上海市3~12岁儿童睡眠状况

陈仪婷; 吕佳骏; 夏缘青; 殷勇; 童世庐; 赵安达; 李生慧

doi:10.16835/j.cnki.1000-9817.2021.06.004

上海市3~12岁儿童睡眠状况

doi: 10.16835/j.cnki.1000-9817.2021.06.004

1.
上海交通大学医学院公共卫生学院, 上海 200025
2.
上海交通大学医学院附属儿童医学中心呼吸科
3.
上海交通大学医学院附属儿童医学中心临床流行病学与生物统计研究室
4.
上海交通大学医学院附属第九人民医院临床营养科

基金项目:

国家自然科学基金项目 81874266

国家自然科学基金项目 81673183

上海市科学技术委员会科技创新行动计划研究专项 18411951600

详细信息

作者简介:
陈仪婷(1997-), 女, 福建省人, 在读硕士, 主要研究方向为睡眠的免疫调节

通讯作者:
李生慧, E-mail: lsh9907@163.com

中图分类号: R 179 B 844.1
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- 文章访问数: 676
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- 被引次数: 0
出版历程
- 收稿日期: 2021-02-02
- 修回日期: 2021-03-28
- 网络出版日期: 2021-06-22
- 刊出日期: 2021-06-25

Sleep status of children aged 3-12 years in Shanghai

1.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai(200025), China

摘要

摘要: 目的了解上海市3~12岁儿童的睡眠特征，为促进儿童睡眠健康提供参考。方法 2019年4—6月在上海市开展多阶段整群抽样，抽取31所幼儿园和17所小学，在纳入研究的16 542名3~12岁儿童中开展睡眠现状横断面调查。睡眠特征采用儿童睡眠习惯问卷(CSHQ)进行评估。结果上海市3~12岁儿童的平时和周末就寝时间分别为(21:27±00:36)和(21:46±00:46)；晨起时间分别为(6:52±00:28)和(7:47±00:48)；睡眠时间分别为(9.05±1.07)和(9.52±1.17)h；睡眠不足发生率分别为81.0%和55.4%。平均睡眠问题得分为(51.56±8.04)，睡眠不良检出率达93.5%。随着年龄增长，睡眠时间逐渐减少，周末和平时睡眠模式的差异不断增大，睡眠持续时间短和日间困倦两大睡眠问题不断突出。与男生相比，女生的平时就寝时间和周末晨起时间更晚，周末和平时的睡眠模式差异更大，睡眠焦虑更加严重。结论上海市儿童总体睡眠时间不足、就寝时间晚、平时和周末睡眠模式差异大、各种睡眠问题多。女生周末和平时睡眠模式差异大和睡眠焦虑表现尤为严重。
- 睡眠 /
- 时间 /
- 睡眠异常 /
- 方差分析 /
- 儿童
Abstract: Objective To investigate the sleep characteristics of children aged 3-12 years old in Shanghai, and to provide a reference for improving pediatric sleep health. Methods From April to June 2019, 16 542 children aged 3-12 years old were randomly selected from 31 kindergartens and 17 primary schods in Shanghai, and a cross-sectional epidemiological survey was conducted using multi-stage cluster sampling. The Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep characteristics. Results The bedtime routine of children in Shanghai was (21:27±00:36) and (21:46±00:46) on weekdays and weekends, respectively. Corresponding wake-up times were (6:52±00:28) and (7:47±00:48), total sleep duration was (9.05±1.07) and (9.52±1.17)h, and the prevalence of inadequate sleep was 81.0% and 55.4%. The average score of sleep problems was (51.56±8.04), and the prevalence of disturbed sleep was 93.5%. With advancing age, the total sleep time of children in Shanghai decreased, and the difference in weekend-weekday sleep patterns increased. Furthermore, two major sleep problems were observed, namely, short sleep duration and daytime sleepiness, which became increasingly more prominent. Girls usually went to bed later on weekdays and woke up later on weekends, and a greater difference in weekend-weekday sleep patterns was observed. Moreover, psychological problems such as sleep anxiety were more serious among girls. Conclusion At present, children in Shanghai have insufficient sleep time and late bedtimes. Large differences in weekend-weekday sleep patterns were observed, and various sleep problems were identified. Sleep-related anxiety and differences in weekend-weekday sleep patterns were particularly high among girls. Sleep; Time; Dyssomnias; Analysis of variance; Child
- Sleep /
- Time /
- Dyssomnias /
- Analysis of variance /
- Child

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表 1 不同年龄和性别儿童就寝-晨起及睡眠时间比较(x ±s)

Table 1. Difference analysis of bedtime, wake-up and sleep time among children of different ages and genders(x ±s)

年龄与性别	人数	统计值	平时就寝时间	周末就寝时间	周末-平时就寝时间差/min	平时晨起时间	周末晨起时间	周末-平时晨起时间差/min	平时睡眠时间/h	周末睡眠时间/h	周末-平时总睡眠时间差/min
年龄/岁
3~4	1 499		21:27±00:38	21:44±00:40	17.20±27.08	7:12±00:27	7:44±00:44	31.96±36.11	9.62±1.28	9.83±1.28	13.01±62.25
5	2 134		21:31±00:37	21:47±00:43	15.81±33.61	7:10±00:26	7:46±00:47	36.10±39.27	9.38±1.21	9.64±1.24	15.83±69.32
6	1 970		21:30±00:36	21:47±00:44	17.05±34.60	7:07±00:25	7:45±00:46	37.51±39.56	9.25±1.21	9.49±1.25	14.57±70.07
7	2 289		21:20±00:34	21:41±00:43	20.61±35.86	6:50±00:25	7:43±00:46	53.33±43.43	9.08±0.93	9.55±1.07	28.52±66.28
8	2 040		21:17±00:32	21:40±00:49	22.88±44.24	6:44±00:22	7:45±00:46	60.86±44.06	9.00±0.97	9.49±1.08	29.33±72.05
9	2 062		21:26±00:36	21:46±00:44	19.72±41.72	6:43±00:22	7:48±00:47	64.84±44.73	8.84±0.89	9.49±1.16	38.82±69.61
10	1 978		21:31±00:35	21:49±00:47	17.78±43.91	6:39±00:23	7:49±00:49	70.60±48.31	8.71±0.94	9.38±1.06	39.89±71.47
11	1 973		21:32±00:36	21:52±00:50	19.91±45.78	6:39±00:24	7:52±00:53	72.73±50.31	8.73±0.94	9.41±1.16	41.24±72.37
12	597		21:31±00:37	21:51±00:55	20.71±48.89	6:37±00:26	7:53±00:54	76.22±53.30	8.64±0.75	9.40±1.37	45.29±81.24
		F/H值	42.71	14.80	146.01	602.85	8.07	1 911.28	167.01	23.85	635.90
		P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
性别
男	8 668		21:26±00:36	21:45±00:45	19.30±38.00	6:52±00:28	7:43±00:47	50.75±45.50	9.04±1.04	9.47±1.16	25.47±68.23
女	7 874		21:28±00:37	21:46±00:47	18.71±41.22	6:52±00:28	7:51±00:48	59.38±47.27	9.05±1.11	9.59±1.18	32.22±71.74
		t/U值	-2.66	-1.29	0.95	1.52	-10.78	-11.95	-0.46	-6.61	-6.19
		P值	< 0.01	0.20	0.34	0.13	< 0.01	< 0.01	0.65	< 0.01	< 0.01
合计	16 542		21:27±00:36	21:46±00:46	19.02±39.56	6:52±00:28	7:47±00:48	54.86±46.55	9.05±1.07	9.52±1.17	28.69±70.00

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表 2 不同年龄和性别儿童睡眠问题得分比较(x ±s)

Table 2. Difference analysis of sleep problems among children of different ages and genders(x ±s)

年龄与性别	人数	统计值	就寝习惯	入睡潜伏期	睡眠持续时间	睡眠焦虑	夜醒	异态睡眠	睡眠呼吸障碍	白天嗜睡	CSHQ总分
年龄/岁
3~4	1 499		11.48±2.17	1.68±0.72	4.67±1.55	6.75±1.40	3.76±1.27	8.38±2.04	3.27±0.79	14.20±2.77	54.18±7.32
5	2 134		11.33±2.36	1.67±0.72	4.86±1.57	6.63±1.40	3.62±1.18	8.21±1.94	3.30±0.83	14.38±2.81	54.00±7.27
6	1 970		10.85±2.49	1.62±0.71	4.90±1.57	6.52±1.53	3.56±1.17	8.22±2.13	3.33±0.88	14.47±2.88	53.47±7.78
7	2 289		9.85±2.68	1.34±0.59	4.80±1.57	6.09±1.60	3.43±1.06	8.03±1.91	3.30±0.82	14.93±3.00	51.77±7.75
8	2 040		9.17±2.63	1.31±0.61	4.82±1.56	5.87±1.68	3.43±1.10	8.03±2.05	3.29±0.87	14.79±2.90	50.71±7.94
9	2 062		8.94±2.59	1.33±0.62	5.06±1.66	5.69±1.64	3.36±0.99	7.91±1.82	3.28±0.80	14.94±2.98	50.52±7.71
10	1 978		8.56±2.55	1.37±0.65	5.16±1.65	5.48±1.66	3.40±1.09	7.88±1.98	3.27±0.85	14.84±3.04	50.00±8.16
11	1 973		8.22±2.47	1.38±0.66	5.08±1.63	5.32±1.72	3.37±1.08	7.87±2.14	3.30±0.95	14.74±3.06	49.29±8.49
12	597		7.90±2.44	1.37±0.67	4.97±1.60	5.29±1.82	3.39±1.07	7.76±1.98	3.27±0.86	14.53±2.96	48.48±8.29
		F值	469.82	103.77	17.77	206.69	26.53	15.01	1.00	14.65	111.98
		P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.43	< 0.01	< 0.01
性别
男	8 668		9.61±2.78	1.45±0.68	4.92±1.61	5.96±1.69	3.50±1.14	8.09±2.02	3.32±0.86	14.63±2.96	51.48±8.11
女	7 874		9.78±2.77	1.45±0.68	4.93±1.59	6.04±1.65	3.45±1.10	8.00±1.99	3.26±0.83	14.72±2.94	51.64±7.97
		t值	-3.93	0.06	-0.70	-3.06	2.70	3.01	4.45	-1.94	-1.25
		P值	< 0.01	0.96	0.48	< 0.01	< 0.01	< 0.01	< 0.01	0.05	0.21
合计	16 542		9.69±2.78	1.45±0.68	4.92±1.60	6.00±1.67	3.48±1.12	8.05±2.01	3.29±0.85	14.68±2.95	51.56±8.04

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表 3 不同年龄和性别儿童睡眠不足和睡眠不良检出率比较

Table 3. Difference analysis of sleep deficiency and sleep malfunction rates among children of different ages and genders

年龄与性别	人数	统计值	平时睡眠不足	周末睡眠不足	睡眠不良
年龄/岁
3~4	1 499		831(55.4)	659(44.0)	1 481(98.8)
5	2 134		1 396(65.4)	1 082(50.7)	2 097(98.3)
6	1 970		1 399(71.0)	1 116(56.6)	1 917(97.3)
7	2 289		1 889(82.5)	1 199(52.4)	2 159(94.3)
8	2 040		1 797(88.1)	1 188(58.2)	1 876(92.0)
9	2 062		1 861(90.3)	1 163(56.4)	1 901(92.2)
10	1 978		1 842(93.1)	1 194(60.4)	1 795(90.7)
11	1 973		1 824(92.4)	1 195(60.6)	1 729(87.6)
12	597		561(94.0)	372(62.3)	506(84.8)
		χ²值	1 708.17	168.02	421.70
		P值	< 0.01	< 0.01	< 0.01
性别
男	8 668		7 035(81.2)	5 046(58.2)	8 072(93.1)
女	7 874		6 365(80.8)	4 122(52.3)	7 389(93.8)
		χ²值	0.82	57.44	3.47
		P值	0.60	< 0.01	0.06
合计	16 542		13 400(81.0)	9 168(55.4)	15 461(93.5)
注：()内数字为检出率/%。

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参考文献(34)

[1]	MATRICCIANI L, BIN Y S, LALLUKKA T, et al. Past, present, and future: trends in sleep duration and implications for public health[J]. Sleep Health, 2017, 3(5): 317-323. doi: 10.1016/j.sleh.2017.07.006
[2]	SHORT M A, BLUNDEN S, RIGNEY G, et al. Cognition and objectively measured sleep duration in children: a systematic review and meta-analysis[J]. Sleep Health, 2018, 4(3): 292-300. doi: 10.1016/j.sleh.2018.02.004
[3]	DUTIL C, CHAPUT J P. Inadequate sleep as a contributor to type 2 diabetes in children and adolescents[J]. Nutr Diabet, 2017, 7(5): e266. doi: 10.1038/nutd.2017.19
[4]	CHAPUT J P, GRAY C E, POITRAS V J, et al. Systematic review of the relationships between sleep duration and health indicators in the early years(0-4 years)[J]. BMC Public Health, 2017, 17(Suppl 5): 855.
[5]	CHAPUT J P, GRAY C E, POITRAS V J, et al. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth[J]. Appl Physiol Nutr Metab, 2016, 41(6 Suppl 3): S266-S282. doi: 10.1139/apnm-2015-0627
[6]	李生慧, 沈晓明, 金星明, 等. 全国城市学龄儿童睡眠状况研究[J]. 中华儿科杂志, 2008, 46(3): 185-189. doi: 10.3321/j.issn:0578-1310.2008.03.006 LI S H, SHEN X M, JIN X M, et al. Sleep habits and sleep disturbance in school-age children of China[J]. Chin J Pediatr, 2008, 46(3): 185-189. doi: 10.3321/j.issn:0578-1310.2008.03.006
[7]	李生慧, 沈晓明, 金星明, 等. 上海市学龄儿童"白天困倦"相关危险因素研究[J]. 中国儿童保健杂志, 2009, 17(4): 376-379. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO200904004.htm LI S H, SHEN X M, JIN X M, et al. Prevalence of daytime sleepiness and association with sleep behaviors, sleep environment in school-aged children of Shanghai City[J]. Chin J Child Health Care, 2009, 17(4): 376-379. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO200904004.htm
[8]	CHEN T, WU Z, SHEN Z, et al. Sleep duration in Chinese adolescents: biological, environmental, and behavioral predictors[J]. Sleep Med, 2014, 15(11): 1345-1353. doi: 10.1016/j.sleep.2014.05.018
[9]	MAGEE C A, LEE J K, VELLA S A. Bidirectional relationships between sleep duration and screen time in early childhood[J]. JAMA Pediatr, 2014, 168(5): 465-470. doi: 10.1001/jamapediatrics.2013.4183
[10]	MATRICCIANI L, OLDS T, PETKOV J. In search of lost sleep: secular trends in the sleep time of school-aged children and adolescents[J]. Sleep Med Rev, 2012, 16(3): 203-211. doi: 10.1016/j.smrv.2011.03.005
[11]	WANG G, ZHANG J, LAM S P, et al. Ten-year secular trends in sleep/wake patterns in Shanghai and Hong Kong school-aged children: a tale of two cities[J]. J Clin Sleep Med, 2019, 15(10): 1495-1502. doi: 10.5664/jcsm.7984
[12]	OWENS J A, SPIRITO A, MCGUINN M. The Children's Sleep Habits Questionnaire(CSHQ): psychometric properties of a survey instrument for school-aged children[J]. Sleep, 2000, 23(8): 1043-1051. http://rheumatology.oxfordjournals.org/external-ref?access_num=11145319&link_type=MED
[13]	李生慧, 金星明, 沈晓明, 等. 儿童睡眠习惯问卷中文版制定及测量性能考核[J]. 中华儿科杂志, 2007, 45(3): 176-180. doi: 10.3760/j.issn:0578-1310.2007.03.005 LI S H, JIN X M, SHEN X M, et al. Development and psychometric properties of the Chinese version of children's sleep habits questionnaire[J]. Chin J Pediatr, 2007, 45(3): 176-180. doi: 10.3760/j.issn:0578-1310.2007.03.005
[14]	JANKOWSKI K S. Social jet lag: sleep-corrected formula. Chronobiol Int[J]. 2017, 34(4): 531-535.
[15]	国家卫生健康委员会. 健康中国行动(2019—2030年). [2021-05-19]. http://www.gov.cn/xinwen/2019-07/15/content_5409694.htm. National Health Commission of the People's Republic of China. Healthy China initiative(2019-2030). [2021-05-19]. http://www.gov.cn/xinwen/2019-07/15/content_5409694.htm.
[16]	国家卫生和计划生育委员会. 0岁~5岁儿童睡眠卫生指南. WS/T 579—2017[S]. 2017-10-12. National Health and Family Planning Commission of the People's Republic of China. Guidelines for sleep hygiene for children aged 0 to 5 years WS/T 579-2017[S]. 2017-10-12.
[17]	PARUTHI S, BROOKS L J, D'AMBROSIO C, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American academy of sleep medicine[J]. J Clin Sleep Med, 2016, 12(6): 785-786. doi: 10.5664/jcsm.5866
[18]	江帆, 颜崇淮, 吴胜虎, 等. 上海市1~6岁儿童睡眠状况的流行病学研究[J]. 中华儿科杂志, 2001, 39(5): 31-35. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEK200105013.htm JIANG F, YAN C H, WU S H, et al. An epidemiological study on sleep characteristics and sleep disorders in children from 1 to 6 years of age in Shanghai[J]. Chin J Pediatr, 2001, 39(5): 31-35. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEK200105013.htm
[19]	MATRICCIANI L, PAQUET C, GALLAND B, et al. Children's sleep and health: a meta-review[J]. Sleep Med Rev, 2019, 46: 136-150. doi: 10.1016/j.smrv.2019.04.011
[20]	BESEDOVSKY L, LANGE T, HAACK M. The sleep-immune crosstalk in health and disease[J]. Physiol Rev, 2019, 99(3): 1325-1380. doi: 10.1152/physrev.00010.2018
[21]	周江燕, 穆叶色·艾则孜, 张斌. 广州市小学生日间活动和睡眠状况调查分析[J]. 中国健康教育, 2016, 32(11): 1006-1009. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201611013.htm ZHOU J Y, MUYESE A Z Z, ZHANG B. Gender difference in daily activities and sleep statues among primary school students in Guangzhou[J]. Chin J Health Educ, 2016, 32(11): 1006-1009. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201611013.htm
[22]	BECKER S P, SIDOL C A, VAN DYK T R, et al. Intraindividual variability of sleep/wake patterns in relation to child and adolescent functioning: a systematic review[J]. Sleep Med Rev, 2017, 34: 94-121. doi: 10.1016/j.smrv.2016.07.004
[23]	LV Y J, CAI L, ZENG X, et al. Association between weekend catch-up sleep and executive functions in Chinese school-aged children[J]. J Clin Sleep Med, 2020, 16(8): 1285-1293. doi: 10.5664/jcsm.8494
[24]	AGOSTINI A, CARSKADON M A, DORRIAN J, et al. An experimental study of adolescent sleep restriction during a simulated school week: changes in phase, sleep staging, performance and sleepiness[J]. J Sleep Res, 2017, 26(2): 227-235. doi: 10.1111/jsr.12473
[25]	LO J C, LEE S M, TEO L M, et al. Neurobehavioral impact of successive cycles of sleep restriction with and without naps in adolescents[J]. Sleep, 2017, 40(2). DOI: 10.1093/sleep/zsw042.
[26]	SIMPSON N S, DIOLOMBI M, SCOTT-SUTHERLAND J, et al. Repeating patterns of sleep restriction and recovery: do we get used to it?[J]. Brain Behav Immun, 2016, 58: 142-151. doi: 10.1016/j.bbi.2016.06.001
[27]	SUN W, LING J, ZHU X, et al. Associations of weekday-to-weekend sleep differences with academic performance and health-related outcomes in school-age children and youths[J]. Sleep Med Rev, 2019, 46: 27-53. doi: 10.1016/j.smrv.2019.04.003
[28]	ANDERSON P. Assessment and development of executive function (EF) during childhood[J]. Child Neuropsychol, 2002, 8(2): 71-82. doi: 10.1076/chin.8.2.71.8724
[29]	ZHAO Z, ZHAO X, VEASEY S C. Neural consequences of chronic short sleep: reversible or lasting?[J]. Front Neurol, 2017, 8: 235. doi: 10.3389/fneur.2017.00235
[30]	LIU Z, WANG G, GENG L, et al. Sleep patterns, sleep disturbances, and associated factors among Chinese urban kindergarten children[J]. Behav Sleep Med, 2016, 14(1): 100-117. doi: 10.1080/15402002.2014.963581
[31]	陈秋, 章景丽, 陈瑞美, 等. 扬州市学龄前儿童睡眠状况调查研究[J]. 中国妇幼保健, 2018, 33(21): 4961-4965. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201821055.htm CHEN Q, ZHANG J L, CHEN R M, et al. A survey on sleep status of preschool children in Yangzhou City[J]. Maternal Child Health Care China, 2018, 33(21): 4961-4965. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201821055.htm
[32]	MOORE M, SLANE J, MINDELL J A, et al. Genetic and environmental influences on sleep problems: a study of preadolescent and adolescent twins[J]. Child Care Health Dev, 2011, 37(5): 638-641. doi: 10.1111/j.1365-2214.2011.01230.x
[33]	LI S, JIN X, YAN C, et al. Bed-and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors[J]. Sleep Med, 2008, 9(5): 555-563. doi: 10.1016/j.sleep.2007.07.008
[34]	管玥, 周红伟. 小学生睡眠质量与焦虑情绪的现状及关系研究[J]. 中国社会医学杂志, 2020, 37(4): 382-385. doi: 10.3969/j.issn.1673-5625.2020.04.013 GUAN Y, ZHOU H W. Study on sleep quality and anxiety of achool-aged children in Wuhan[J]. Chin J Soc Med, 2020, 37(4): 382-385. doi: 10.3969/j.issn.1673-5625.2020.04.013