上海市低年级小学生近视进展与睡眠特征的关系

彭慧; 史慧静; 朱鸿飞; 杨飞飞; 白慧莹; 薛俊磊; 张颜菲; 马飞飞; 彭谦; 王颖

doi:10.16835/j.cnki.1000-9817.2024148

上海市低年级小学生近视进展与睡眠特征的关系

doi: 10.16835/j.cnki.1000-9817.2024148

彭慧¹,
史慧静²,
朱鸿飞^{2, 3},
杨飞飞¹,
白慧莹^{2, 3},
薛俊磊¹,
张颜菲¹,
马飞飞¹,
彭谦¹,
王颖^{2, 3, ,}

1.
上海市嘉定区疾病预防控制中心学校卫生与眼病防治科，201899
2.
复旦大学公共卫生学院
3.
复旦大学国家卫生健康委员会卫生技术评估重点实验室

基金项目:

复旦大学公共卫生学院-嘉定区卫生健康委公共卫生高质量发展重点专项 GWGZLXK-2023-04

嘉定区卫生健康委课题项目 2022-QN-08

上海市眼病防治中心儿童青少年近视防控人员培养项目 HYXG-QJ04

详细信息

作者简介:
彭慧(1983-)，女，湖南长沙人，硕士，副主任医师，主要研究方向为学校卫生与眼病防治

通讯作者:
王颖，E-mail：wangying1013@fudan.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R778.1⁺¹ Q428
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-23
- 修回日期: 2024-02-06
- 网络出版日期: 2024-05-30
- 刊出日期: 2024-05-25

Assiciation of myopia progression and sleep characteristics among lower grade primary school students in Shanghai

1.
Department of School Health and Eye Disease Prevention, Center for Disease Control and Prevention of Jiading District, Shanghai (201899), China

摘要

摘要: 目的探究睡眠特征对低年级小学生近视发生发展的影响，为近视防控工作提供参考依据。方法于2022年10月，采取整群随机抽样方法选取上海市嘉定区2所学校一、二年级小学生636名进行问卷调查与眼科检查，采用儿童睡眠习惯量表(CSHQ)评估睡眠质量；2023年10月进行视力检查随访(479名)，期间针对学生学习、屏幕与户外活动时间等开展2次且每次持续2周监测。使用广义估计方程的多变量Logistic回归或线性回归模型来检验睡眠相关因素和近视之间的关联及其强度。结果基线调查上海市低年级小学生近视率为18.58%，随访新发近视率为17.18%。CSHQ总分平均值为(51.58±4.44)分，自然日平均睡眠持续时间为(9.43±4.84)h/d，其中仅11.6%儿童睡眠充足。调整混杂因素后，多变量Logistic回归分析结果显示，小学生睡眠不足与新发近视(OR=1.64，95%CI=1.05~2.56)存在正相关，卧床休息时间与新发近视(OR=0.74，95%CI=0.63~0.91)的关联有统计学意义(P值均<0.05)。卧床休息时间不一致与新发近视呈正相关(OR=1.07，P<0.05)，卧床休息时间一致性、苏醒时间一致性与等效球镜之间的关联有统计学意义，睡眠时间、卧床休息时间及苏醒时间的一致性与眼轴长度之间的关联有统计学意义(P值均<0.05)。结论睡眠时间不足、卧床时间与近视发生发展存在一定关联。应保证儿童的充足睡眠时长，规律睡眠作息，减少小学生近视的发生。
- 近视 /
- 睡眠 /
- 患病率 /
- 回归分析 /
- 学生
Abstract: Objective To study the impact of sleep characteristics on myopia, among lower primary school students in Shanghai, so as to provide foundation for the prevention of the onset and development of myopia. Methods A total of 636 students from the first and second grades of two primary schools in Jiading District, Shanghai, were selected through cluster random sampling for questionnaire surveys and ophthalmological examinations in October 2022. The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep quality at baseline. Ophthalmological examinations were conducted in October 2023(479), during which the students' study time, screen time and outdoor activity time were monitored for two-week, repeated twice. Generalized multivariable Logistic regression models and linear regression models were employed to examine the association between sleep-related factors and myopia, as well as the strength of this association. Results The baseline survey indicated a myopia prevalence of 18.58%, with 17.18% at follow-up. The average CSHQ total score was (51.58±4.44), and the average daily sleep duration was (9.43±4.84)h/d, with only 11.6% of participants meeting the recommended sleep sufficiency. Multivariable regression models indicated that insufficient sleep showed positive association with myopia (OR=1.64, 95%CI=1.05-2.56), while bedtime duration was significantly negative associated with myopia (OR=0.74, 95%CI=0.63-0.91, P<0.05), adjusting for confounding factors. Inconsistency in bed rest time was a risk factor for myopia (OR=1.07, P<0.05), and the consistency of bed rest time, and wake-up time showed statistically significant correlations with SE (P<0.05). There was also statistically significant correlations between consistency in sleep time, bed rest time, and wake-up time with AL (P<0.05). Conclusions Insufficient sleep and bedtime duration are correlated with the onset and progression of myopia. It is critical to ensure sufficient sleep duration and regular sleep habits for children to reduce the occurrence of myopia in the primary school students.
- Myopia /
- Sleep /
- Prevalence /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 儿童睡眠特征和新发近视、等效球镜度数、眼轴长度的关联分析[n=479，OR/β值(95%CI)]

Table 1. Association analysis of sleep characteristics and newly myopia, SE and AL[n=479, OR/β(95%CI)]

睡眠特征	新发近视^△		SE		AL
睡眠特征	单变量模型	多变量模型	单变量模型	多变量模型	单变量模型	多变量模型
CSHQ总分	0.97(0.94~1.01)	0.97(0.94~1.01)	0.01(-0.01~0.02)	0.01(-0.02~0.02)	0.01(-0.02~0.02)	0.01(-0.01~0.02)
睡眠持续时间/(h·d^-1)	0.87(0.62~1.21)	0.79(0.55~1.15)	-0.14(-0.30~0.03)	-0.10(-0.26~0.07)	0.09(-0.06~0.20)	0.09(-0.06~0.24)
睡眠是否充足	1.51(0.98~2.33)	1.64(1.05~2.56)^*	-0.27(-0.58~0.31)	-0.31(-0.61~-0.02)	0.28(-0.01~0.56)	0.28(-0.01~0.55)
卧床休息时间/(h·d^-1)	0.75(0.63~0.89)^**	0.74(0.63~0.91)^**	0.13(0.05~0.21)^**	0.12(0.04~0.19)^**	-0.07(-0.14~-0.01)^*	-0.04(-0.11~0.02)
注：睡眠是否充足以是为参照。*P<0.05，P<0.01。△为OR值(95%CI)，其余为β值(95%CI)。

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表 2 儿童睡眠社会时差和新发近视、等效球镜度数、眼轴长度的关联分析(n=479)

Table 2. Association analysis of social time difference of sleep characteristics and newly myopia, SE and AL in children(n=479)

睡眠特征 (社会时差)	新发近视[OR值(95%CI)]		SE[β值(95%CI)]		AL[β值(95%CI)]
睡眠特征 (社会时差)	单变量模型	多变量模型	单变量模型	多变量模型	单变量模型	多变量模型
睡眠时间	1.18(0.93~1.50)	1.12(0.87~1.43)	-0.14(-0.26~-0.01)	-0.10(-0.22~0.02)	0.20(0.07~0.32)^**	0.03(0.01~0.05)^**
卧床时间	1.08(1.02~1.14)^**	1.07(1.01~1.13)^*	-0.06(-0.30~0.03)^**	-0.05(-0.08~-0.03)^**	0.04(0.01~0.06)^**	0.19(0.07~0.31)^**
入睡时间	1.03(0.98~1.09)	1.03(0.98~1.09)	-0.01(-0.01~-0.03)	-0.01(-0.05~-0.00)	0.01(-0.01~0.02)	0.00(-0.01~0.02)
苏醒时间	1.18(1.00~1.38)^*	1.13(0.96~1.34)	-0.02(-0.03~-0.01)^**	-0.02(-0.03~-0.01)^*	0.11(0.03~0.18)^**	0.09(0.02~0.16)^**
注：*P<0.05，P<0.01。

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