贵州农村老年人社会支持与认知功能的关系及焦虑睡眠的中介作用

目的 探讨贵州农村老年人社会支持与认知功能的联系,并分析焦虑和睡眠在其间的中介作用,为认知功能减退及痴呆的行为预防提供科学参考。方法 于2019年7—8月采用多阶段整群随机抽样方法选取贵州农村≥60岁者共1 615人作为调查对象,采用自编一般情况调查表、社会支持评定量表（SSRS）、简易智力状态检测量表（MMSE）、阿森斯失眠量表（AIS）、焦虑状态量表（GAD - 2）进行问卷调查。采用结构方程模型探讨老年人社会支持水平、焦虑、睡眠及认知功能四者间的联系。结果 1 615名老年人认知功能得分为（21.09±5.21）分,女性（t = 16.559,P＜0.001）、少数民族（t = 2.425,P = 0.015）、非在婚（t = 8.954,P＜0.001）、年龄越大（F = 42.638,P＜0.001）、文化程度越低（F = 174.167,P＜0.001）的老年人认知功能相对较差。MMSE得分与GAD - 2、AIS得分均呈负相关,与SSRS得分呈正相关（r = - 0.135、 - 0.135、0.271,P＜0.01）。结构方程模型结果显示,社会支持水平对认知功能的总效应值为0.374,其中社会支持对认知功能的直接效应值0.353（95%CI:0.294～0.411）,睡眠的中介效应值0.010（95%CI:0.002～0.020）及焦虑和睡眠的链式中介效应值0.011（95%CI:0.003～0.020）。结论 老年人社会支持可能直接影响认知功能,也可能通过睡眠质量的中介作用及睡眠和焦虑的链式中介作用间接影响认知功能。     

网络成瘾和睡眠时长在青少年受校园欺凌与抑郁间的链式中介作用

目的 探索青少年网络成瘾和睡眠时长在受校园欺凌与抑郁关系之间的中介作用,为青少年抑郁的预防干预提供依据。 方法 使用青少年健康相关危险行为问卷及CES - D抑郁量表,采用多阶段整群抽样法抽取徐州市4 190名青少年进行问卷调查。结果 在控制人口学等变量后,受校园欺凌、网络成瘾、睡眠时长对抑郁均有预测作用（r = 0.283,P＜0.01;r = 0.331,P＜0.01;r = - 0.184,P＜0.01）。路径分析表明,网络成瘾在受校园欺凌和青少年抑郁之间起中介作用;网络成瘾和睡眠时长在受校园欺凌和青少年抑郁间起链式中介作用。结论 受校园欺凌不仅直接影响青少年抑郁,还通过网络成瘾和睡眠时长的链式中介作用间接影响青少年抑郁。可通过减少青少年网络使用和提高睡眠时长来降低受校园欺凌对青少年抑郁的影响。     

河南省7~18岁儿童青少年睡眠时长与超重肥胖的关联

  目的  分析河南省7~18岁儿童青少年睡眠时长与超重肥胖的关系,为有效控制超重肥胖提供支持。  方法  采用分层整群随机抽样方法,于2019年随机抽取河南省内8个市18 823名学生为研究对象,进行问卷调查和体格检查。采用χ2检验、秩和检验、单因素方差分析及Logistic回归分析模型进行数据分析。  结果  本次调查对象中,正常组有11 185人,超重有4 415人,肥胖有3 223人。男生有10 073人,女生有8 750人,调查对象的平均年龄(11.6±4.1)岁,平均睡眠时长为(8.19±1.27)h/d,不同体重3组之间的性别、年龄及睡眠时长的差异均有统计学意义(均有P＜0.001)。男生和女生的超重和肥胖检出率随着睡眠时长的减少而增加(均有P_趋势＜0.05),且在不同睡眠时长下男生的超重和肥胖检出率高于女生(均有P＜0.05)。在小学、初中及高中人群分别进行多变量Logistic回归分析模型分析,结果发现随着睡眠时间的减少,儿童青少年发生超重肥胖的风险增加(均有P＜0.05)。  结论  睡眠不足是河南省儿童青少年超重肥胖的危险因素,保证充足的睡眠时长有利于减少超重肥胖的发生。     

Sleep following intense physical exercise stabilizes motor learning in typically developing boys

There is compelling evidence that sleep (N2, REM sleep, but also N3) supports the consolidation of motor memory in adults. Although children express higher levels of REM sleep and N3, it is still not understood why sleep does not benefit the consolidation of motor memory in children as in adults. Here, we aimed to manipulate sleep by daytime physical exercise in typically developing boys (N = 12; range 9–12 yrs) to test the impact on sleep and motor learning. The manipulation consisted of 1 h of intense ergometer exercise during the daytime before a night of restorative sleep. In a rest control condition, children were seated comfortably and listened to an audio drama. Motor learning was assessed with a visuomotor finger sequence tapping task; in both conditions learning took place before either exercise or rest. Prior to sleep in the sleep laboratory, motor memory was assessed as a baseline. Motor memory was again collected in the morning after a night of sleep in the lab. While there was no change in N3, we found prolonged REM sleep latency after physical activity compared to rest, corresponding to a prolonged first sleep cycle. With respect to motor learning, we found superior accuracy of motor performance after physical exercise compared to rest. Our findings suggest that physical exercise during the daytime stabilizes sleep-dependent motor learning.     

Examining the feasibility,acceptability, validity and reliability of physical activity,sedentary behaviour and sleep measures in people with schizophrenia

BackgroundSchizophrenia is associated with a more than doubled risk of death from cardiovascular disease (CVD). Risk factors for CVD include low levels of physical activity, sedentary behaviour and sleep problems. These risk factors are not systematically assessed by health services.AimsExamine the feasibility, acceptability, validity and reliability of tools measuring physical activity, sedentary behaviour and sleep.MethodsThirty participants with schizophrenia measured their physical activity, sedentary behaviour and sleep by wearing ActiGraph wGT3X-BT accelerometers on their wrist and waist, and recorded their sleep using the SleepBot smartphone app for 7 days. After 7 days they completed the 5-item Simple Physical Activity Questionnaire (SIMPAQ) to retrospectively measure their physical activity and sedentary behaviour over the study period. Concurrent SIMPAQ and SleepBot validity and inter-rater reliability were assessed against accelerometer-derived measures of physical activity, sedentary behaviour and sleep. A qualitative interview was conducted at the end of the study to assess acceptability.ResultsThe tools were feasible: 93% of participants provided valid wear-time accelerometry data and 83% provided SleepBot data. The SIMPAQ showed moderate concurrent validity but poor agreement for moderate-vigorous physical activity (MVPA) and moderate validity and agreement as a measure of sedentary behaviour. The SleepBot app showed poor concurrent validity and agreement for measures of sleep. The qualitative interviews demonstrated the tools were acceptable.ConclusionMonitoring physical activity, sedentary behaviour and sleep by accelerometry, smartphone and questionnaire was feasible and acceptable to people with schizophrenia. The SIMPAQ could be a valid and appropriate tool for routine clinical use.     

Sleep Problems among Mothers of Youth Stopped by the Police

Police stops are the most common form of criminal justice exposure in the USA, and are particularly common among urban youth, with 23% of them reporting a stop by the age of 15. While recent work has begun to illuminate the health impacts of police stops for these youth, little is known about the health consequences of youth police contact for the mothers of youth stopped by the police. The current study employs data from the Fragile Families and Child Wellbeing Study (FFCWS), a sample of urban, at-risk youth and their families. Multivariate logistic regression models are conducted to examine the link between youth police stops and sleep difficulties among mothers. Additional analyses examine whether the features and consequences of police stops are associated with sleep difficulties among mothers. The findings indicate that mothers with youth who have experienced police stops are more than twice as likely to report both depression- and anxiety-related sleep difficulties compared to their counterparts. Furthermore, stops with certain features—including those characterized by intrusiveness, high trauma, and high stigma—emerged as consistently significant predictors of maternal sleep difficulties. The findings suggest that mothers who are vicariously exposed to police contact via their children are a vulnerable group. Given the non-random distribution of police contact across the population of youth, with police contact concentrated among children of color, the findings suggest that police contact may exacerbate racial inequalities in sleep, which may itself contribute to racial disparities in broader mental and physical health outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11524-021-00518-1.     

Metabolic rate and substrate oxidation of young males with obesity at the different sleep stages

ObjectiveInsufficient and poor-quality sleep among young adults is closely related to obesity and may impact metabolic processes. The mobilization and use of endogenous substrates during sleep, especially fat oxidation, is essential for energy metabolism. This study investigated whether there are differences in sleep structure, metabolic rate, substrate oxidation, and the respiratory quotient (RQ) between young males with normal weight and obesity according to sleep stages and overnight sleep.MethodsFifteen young males with normal weight and fifteen with obesity posited electrodes of polysomnography (PSG) and slept in the metabolic chamber for estimation of sleep structure, sleep metabolic rate (SMR), carbohydrate oxidation (CHOO), fat oxidation (FATO), and RQ. Fat-free mass (FFM) was measured by bioelectrical impedance analysis.ResultsThe sleep period time (p = 0.038) and total sleep time (p = 0.032) were significantly shorter in the obesity group than in the normal-weight group. The obesity group also had a longer sleep latency (p = 0.034) and more sleep-turning events (p = 0.018). CHOO/FFM and the RQ were higher in the obesity group while FATO/FFM was significantly higher in the normal-weight group. FATO/FFM was also higher in the normal-weight group in each sleep stage whereas the RQ was higher in the obesity group (p < 0.05).ConclusionsYoung males with obesity showed lower fat oxidation and more dominant carbohydrate-derived fuel oxidation than normal-weight during sleep and experienced shorter sleep periods and total sleep time.     

孕妇睡眠质量与焦虑、抑郁的相关性研究

目的,了解孕妇在妊娠期睡眠质量与焦虑抑郁情绪状态的相关关系。方法：采用匹茨堡睡眠质量指数量表,症状自评量表,状态－特质焦虑问卷,焦虑自评量表,抑郁自评量表定,对83例孕妇的睡眠质量,状态－－特质焦虑,焦虑和抑郁状态水平进行调查分析。结果：孕妇的睡眠质量,入睡时间,睡眠时间,白天功能与焦虑和抑郁情绪症状呈正相关（P＜0．05）;孕妇睡眠质量与状态焦虑呈正相关关系（P＜0．05）,而入睡时间与特质焦虑呈正相关关系（P＜0．05）,结论;孕妇妊娠期睡眠质量与焦虑和抑郁情绪症状有正相关关系。     

六味地黄汤联合逍遥散加减治疗肾虚肝郁型围绝经期睡眠障碍临床研究

目的:评价六味地黄汤联合逍遥散加减治疗肾虚肝郁型围绝经期睡眠障碍的有效性和安全性。方法:受试者随机分为两组,试验组予六味地黄汤联合逍遥散加减口服;对照组予戊酸雌二醇联合地屈孕酮序贯口服。试验组以30 d为1个疗程,对照组以21 d为1个疗程,连续治疗3个疗程。观察两组治疗前后PSQI评分、Kupperman评分、中医证候积分、血清FSH、E₂及血尿常规、肝肾功和心电图等指标的变化。结果:试验组总有效率93.3%,对照组90.0%;两组均能明显降低PSQI、改良Kupperman和中医证候评分,在改善中医证候积分方面试验组明显优于对照组,差异有统计学意义(P<0.01)。对照组在减低Kupperman评分上优于试验组,差异有统计学意义(P<0.01)。两组对血清FSH水平均有下调趋势,均可上调血清E₂水平,对照组较试验组对血清E₂上调更明显(P<0.01)。结论:六味地黄汤联合逍遥散加减治疗肾虚肝郁型围绝经期睡眠障碍安全有效。     

基于“人卧血归于肝”探讨睡眠障碍对代谢相关脂肪性肝病的影响

“人卧血归于肝”是睡眠与“肝”藏象功能的重要关联,也是肝主藏血、肝主疏泄的具体体现。现基于“人卧血归于肝” 梳理睡眠与“肝”藏象的必然联系,总结睡眠障碍对肝脏糖脂代谢紊乱的影响,指出睡眠障碍通过中枢调控系统引发进食异常从而增加肝脏代谢负担,并通过其诱发的免疫反应加重肝脏代谢紊乱和肝脏炎症,也可增加胰岛素抵抗引发糖脂代谢异常并增加肝脏脂肪堆积。除此以外,睡眠障碍还可通过影响肠道菌群的变化对脂肪的消化吸收促进肝脏脂肪变性。故以“人卧血归于肝”的理论引出睡眠对于肝脏疾病的重要作用,并以期为进一步探索中西医结合防治方案提供理论参考。