Sleep disorders and associated factors among Tibetan secondary school students in high altitude areas
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摘要:
目的 分析中国高海拔地区藏族初中生睡眠障碍状况及其影响因素, 为高海拔地区藏族中学生睡眠质量的改善和干预提供参考和帮助。 方法 2022年4—7月, 采用分层随机整群抽样的方法在中国西藏地区的拉萨、日喀则、那曲地区对5 486名藏族初中生使用匹兹堡睡眠质量量表(PSQI)、症状自评量表(SCL-90)等进行人口学因素、睡眠障碍、生活方式等方面的问卷调查。采用描述性统计、Logistic回归分析等方法分析藏族中学生睡眠障碍及其影响因素。 结果 高海拔地区藏族初中生PSQI平均得分为(5.67±3.23)分, 睡眠障碍检出率为24.72%。初中一至三年级学生睡眠障碍检出率分别为21.61%, 28.59%, 24.84%, 差异有统计学意义(χ2=23.95, P<0.01)。Logistic回归分析显示, 人际关系敏感(中度及以上)、抑郁(较轻、中度及以上)、焦虑(较轻、中度及以上)、学业压力(中度、重度)、零点后入睡(偶尔、有时、经常、总是)、睡眠环境评价(过亮、噪音大)、父母睡眠障碍与藏族中学生睡眠障碍的发生呈正相关(OR值分别为2.74, 1.68, 2.62, 1.32, 2.02, 1.85, 2.61, 1.31, 2.19, 2.88, 4.91, 2.94, 2.51, 1.36, P值均<0.05)。 结论 高海拔地区藏族初中生睡眠质量不佳, 睡眠障碍问题普遍。学校、家庭应给予中学生更多的生活引导、保持适当运动、减轻学业压力, 以提高睡眠质量, 保障身心健康发展。 Abstract:Objective To analyze the status of sleep disorders and their influencing factors among Tibetan secondary school students in high altitude areas in China, so as to provide a reference for the improvement and intervention of sleep quality among Tibetan secondary school students in high altitude areas. Methods From April to July, 2022, a questionnaire survey on demographic factors, sleep disorders, and lifestyle was conducted on 5 486 Tibetan secondary school students in the Lhasa, Shigatse, and Nagqu regions of Tibet, China, using stratified whole-group sampling. Descriptive statistics and Logistic regression analysis were used to analyze the sleep disorders of Tibetan secondary school students and their influencing factors. Results The average score of PSQI for Tibetan secondary school students at high altitude was (5.67±3.23), and the detection rate of sleep disorders (PSQI > 7) was 24.72%. There were significant differences in the prevalence of sleep disorders among different grades (χ2=23.95, P < 0.01). Logistic regression analysis showed that interpersonal sensitivity, depression, anxiety, academic stress, falling asleep after midnight, sleep environment, and parental sleep disorders were positively associated with the occurrence of sleep disorders among Tibetan secondary school students (OR=2.74, 1.68, 2.62, 1.32, 2.02, 1.85, 2.61, 1.31, 2.19, 2.88, 4.91, 2.94, 2.51, 1.36, P < 0.05). Conclusion Tibetan secondary school students in high altitude areas have poor sleep quality and widespread sleep disorder problems, which should be given intervention and improvement. Schools and families should give secondary school students more guidance on appropriate exercise, and reduce academic stress to improve sleep quality and ensure healthy physical and mental development for secondary school students. -
Key words:
- Sleep disorders /
- Mental health /
- Regression analysis /
- Students /
- Altitude /
- Minority groups
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 高海拔地区不同组别藏族初中生睡眠障碍检出率比较
Table 1. Single factor comparison of sleep disorders among different categories of Tibetan middle school students in high altitude areas
组别 选项 人数 睡眠障碍 χ2值 P值 组别 选项 人数 睡眠障碍 χ2值 P值 年级 初一 2 096 453(21.61) 23.95 <0.01 有时 284 88(30.99) 初二 1 623 464(28.59) 经常 203 89(43.84) 初三 1 767 439(24.84) 总是 214 104(48.60) 焦虑 无 3 929 482(12.27) 1345.51 <0.01 体育锻炼 不锻炼 857 257(29.99) 15.38 <0.01 较轻 1 052 480(45.63) 偶尔 1 902 448(23.55) 中度及以上 505 394(78.02) 有时 1 317 310(23.54) 抑郁 无 3 604 373(10.35) 1445.92 <0.01 经常 870 210(24.14) 较轻 1 198 475(39.65) 总是 540 131(24.26) 中度及以上 684 508(74.27) 零点后入睡 不 703 55(7.82) 551.81 <0.01 人际关系敏感 无 3 327 357(10.73) 1212.05 <0.01 偶尔 1 601 207(12.93) 较轻 1 381 466(33.74) 有时 1 124 274(24.38) 中度及以上 778 533(68.51) 经常 1 225 407(33.22) 家庭压力 轻度 2 531 357(14.11) 435.98 <0.01 总是 833 413(49.58) 中度 2 079 571(27.47) 睡眠环境评价 满意 4 274 791(18.51) 401.15 <0.01 重度 876 428(48.86) 过亮 288 137(47.57) 学业压力 轻度 1 172 82(7.00) 583.74 <0.01 噪音大 924 428(46.32) 中度 2 502 484(19.34) 非网课时间手持视屏 <2 1 915 315(16.45) 179.16 <0.01 重度 1 812 790(43.60) 时长/(h·d-1) 2~<3 1 390 324(23.31) 人际关系压力 轻度 2848 375(13.17) 556.99 <0.01 3~<4 995 289(29.05) 中度 1 717 517(30.11) 4~<5 581 181(31.15) 重度 921 464(50.38) ≥5 605 247(40.83) 饮酒 不饮用 4 401 964(21.90) 132.22 <0.01 非网课时间电视视屏 <2 3 641 803(22.05) 89.74 <0.01 偶尔 873 281(32.19) 时长/(h·d-1) 2~<3 778 182(23.39) 有时 112 46(41.07) 3~<4 422 130(30.81) 经常 55 35(63.64) 4~<5 298 93(31.21) 总是 45 30(66.67) ≥5 347 148(42.65) 吸烟 不吸烟 4 012 888(22.13) 126.00 <0.01 父母睡眠障碍 无 4 958 1 139(22.97) 84.25 <0.01 偶尔 773 187(24.19) 有 528 217(41.10) 注:()内数字为检出率/%。 表 2 高海拔地区藏族初中生睡眠障碍的Logistic回归分析(n=5 486)
Table 2. Logistic regression analysis of sleep disorders among Tibetan middle school students in high altitude areas (n=5 486)
自变量 选项 β值 P值 OR值(95%CI) 人际关系敏感 较轻 0.23 0.06 1.26(0.98~1.59) 中度及以上 0.55 <0.01 2.74(1.23~2.46) 抑郁 较轻 0.77 <0.01 1.68(1.69~2.75) 中度及以上 1.34 <0.01 2.62(2.61~5.42) 焦虑 较轻 0.52 <0.01 1.72(1.32~2.12) 中度及以上 1.09 <0.01 3.18(2.02~4.32) 学业压力 中度 0.62 <0.01 1.85(1.37~2.49) 重度 0.96 <0.01 2.61(1.92~3.52) 零点后入睡 偶尔 0.27 <0.05 1.31(0.89~1.92) 有时 0.79 <0.01 2.19(1.49~3.21) 经常 1.06 <0.01 2.88(1.97~4.19) 总是 1.61 <0.01 4.91(3.35~7.22) 睡眠环境评价 过亮 1.08 <0.01 2.94(2.12~4.07) 噪音大 0.91 <0.01 2.51(2.04~3.04) 父母睡眠障碍 有 0.31 0.01 1.36(1.05~1.75) -
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