Sleep duration, sleep quality and related factors among primary school students in Shanghai
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摘要:
目的 研究上海地区小学生睡眠时间和睡眠质量现状及影响因素，为该阶段学生提升睡眠健康的干预促进工作提供依据。 方法 采用分层整群随机抽样方法，抽取上海市4个城区和4个郊区16所小学的3 410名学生进行问卷调查和体格检查。运用χ2检验进行定性资料的组间比较，用二元Logistic回归法分析睡眠质量的影响因素。 结果 上海地区小学生每日平均睡眠时间 < 10 h的比例有93.0%。睡眠质量不良的发生率为66.8%，其中女生为67.1%，男生为66.6%，发生率最高的3项睡眠问题依次为白天嗜睡(80.9%)、睡眠持续时间不规律(74.1%)以及睡眠焦虑(59.5%)。多因素Logistic回归分析显示，年级、每天进行中等强度体力活动(OR=1.51，95%CI=1.04~2.21)以及每天步行10 min以上(OR=1.27，95%CI=1.08~1.50)是影响上海市小学生睡眠质量的主要因素(P值均 < 0.05)。 结论 上海地区小学生睡眠时间不足和睡眠质量不良发生率高，且与年级和体力活动相关。低年级的睡眠健康干预重点是睡眠质量，而高年级的重点是睡眠时间，适度增加中等强度体力活动和步行运动是促进学生睡眠健康的重要措施。 Abstract:Objective To investigate the general situation of sleep duration, sleep quality and related risk factors among primary students in Shanghai and to provide evidence for the prevention and control of students' sleep health. Methods By using stratified cluster random sampling method, 3 410 students from 16 primary schools in four urban areas and four suburb areas of Shanghai were selected to conduct sleep health questionnaire survey and physical examination Chi-square test was used for group comparison while binary Logistic regression was used to assess possible factors related with sleep quality. Results The detection rate of sleep insufficiency (< 10 h) among students was 93.0%. The detection rate of poor sleep quality was 66.8% with 67.1% in girls and 66.6% in boys. The top three sleep problems were daytime sleepiness(80.9%), irregular sleep duration (74.1%) and sleep anxiety(59.5%). Multivariate Logistic regression analysis showed that everyday moderate-intensity physical activity (OR=1.51, 95%CI=1.04-2.21) and daily walking activity (more than 10 minutes)(OR=1.27, 95%CI=1.08-1.50) were risk factors of poor sleep quality(P < 0.05). Conclusion In Shanghai, the prevalence of sleep insufficiency and poor sleep quality among primary students are high. Sleep health was associated with moderate physical activity and walking activity. Increasing the duration of moderate physical activity and daily walking activity is the very important measures in prevention and control of the sleep problems. -
Key words:
- Sleep /
- Time /
- Regression analysis /
- Health promotion /
- Students
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表 1 上海市不同性别小学生睡眠不良报告率比较
Table 1. Comparison of the detection rate of poor sleep quality among primary school students of different genders in Shanghai
性别 人数 睡眠质量不良 就寝习惯不良 白天嗜睡 睡眠焦虑 睡眠持续时间不规律 睡眠呼吸障碍 异态睡眠 夜醒 入睡潜伏期时间延长 男 1 816 1 209(66.6) 897(49.4) 1 464(80.6) 1 041(57.3) 1 353(74.5) 415(22.9) 992(54.6) 423(23.3) 476(26.2) 女 1 594 1 069(67.1) 855(53.6) 1 295(81.2) 987(61.9) 1 173(73.6) 258(16.2) 822(51.6) 364(22.8) 420(26.3) χ2值 0.09 6.12 0.22 7.44 0.37 23.82 3.19 0.10 0.01 P值 0.76 < 0.05 0.64 < 0.05 0.54 < 0.05 0.07 0.75 0.93 注：()内数字为报告率/%。 
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表 2 上海市不同组别小学生睡眠时间不足和睡眠质量不良报告率比较
Table 2. Comparison of the detection rate of sleep insufficiency and poor sleep quality among Shanghai primary school students in different groups
组别 选项 人数 睡眠时间不足 睡眠质量不良 人数 χ2值 P值 人数 χ2值 P值 性别 男 1 816 1 698(93.5) 1.23 0.27 1 209(66.6) 0.09 0.76 女 1 594 1 475(92.5) 1 069(67.1) 年级 一 744 667(89.7) 27.69 < 0.01 533(71.6) 41.13 < 0.01 二 690 635(92.0) 487(70.6) 三 659 612(92.9) 459(69.7) 四 682 651(95.5) 431(63.2) 五 635 608(95.7) 368(58.0) 营养状况 正常 2 227 2 076(93.2) 0.40 0.82 1 480(66.5) 0.74 0.69 超重 544 503(92.5) 372(68.4) 肥胖 639 594(93.0) 426(66.7) 每天中等强度体力活动 无 3 263 3 036(93.0) 0.01 0.94 2 195(67.3) 7.41 < 0.01 有 147 137(93.2) 83(56.5) 每天高等强度体力活动 无 3 335 3 101(93.0) 1.03 0.31 2 230(66.9) 0.27 0.60 有 75 72(96.0) 65(64.0) 每天步行10 min以上 无 2 483 2 311(93.1) 0.01 0.93 1 697(68.3) 9.78 < 0.01 有 927 862(93.0) 581(62.7) 注：()内数字为报告率/%。
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表 3 上海市小学生睡眠质量不良的多因素Logistic回归分析(n=3 410)
Table 3. Multivariate Logistic regression analysis of poor sleep quality among primary school students in Shanghai(n=3 410)
自变量 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 性别 男 -0.04 0.08 0.22 0.64 0.97(0.83~1.12) 年级 一 0.62 0.12 28.76 < 0.01 1.85(1.48~2.32) 二 0.55 0.12 22.62 < 0.01 1.74(1.38~2.18) 三 0.50 0.12 17.90 < 0.01 1.64(1.31~2.07) 四 0.21 0.11 3.46 < 0.01 1.24(0.99~1.54) 营养状况 正常 -0.03 0.10 0.12 0.73 0.97(0.80~1.17) 超重 0.08 0.13 0.36 0.55 1.08(0.84~1.38) 每天中等强度体力活动 无 0.41 0.19 4.58 < 0.05 1.51(1.04~2.21) 每天高等强度体力活动 无 -0.26 0.27 0.91 0.34 0.77(0.45~1.32) 每天步行10 min以上 无 0.24 0.08 8.44 < 0.01 1.27(1.08~1.50)
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