上学日和周末视屏时间与青少年主观睡眠质量的关联

曹润泽; 赵敏; 王明明; 席波

doi:10.16835/j.cnki.1000-9817.2025231

上学日和周末视屏时间与青少年主观睡眠质量的关联

doi: 10.16835/j.cnki.1000-9817.2025231

曹润泽¹,
赵敏²,
王明明^3, ,,
席波^{1, 3, ,}

1.
山东大学齐鲁医学院公共卫生学院流行病学系/山东大学儿童心血管研究中心，济南 250012
2.
山东大学齐鲁医学院公共卫生学院营养与食品卫生学系
3.
山东大学齐鲁医学院公共卫生学院儿少卫生与妇幼保健学系

基金项目:

国家自然科学基金项目 81673195

详细信息

作者简介:
曹润泽(2000-)，男，山东济南人，在读硕士，主要研究方向为儿童心血管健康

通讯作者:
王明明，E-mail：wangmingmingsdu@163.com

席波，E-mail: xibo2010@sdu.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 Q428 F764.6 TN711
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- 被引次数: 0
出版历程
- 收稿日期: 2025-05-12
- 修回日期: 2025-06-01
- 网络出版日期: 2025-08-30
- 刊出日期: 2025-08-25

Associations between weekday-weekend screen time and subjective sleep quality among adolescents

CAO Runze¹,
ZHAO Min²,
WANG Mingming^{3
, ,},
XI Bo^{1, 3
, ,}

1.
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Jinan 250012, Shandong Province, China

摘要

摘要: 目的探讨青少年上学日和周末视屏时间的联合效应与自评睡眠质量的关联，为改善青少年睡眠健康提供科学依据。方法基于2023年11—12月进行的“桓台儿童心血管健康随访队列”调查数据，纳入1 197名12~17岁具有完整人口学特征、体格测量及问卷调查数据的青少年。通过限制性立方样条(RCS)评估视屏时间与睡眠质量的剂量-反应关系。根据上学日和周末视屏时间(正常： < 2 h/d；过长：≥2 h/d)将青少年分为4组，采用多因素Logistic回归模型分析上学日和周末视屏时间的联合效应与睡眠质量的关联。结果 RCS分析结果显示，平均每日及周末每日视屏时间与青少年睡眠质量差之间存在线性剂量-反应关系(非线性P值均>0.05)。多因素Logistic回归分析结果显示，调整潜在协变量，与上学日及周末视屏时间均正常的青少年相比，上学日及周末视屏时间均过长的青少年睡眠质量差的风险升高(OR=2.51，95%CI=1.33~4.62，P < 0.01)；性别分层分析显示，与上学日及周末视屏时间均正常的女生相比，上学日及周末视屏时间均过长的女生睡眠质量差的风险增加(OR=3.03，95%CI=1.23~7.14，P=0.01)。结论青少年视屏时间与睡眠质量差存在线性剂量-反应关系；上学日和周末视屏时间过长均与青少年睡眠质量差正性相关，在女生群体中关联更为显著。
- 注视，眼 /
- 时间 /
- 睡眠 /
- 精神卫生 /
- 回归分析 /
- 青少年
Abstract: Objective To explore the association between the joint association of screen time on weekdays and weekends with self-rated sleep quality among adolescents, providing scientific basis for improving adolescent sleep health. Methods Using data from "Huantai Children's Cardiovascular Health Follow-up Cohort" survey conducted during November to December 2023, a total of 1 197 adolescents aged 12-17 years with complete demographic characteristics, physical measurements, and questionnaire data were included. The dose-response relationship between screen time and sleep quality was evaluated by restrictive cubic splines (RCS). Based on screen time on weekdays and weekends (normal: < 2 h/d; excessive: ≥ 2 h/d), adolescents were categorized into 4 groups. Multivariate Logistic regression models were used to analyze the association between the combined effect of screen time on weekdays and weekends and sleep quality. Results The RCS analysis results showed that there was a linear dose-response relationship between average daily screen time and poor sleep quality in adolescents (non-linear P>0.05). The results of multiple Logistic regression analysis showed that adjusting for potential covariates, compared with adolescents having normal screen time on both weekdays and weekends, those with excessive screen time on both weekdays and weekends had increased risk of poor sleep quality (OR=2.51, 95%CI=1.33-4.62, P < 0.01). Sex-stratified analysis revealed that girls with excessive screen time on both weekdays and weekends had increased odds of poor sleep quality (OR=3.03, 95%CI=1.23-7.14, P=0.01), compared to girls who had normal screen time on both weekdays and weekends. Conclusions A linear dose-response relationship exists between daily screen time and poor sleep quality in adolescents. Excessive screen time on both weekdays and weekends is positively associated with poor sleep quality, particularly more pronounced among female adolescents.
- Fixation, ocular /
- Time /
- Sleep /
- Mental health /
- Regression analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

图 1 青少年每日视屏时间与主观睡眠质量的剂量反应关系

注：模型调整年龄、性别、BMI、SBP、DBP、家庭二手烟暴露、体力活动、饮食习惯，上学日与周末视屏时间在两组内互相调整。A、B、C图中，分段与传统Logistic回归模型的似然比检验P值分别为0.23，0.03和0.85。

Figure 1. The dose-response relationship between daily screen time and subjective sleep quality in adolescents

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表 1 不同上学日和周末视屏时间青少年各变量分布比较

Table 1. Comparison of the distribution of each variable of adolescents with different screen time on weekdays and weekends

上学日和周末视屏时间	人数	性别		体力活动		家庭二手烟暴露			饮食习惯		主观睡眠质量
上学日和周末视屏时间	人数	男	女	< 1 h/d	≥1 h/d	0 d	1~2 d	≥3 d	健康	不健康	好	差
均正常	478	228(47.7)	250(52.3)	357(74.7)	121(25.3)	381(79.7)	45(9.4)	52(10.9)	41(8.6)	437(91.4)	442(92.5)	36(7.5)
仅周末过长	606	326(53.8)	280(46.2)	432(71.3)	174(28.7)	422(69.6)	79(13.0)	105(17.3)	23(3.8)	583(96.2)	547(90.3)	59(9.7)
均过长	113	65(57.5)	48(42.5)	74(65.5)	39(34.5)	74(65.5)	19(16.8)	20(17.7)	3(2.7)	110(97.3)	93(82.3)	20(17.7)
χ²值		5.66		4.24		18.37			13.61		10.90
P值		0.06		0.12		< 0.01			< 0.01		< 0.01
注：()内数字为构成比/%。

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表 2 视屏时间与青少年主观睡眠质量的多因素Logistic回归分析[OR值(95%CI), n=1 197]

Table 2. Multivariable Logistic regression analysis of screen time and subjective sleep quality in adolescents [OR(95%CI), n=1 197]

视屏时间/ (h·d^-1)	模型1	模型2	模型3
日平均
< 2	1.00	1.00	1.00
≥2	1.39(1.19~1.62)^**	1.40(1.20~1.64)^**	1.39(1.19~1.62)^**
周末
< 2	1.00	1.00	1.00
≥2	1.17(1.08~1.26)^**	1.17(1.09~1.27)^**	1.14(1.04~1.24)^**
上学日
< 2	1.00	1.00	1.00
≥2	1.38(1.12~1.67)^**	1.38(1.13~1.68)^**	1.16(0.91~1.45)
注：模型1调整年龄、性别；模型2在模型1基础上调整BMI、SBP、DBP；模型3在模型2基础上调整家庭二手烟暴露、体力活动、饮食习惯；上学日与周末视屏时间在两组互相调整。^**P < 0.01。

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表 3 青少年上学日和周末视屏时间联合效应与主观睡眠质量的多因素Logistic回归分析[OR值(95%CI)]

Table 3. Multivariable Logistic regression of combined effects of screen time on weekdays and weekends with subjective sleep quality in adolescents[OR(95%CI)]

组别	模型1	模型2	模型3
总体(n=1 197)
均正常	1.00	1.00	1.00
仅周末过长	1.31(0.84~2.04)	1.32(0.85~2.07)	1.26(0.81~1.98)
均过长	2.57(1.38~4.69)^**	2.63(1.41~4.81)^**	2.51(1.33~4.62)^**
男生(n=619)
均正常	1.00	1.00	1.00
仅周末过长	1.56(0.84~3.04)	1.55(0.83~3.03)	1.49(0.79~2.93)
均过长	2.16(0.87~5.17)	2.25(0.91~5.40)	2.25(0.90~5.47)
女生(n=578)
均正常	1.00	1.00	1.00
仅周末过长	1.08(0.58~2.04)	1.15(0.62~2.17)	1.05(0.55~2.01)
均过长	3.21(1.32~7.44)^**	3.26(1.34~7.60)^**	3.03(1.23~7.14)^*
注：模型1调整年龄、性别；模型2在模型1基础上调整BMI、SBP、DBP；模型3在模型2基础上调整家庭二手烟暴露、体力活动、饮食习惯。^P < 0.05，^*P < 0.01。

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