青少年晚睡影响因素及与抑郁和外化问题关系

Late bedtime: influencing factors and its association with depression and externalizing problems among adolescents

目的讨论青少年晚睡影响因素,分析平时和周末晚睡以及睡眠时间差值与抑郁和外化问题的关系。方法采用多阶段分层整群随机抽样方法,于2009年对东北部、东部、西部和中部4大区域中7个城市的4 464名10～21岁青少年进行问卷调查。结果平时男女生晚睡的比例分别为24.3%和28.9%,周末男女生晚睡的比例分别为35.9%和38.9%,差异均有统计学意义(P平时<0.001,P周末<0.05),提示女生比男生更倾向于晚睡;相对于父母关系不和睦的青少年,父母关系和睦的青少年平时较少晚睡(P <0.05),父母关系和睦和比较和睦的青少年周末也较少晚睡(P关系和睦<0.01,P比较和睦<0.05);平时非晚睡组和晚睡组的平均年龄为(15.07±2.45)和(16.8±2.02)岁,周末非晚睡组和晚睡组的平均年龄为(15.19±2.48)岁和(16.20±2.35)岁,差异均有统计学意义(P <0.001),提示年龄稍大的青少年更倾向于晚睡;控制人口学变量后,平时和周末睡眠时间与抑郁得分呈显著的正向关系(β周末=0.051,P <0.01;β平时=0.099,P <0.001);平时和周末睡眠时间越晚,外化问题得分越高(β平时=0.038,P <0.05;β周末=0.122,P <0.001);平时与周末睡眠时间差异越大,抑郁(β周末–平时=0.097,P <0.001)和外化问题的得分(β周末–平时=0.151,P <0.001)也越高。结论无论是平时还是周末,女生、年龄稍大、父母关系不和睦、住校的青少年均容易出现晚睡情况,晚睡的青少年有更高的抑郁和外化问题发生风险。

Objective To explore influencing factors of late bedtime and associations of late bedtime on weekday/weekend, discrepancy between weekday and weekend bedtime with depression and externalizing problems in adolescents.Methods The data of the study were from the second survey of Adolescent Mental Health in China conducted in 2009. Totally 4 464 adolescents aged 10-21 years were selected with stratified multistage cluster random sampling in 9 cities located in north-western, eastern, western and central China for a self-administered on-site questionnaire survey.Results Weekday and weekend late bedtime were reported by 24.3% and 35.9% of the male participants, but by 28.9% and 38.9% of the female participants, with significant differences(Pweekday <0.001 and Pweekend <0.05)and suggesting that the female participants were more likely to have late bedtime. Compared to the participants with poor parental relationship, the participants with very good and good parental relationship reported both significantly less weekday and less weekend late bedtime(Pvery good parental relationshiP<0.01, Pgood parental relationshiP<0.05). The average age was 15.07±2.45 and 16.8±2.02 years for the participants reporting weekday and weekend late bedtime, which were significantly different from those not reporting weekday and weekend late bedtime(15.19±2.48 and 16.20±2.35)(both P<0.001), suggesting that the participants at elder age were more likely to have late bedtime. After adjusting demographic variables, both weekday and weekend late bedtime were positively associated with depression score(βweekday =0.051, P<0.01;βweekend=0.099, P<0.001)and with the score for externalizing problems(βweekday=0.038, P<0.05;βweekend=0.122, P<0.001). The discrepancy between weekday and weekend late bedtime was positively correlated with both depression score(βweekend-weekday=0.097, P<0.001)and the score for externalizing problems(βweekend-weekday=0.151, P<0.001).Conclusion The adolescent being female, at elder age, in a family with poor parental relationship, and being a resident student are more likely to have weekday and weekend bedtime. The adolescents having late bedtime are at a high risk of depression and have externalizing problems.