青少年失眠状况和睡眠质量及二者相关性分析

Study on insomnia and sleep quality in adolescents and their correlation analysis

目的调查青少年失眠状况和睡眠质量及二者之间的相关性。方法对技工学校学生统一发放4733份调查问卷,最终获得有效问卷3342份,记录社会人口学资料,包括性别、年龄、身高、体重、健康状况、户籍、是否为独生子女、父母受教育程度、家庭收入、学习压力、吸烟和饮酒等,以及睡眠和情绪相关量表评分,包括失眠严重指数(ISI)中文版、匹兹堡睡眠质量指数(PSQI)、Epworth嗜睡量表(ESS)、焦虑自评量表(SAS)和Beck抑郁量表(BDI)。结果 3342名青少年中存在失眠997例(29.83%)、日间嗜睡568例(17.00%)、焦虑243例(7.27%)和抑郁1287例(38.51%)。根据ISI中文版评分分为非失眠组(2345名)和失眠组(997例),失眠组女性(P=0.000)、健康状况不良(P=0.000)、非独生子女(P=0.006)、有学习压力(P=0.000)和吸烟(P=0.027)比例,以及ISI中文版评分(P=0.000)、ESS评分(P=0.000)、SAS评分(P=0.000)和BDI评分(P=0.000)均高于非失眠组。Pearson相关分析显示,ISI中文版评分和PSQI评分均与ESS评分(r=0.361,P=0.000;r=0.064,P=0.000)、SAS评分(r=0.326,P=0.000;r=0.069,P=0.000)和BDI评分(r=0.529,P=0.000;r=0.067,P=0.000)呈正相关,且ISI中文版评分的上述相关性(r=0.300～0.600)高于PSQI评分(r<0.100)。进一步偏相关分析显示,ISI中文版评分与PSQI评分呈负相关(r=-0.056,P=0.001)。结论失眠组女性更多、健康状况更差、非独生子女更多、学习压力更大、吸烟比例更高,以及日间嗜睡、焦虑和抑郁更严重。与PSQI量表相比,ISI量表中文版与日间嗜睡、焦虑和抑郁的关系更紧密,可能更适用于筛查和评价青少年失眠状况。

Objective To investigate the correlation between insomnia and sleep quality in adolescents. Methods According to Insomnia Severity Index （ISI） Chinese Version, 3342 students technician training in school were divided into non insomnia group （N = 2345） and insomnia group （N = 997）. Sleep and emotional state were assessed by ISI Chinese Version, Pittsburgh Sleep Quality Index （PSQI）, Epworth Sleepiness Scale （ESS）, Self？Rating Anxiety Scale （SAS） and Beck Depression Inventory （BDI）. The social demographic data were collected simultaneously. Results The number of insomnia, daytime sleepiness, anxiety and depression in the population was 997 （29.83%）, 568 （17.00%）, 243 （7.27%） and 1287 （38.51%）, respectively. The comparison of social demographic data between 2 groups showed that the proportion of female （P = 0.000）, poor physical condition （P = 0.000）, non？only child （P = 0.006）, high learning pressure （P = 0.000） and smoking （P = 0.027） in insomnia group were significantly higher than those in non insomnia group. The total scores of ISI Chinese Version （P = 0.000）, ESS （P = 0.000）, SAS （P = 0.000） and BDI （P = 0.000） in insomnia group were significantly higher than those in non insomnia group. Pearson correlation analysis showed that ISI Chinese Version and PSQI scores were positively correlated with ESS score （r = 0.361, P = 0.000; r = 0.064, P = 0.000）, SAS score （r = 0.326, P = 0.000; r = 0.069, P = 0.000） and BDI score （r = 0.529, P = 0.000; r = 0.067, P = 0.000）, and ISI Chinese Version had higher correlation （r = 0.300-0.600） with the above scores than PSQI （r 〈 0.100）. Further partial correlation analysis showed that ISI Chinese Version score was negatively correlated with PSQI score （r = ？ 0.056, P = 0.001）. Conclusions Higher proportion of female, worse physical condition, more non？only child, greater learning pressure and higher smoking rate were observed in insomnia group. Daytime sleepiness, anxiety and depression in insomnia group were more serious than those in non insomnia group, but PSQI score can not distinguish the above differences. Compared with PSQI, ISI Chinese Version is more closely related to daytime sleepiness, anxiety and depression, and might be more suitable for assessing insomnia in adolescents.