, 1.14–1.73) for 6 hours, and 2.38 (95% CI, 1.81–3.11) for <6 hours. Using very good sleep quality as the reference, good, poor, and very poor sleep quality were associated with hypertension, with odds ratios of 1.20 (95% CI, 1.01–1.42), 1.67 (95% CI, 1.32–2.11), and 2.32 (95% CI, 1.67–3.21), respectively. More importantly, further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated an additive interaction.

Conclusions

There is an additive interaction of poor sleep quality and short sleep duration on hypertension prevalence. More comprehensive measurement of sleep should be performed in future studies.Key words: sleep duration, sleep quality, hypertension     

Social Engagement and Sleep Quality among Older Adults in Rural China: Is There a Sex Difference?

ObjectivesSleep quality plays a crucial role in maintaining the health of older people and has become a major public health concern throughout the world. Social engagement, as a core component of “Active Ageing”, is one of the key determinants of health outcomes of older adults. This study estimated the relationship between social engagement and sleep quality among older adults living in rural China, and to determine whether there is a sex difference in these associations.DesignA cross-sectional design. Multilevel, multiple linear regression models were used to examine the independent associations between each type of social engagement and sleep quality. All standard errors were clustered at the community level.Setting and ParticipantsData were from 3243 adults age 60 years or older from rural areas in China.MethodsSleep quality was measured by the Pittsburgh Sleep Quality Index. Social engagement was measured by 3 types of social groups’ activity in this study, including participation in hobby groups, community-related organization, and sports groups.ResultsParticipating in hobby groups, community-related organization, and sports groups with high frequency are all associated with better sleep quality. In addition, the positive relation between participating in community-related organization and sleep quality is stronger for older male than female adults, and the positive association between participating in hobby groups/sports groups is stronger for older female than male adults.Conclusions and ImplicationsOlder adults with high-frequency of social engagement may have better sleep quality. This study offers new insight for the sleep quality from the perspective of social engagement among older people, implies that encouraging targeted social engagement in older people with different sex may be effective in promoting sleep quality in rural China.     

睡眠质量在童年期不良经历与中学生抑郁症状关联中的中介作用及性别差异

目的 探讨睡眠质量在不同类型童年期不良经历(ACEs)与中学生抑郁症状关联中的中介效应及性别差异,为中学生心理健康的促进提供参考。方法 采用分层整群抽样的方法,于2017年12月-2018年1月选取沈阳市某寄宿制中学1 086名在校生为研究对象,采用独立样本t检验和χ²检验比较不同性别一般人口学特征差异,使用Pearson相关分析ACEs、睡眠质量和抑郁症状评分的关联性,自举(Bootstrap)程序和PROCESS软件检验睡眠质量的中介效应。结果 ACEs与睡眠质量和抑郁症状得分呈正相关(r=0.194、0.378,P<0.01),睡眠质量得分和抑郁症状得分呈正相关(r=0.361,P<0.01)。总样本中,调整混杂因素后,睡眠质量在ACEs、虐待和忽视与抑郁症状关联中起部分中介作用,中介效应分别为14.58%、21.66%、11.60%;睡眠质量在家庭功能不全与抑郁症状关联中起完全中介作用,中介效应为59.79%。女生中睡眠质量在ACEs及其各维度(虐待、忽视、家庭功能不全)与抑郁症状关联中的中介效应均高于男生。 结论 睡眠质量在ACEs与中学生抑郁症状关联中起中介作用,提高中学生尤其是女生的睡眠质量,有助于ACEs经历者抑郁症状的防控。     

农村地区老年人自评身体状况和睡眠质量的关系研究——心理健康的中介作用

目的 探讨心理健康在农村地区老年人自评身体状况和睡眠质量间的中介作用。方法 采用EQ-5D量表中的VAS评分、GHQ-12老年人健康问卷和匹兹堡睡眠质量量表(PSQI)分别评估老年人自评身体状况、心理健康和睡眠质量;采用bootstrap法进行中介效应检验。结果 自评身体状况与睡眠质量、身体健康得分呈负相关(r=-0.422,-0.224, P<0.001),心理健康与睡眠质量得分呈正相关(r=0.258, P<0.001);中介作用结果显示,农村地区老年人的心理健康在自评身体状况与睡眠质量之间起部分中介作用,其中介效应值为-0.476 (95%CI:-0.648～-0.319),占总效应的39.18%。结论 自评身体状况与睡眠质量存在关联,同时,心理健康在其中发挥了部分中介的作用。