高海拔地区藏族初中生睡眠障碍及影响因素

苗秋香; 乔瑞红; 李艳红; 次仁贡加

doi:10.16835/j.cnki.1000-9817.2023.08.017

高海拔地区藏族初中生睡眠障碍及影响因素

doi: 10.16835/j.cnki.1000-9817.2023.08.017

1.
河南医学高等专科学校思政部, 郑州 451191
2.
西藏藏医药大学基础部

详细信息

作者简介:
苗秋香(1983-), 女, 河南郑州人, 硕士, 讲师, 主要研究方向为青少年健康教育与发展

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中图分类号: G444 R179 G812.47
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出版历程
- 收稿日期: 2023-03-03
- 修回日期: 2023-03-19
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

Sleep disorders and associated factors among Tibetan secondary school students in high altitude areas

1.
Ministry of Thought, Henan Higher Institute of Medical Sciences, Zhengzhou (451191), China

摘要

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。
- 睡眠障碍 /
- 精神卫生 /
- 回归分析 /
- 学生 /
- 高海拔 /
- 少数民族
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.
- Sleep disorders /
- Mental health /
- Regression analysis /
- Students /
- Altitude /
- Minority groups
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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/%。

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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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参考文献(20)

[1]	LISSAK G. Adverse physiological and psychological effects of screen time on children and adolescents: literature review and case study[J]. Environ Res, 2018, 164: 149-157. doi: 10.1016/j.envres.2018.01.015
[2]	MASON G M, LOKHANDWALA S, RIGGINS T, et al. Sleep and human cognitive development[J]. Sleep Med Rev, 2021, 57: 101472. doi: 10.1016/j.smrv.2021.101472
[3]	TROSMAN I, IVANENKO A. Classification and epidemiology of sleep disorders in children and adolescents[J]. Child Adolesc Psychiatr Clin N Am, 2021, 30(1): 47-64. doi: 10.1016/j.chc.2020.08.002
[4]	ZHAO J, XU J, HE Y, et al. Children and adolescents' sleep patterns and their associations with mental health during the COVID-19 pandemic in Shanghai, China[J]. J Affect Disord, 2022, 301: 337-344. doi: 10.1016/j.jad.2021.12.123
[5]	TAROKH L, SALETIN J M, CARSKADON M A. Sleep in adolescence: physiology, cognition and mental health[J]. Neurosci Biobehav Rev, 2016, 70: 182-188. doi: 10.1016/j.neubiorev.2016.08.008
[6]	KOLIP P, KUHNERT R, SASS A C. Social, health-related, and environmental factors influencing sleep problems of children, adolescents and young adults[J]. J Health Monit, 2022, 7(Suppl 2): 2-19.
[7]	李雪莹. 初中生学业压力、同伴关系与睡眠质量的关系和干预研究. 昆明: 云南师范大学, 2022. LI X Y. Study on the relationship and intervention between academic stress, peer relationship and sleep quality for junior high school students. Kunming: Yunnan Normal University, 2022. (in Chinese)
[8]	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. doi: 10.16168/j.cnki.issn.1002-9982.2016.11.012 ZHOU J Y, MUYESE A, 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. (in Chinese) doi: 10.16168/j.cnki.issn.1002-9982.2016.11.012
[9]	马舒, 孔繁一, 符丽艳, 等. 高原睡眠障碍者脑血流变化的临床研究[J]. 西南国防医药, 2019, 29(7): 784-786. doi: 10.3969/j.issn.1004-0188.2019.07.022 MA S, KONG F Y, FU L Y, et al. Clinical study of cerebral blood flow changes in people with altitude sleep disorders[J]. Med J Natl Defend Forces Southwest Chin, 2019, 29(7): 784-786. (in Chinese) doi: 10.3969/j.issn.1004-0188.2019.07.022
[10]	王欢欢. 渐进性高原环境下某部官兵睡眠短时记忆情绪状态分析. 延安: 延安大学, 2022. WANG H H. Analysis of sleep parameters, short-term memory, and mood states in soldiers with increasing altitude. Yan'an: Yan'an University, 2022. (in Chinese)
[11]	汪向东, 王希林, 马弘. 心理卫生评定量表手册: 增订版[M]. 北京: 中国心理卫生杂志社, 1999: 31-35, 375-378. WANG X D, WANG X L, MA H. Rating scales of mental healthy: re-vised edition[M]. Beijing: Chinese Mental Health Journal, 1999: 31-35, 375-378. (in Chinese)
[12]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm LIU X C, TANG M Q, HU L, et al. Reliability and validity of the Pitts-burgh Sleep Qality Index[J]. Chin J Psychol, 1996, 29(2): 103-107. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm
[13]	KASS F, CHARLES E, KLEIN D F, et al. Discordance between the SCL-90 and therapists' psychopathology ratings[J]. Arch Gen Psychiatry, 1983, 40(4): 389-393. doi: 10.1001/archpsyc.1983.01790040043006
[14]	丛皓, 郭菲, 陈祉妍. 青少年昼夜偏好类型及其与睡眠质量关系[J]. 中国公共卫生, 2019, 35(10): 1400-1403. doi: 10.11847/zgggws1122257 CONG H, GUO F, CHEN Z Y. Relationship between morningness-eveningness and sleep quality among Chinese adolescents[J]. Chin J Public Health, 2019, 35(10): 1400-1403. (in Chinese) doi: 10.11847/zgggws1122257
[15]	黄国明, 李梦倩, 陈建云, 等. 高中学生睡眠质量与心理社会因素的相关性研究[J]. 中国健康教育, 2015, 31(5): 470-472. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201505011.htm HUANG G M, LI M Q, CHEN J Y, et al. A correlative study of sleep quality and psychosocial factor among high school students[J]. Chin J Health Educ, 2015, 31(5): 470-472. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201505011.htm
[16]	LUIJTEN M, Van MUILEKOM M M, TEELA L, et al. The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents[J]. Q Life Res, 2021, 30(10): 2795-2804. doi: 10.1007/s11136-021-02861-x
[17]	LUO B, YANG Y, ZHANG D, et al. Sleep disorders mediate the link between childhood trauma and depression severity in children and adolescents with depression[J]. Front Psychiatry, 2022, 13: 993284.
[18]	BRAND C, SEHN A P, TODENDI P F, et al. The genetic predisposition to obesity has no influence on waist circumference when screen time and sleep duration are adequate in children and adolescents[J]. Eur J Sport Sci, 2022, 22(11): 1757-1764.
[19]	HALE L, GUAN S. Screen time and sleep among school-aged children and adolescents: a systematic literature review[J]. Sleep Med Rev, 2015, 21: 50-58.
[20]	UCROS S, CASTRO-GUEVARA J A, HILL C M, et al. Breathing patterns and oxygenation saturation during sleep in children habitually living at high altitude in the andes: a systematic review[J]. Front Pediatr, 2021, 9: 798310.