学龄前儿童电子媒体的使用与睡眠模式及质量的相关性研究

Study on the association of media use with sleep habits and quality among preschool children

目的分析广州市学龄前儿童电子媒体的使用与睡眠模式及质量的相关性,为改善儿童睡眠质量提供依据。方法 2016年采用随机整群抽样方法选取广州市876名3~5岁儿童作为研究对象,采用自编调查问卷调查其电子设备的使用情况,采用儿童睡眠习惯问卷调查其睡眠习惯及睡眠质量。结果每天使用媒体设备的儿童与未每天使用的儿童相比,入睡时间更晚[β(95%CI)为11.4 min(6.0~16.8)],夜间睡眠和总睡眠时长更短[β(95%CI)分别为:-0.20 h(-0.31^-0.08),-0.20 h(-0.04^-0.02)),且呈现较高的就寝习惯不良[β(95%CI)为0.61(0.17~1.05)]、睡眠焦虑[β(95%CI)为0.38(0.06~0.70)]及白天嗜睡[β(95%CI)为0.59(0.13~1.06),P<0.05]得分。单次使用时间≥30 min的儿童与<30 min的儿童相比入睡时间晚[β(95%CI)为9.0 min(3.0~14.4)]、总入睡时间较短(β(95%CI)为-0.20 h(-0.36^-0.03)),就寝习惯不良、睡眠时间不规律、睡眠焦虑及白天嗜睡得分较高[β(95%CI)分别为0.68(0.23~1.12),0.32(0.10~0.53),0.38(0.06~0.71),0.70(0.23~1.18)],2岁前即开始规律使用媒体设备的儿童与2岁后使用的儿童相比入睡延迟分量表得分较高[β(95%CI)为0.17(0.03~0.30)],2岁前开始使用电子媒体设备、每天使用及平均每次使用时间超过30 min的儿童总睡眠量表得分都较高[β(95%CI)分别为1.67(0.26~3.11),1.91(0.80~3.02),2.01(0.88~3.14)],即总体睡眠质量略差。结论儿童使用电子媒体设备过早及过多与不良睡眠习惯及质量均相关,应引起高度重视。

Objective To explore association of media use with sleep habits and sleep quality among pre-schoolers in Guangzhou, in order to provide reference for improving children′s sleep quality. Methods A total of 876 children aged 3 to 5 years were randomly recruited to this cross-sectional study in 2016. A self-designed questionnaire was used to investigate child media use information, and child sleep habits and sleep quality were derived from the Children′s Sleep Habits Questionnaire(CSHQ). Results Daily use of media device was associated with later bedtime(β=11.4 min, 95% CI: 6.0 -16.8), shorter nocturnal sleep duration(β=-0.20 h, 95% CI:-0.31--0.08), shorter total sleep duration(β=-0.20 h, 95%CI:-0.04 --0.02), as well as higher total CSHQ score(β=1.91, 95%CI:0.80 -3.02), scores of bedtime resistance(β=0.61, 95%CI: 0.17 - 1.05), sleep anxiety(β=0.38, 95%CI: 0.06 -0.70) and daytime sleepiness(β=0.59, 95%CI :0.13 -1.06). Children who consumed screen time ≥ 30 mintues/time had later bedtime(β=9.0 min, 95%CI: 3.0 -14.4) and shorter total sleep duration(β=-0.20 h, 95% CI:-0.36 --0.03), as well as higher total CSHQ score(β=2.01, 95% CI:0.88-3.14) and higher scores of bedtime resistance(β=0.68, 95%CI: 0.23-1.12),sleep duration(β=0.32, 95%CI: 0.10 -0.53), sleep anxiety(β=0.38, 95% CI: 0.06 -0.71) and daytime sleepiness(β=0.70, 95% CI:0.23 -1.18). Children who started to use media devices before 2 years old tended to have higher total CSHQ score(β=1.67, 95% CI:0.26 -3.11) and higher sleep onset delay score(β=0.17, 95% CI:0.03 - 0.30) than those started to use devices after age 2 years. Moreover, children who started to use media devices before 2 years old(β=1.67,95%CI:0.26-3.11), who had daily use of media device(β=1.91,95%CI:0.80-3.0) and who consumed screen time≥30 mintues/time(β=2.01,95%CI:0.88-3.14) tended to have gigher total CSHQ Score respectively, indicating that their general sleep quality were probably poorer than their counterparts. Conclusion Early exposure to media use, high frequency of electric devices use, and long screen time are associated with poor sleep habits and sleep quality among pre-schoolers, which is supposed to be attached great importance.