中国2014年9-18岁汉族学生睡眠不足状况及与体育锻炼的关系研究

Analysis on the current situation of insufficient sleep and its association with physical exercise among Chinese Han students aged 9-18 years, in 2014

目的分析我国9-18岁汉族中小学生睡眠不足状况，并探索睡眠不足与体育锻炼的关系。方法选取2014年全国学生体质与健康调研中9-18岁汉族中小学生172 197人，将9-12岁儿童每日睡眠时间〈9 h、13-18岁青少年〈8 h定义为睡眠不足。采用秩和检验比较不同群体睡眠时间分布的差异；采用χ2检验分析不同群体睡眠不足报告率的差异；采用χ2趋势检验分析睡眠不足报告率随年龄变化的情况。采用logistic回归分析睡眠不足与体育锻炼的关系。结果2014年，我国有6.6%的中小学生每日睡眠时间〈6 h，30.8%的学生为6-7 h，26.3%的学生为7-8 h，20.8%的学生为8-9 h，分别有13.8%和1.8%的学生睡眠时间为9-10 h和≥10 h。睡眠不足总报告率为77.2%，男、女生分别为75.8%、78.6%。对于各个年龄不同性别学生睡眠不足报告率的比较，9-11岁男、女生差异无统计学意义（均P〉0.05），≥12岁女生报告率均高于男生，差异有统计学意义（均P〈0.001）。小学、初中、高中学生睡眠不足报告率分别为66.6%、74.1%、93.8%；9-12岁儿童、13-18岁青少年睡眠不足报告率分别随年龄的增加而上升。30个省份中，浙江（68.8%）、江苏（66.7%）和陕西（65.2%）中小学生睡眠不足报告率较低。logistic回归结果显示，与平均每日锻炼时间〈0.5 h相比，平均每日锻炼时间0.5-1 h（OR=0.72，95%CI：0.69-0.74）、平均每日锻炼时间≥1 h（OR=0.46，95%CI：0.44-0.47）为睡眠不足的保护因素；与体育课频率〈2次/周相比，体育课频率2次/周（OR=0.82，95%CI：0.78-0.86）、〉2次/周（OR=0.65，95%CI：0.62-0.68）为睡眠不足的保护因素。结论我国9-18岁中小学生睡眠不足报告率高，适量体育锻炼和推迟到校时间可能会缓解学生睡眠不足状况。

Objective To describe the situation of insufficient sleep and the association between insufficient sleep and physical exercise, among Chinese Han students aged 9-18 years.Methods We selected 172 197 Chinese Han students aged 9-18 years from the project 2014 Chinese National Survey on Students Constitution and Health. The average sleep duration per day of less than 9 h for children aged 9-12 years and of less than 8 h for adolescents aged 13-18 years, were defined as insufficient sleep. We described the distribution of sleep duration and the prevalence rates of insufficient sleep for each subgroup. Logistic regression models were established to assess the association between insufficient sleep and physical exercise.Results In 2014, 6.6%, 30.8%, 26.3%, 20.8%, 13.8% and 1.8% of the Chinese Han students self-reported sleep duration were 〈6, 6-, 7-, 8- and ≥10 h, respectively. The overall prevalence rate of insufficient sleep was 77.2%, with 75.8% for boys and 78.6% for girls. No gender disparity was found at each 9-11 age groups. However, in the 12-18 age groups, the prevalence rates for girls were significantly higher than that for boys. The prevalence rates of insufficient sleep for primary school, middle school and high school students were66.6%, 74.1% and 93.8%, respectively. Rates were increasing with age for children aged 9-12 years and adolescents aged 13-18 years respectively. The three provinces with the lowest prevalence rates of insufficient sleep were Zhejiang （68.8%）, Jiangsu （66.7%） and Shaanxi （65.2%）. Data from the logistic regression models revealed that, when comparing to those students with only exercise of 〈0.5 h per day, the exercise hours of 0.5-1 h （OR=0.72, 95%CI： 0.69-0.74） or ≥1 h （OR=0.46, 95%CI： 0.44-0.47） per day seemed as protective factors for insufficient sleep. When compared with physical exercise frequency 〈2 times per week, the 2 times （OR=0.82, 95%CI： 0.78-0.86） or 〉2 times （OR=0.65, 95%CI： 0.62-0.68） frequencies also appeared as protective.Conclusions The prevalence rate of insufficient sleep prevailing among students aged 9-18 years was high, in China. Our data called for setting up effective measures to deal with this situation.