中青年人群睡眠质量对健康相关生命质量的影响

The different effect of sleep quality on health-related quality of life among young and middle-aged people

目的探究中青年人群的睡眠质量和健康相关生命质量(health-related quality of life,HRQoL)特征,并分析睡眠质量对中青年HRQoL的差异性影响。方法利用横断面现场调查法,收集一般情况调查问卷、匹兹堡睡眠质量指数问卷(Pittsburgh sleep quality index,PSQI)和36条目简明健康状况调查问卷(short-form health survey,SF-36)调查数据,共1976例中青年纳入研究,根据年龄将研究对象分为3个年龄组:18~29岁组(n=1148)、30~44岁组(n=586),45~59岁组(n=242)。采用SPSS 23.0软件进行统计学分析,以卡方检验分析三组的一般情况分布特征;以非参数检验对比三组在PSQI不同维度得分[M(P25,P75)]差异性,以单因素方差分析对比三组在SF-36不同维度的均值得分差异性;以非参数检验对比三组在睡眠质量和生命质量不同维度的均值得分差异性;以逐步回归分析在排除混杂因素后睡眠质量对HRQoL的差异性影响。结果睡眠质量方面,18~29岁,30~44岁和45~59岁年龄组的PSQI总分分别为[4(2,6)分,4(2,6)分,4(2,6)分],差异具有统计学意义(Z=10.951,P=0.004)。HRQoL方面,三个年龄组的生理领域得分[18~29岁:(82.51±12.62)分,30~34岁:(80.72±13.63)分,45~59岁:(82.04±13.07)分,F=3.667,P=0.026]和心理领域得分[18~29岁:(76.09±15.46)分,30~44岁:(77.20±16.14)分,45~59岁:(81.82±14.14)分,F=13.649,P<0.001]的差异具有统计学意义。逐步回归分析发现日间功能障碍是影响中青年人群HRQoL的独立影响因素(β=-0.308~-0.425,均P<0.01),睡眠障碍显著降低中青年生理领域得分(β=-0.127~-0.215,均P<0.05),催眠药物使用显著降低30~44岁青年人生理领域得分(β=-0.076,P<0.05),睡眠时间显著降低30~44岁青年人心理领域得分(β=-0.112,P<0.01),主观睡眠质量是显著降低18~29岁和30~44岁青年人HRQoL的独立影响因素(β=-0.089~-0.169,均P<0.05)。结论不同年龄组中青年人群的睡眠质量和HRQoL呈现出不同的特点,可根据不同年龄人群睡眠质量对HRQoL的影响,更具针对性的对中青年人群进行健康管理。

Objective To investigate the characteristics of the sleep quality and health-related quality of life(HRQoL),and analyze the different effects of sleep quality on HRQoL among young and middle-aged people.Methods A cross-sectional study recruited 1976 participants.All participants completed a self-designed questionnaire for the adults'general condition,the Pittsburgh sleep quality index(PSQI)and Short-Form health survey(SF-36).All participants were divided into 3 age groups:18-29-year-old group(n=1148),30-44-year-old group(n=586)and 45-59-year-old group(n=242).SPSS 23.0 software was used for statistical analysis.Chi-square test was used to analyze the general characteristics of the three age groups.Non-parametric test was used to analyze the scores of the three age groups in different dimensions of sleep quality.One-way ANOVA was used to analyze the mean scores of the three age groups in different dimensions of HRQoL.Stepwise regression analysis was used to analyze the effect of sleep quality on HRQoL among the three groups after control the confounding factors such as marital status,education,smoking,drinking and exercise habits and past medical history.Results In terms of sleep quality,the total PSQI scores of 18-29-year-old,30-44-year-old and 45-59-year-old groups(4(2,6),4(2,6),4(2,6))showed statistically significant differences(Z=10.951,P=0.004).In terms of HRQoL,there were statistically significant differences in physical component summary scores(18-29-year-old:82.51±12.62,30-44-year-old:80.72±13.63,45-59-year-old:82.04±13.07,F=3.667,P=0.026)and mental component summary scores(18-29-year-old:76.09±15.46,30-44-year-old:77.20±16.14,45-59-year-old:81.82±14.14,F=13.649,P<0.001)among young and middle-aged people in different age groups.Regression analysis found that daytime dysfunction was an independent influencing factor for HRQoL in young and middle-aged population(β=-0.308--0.425,all P<0.01).Sleep disorders significantly decreased Physical Component Summary of HRQoL in young-aged people(β=-0.127--0.215,all P<0.01).The use of hypnotic drugs significantly reduced the scores in the physiological field in the young adults aged 30-44(β=-0.076,P<0.05).The duration of sleep significantly decreased the scores in the mental domain of young adults aged 30-44(β=-0.112,P<0.01).Subjective sleep quality was an independent factor that significantly decreased HRQoL in young adults aged 18-29 and 30-44 years(β=-0.089--0.169,all P<0.01).Conclusion Sleep quality and HRQoL of young and middle-aged people in different age groups show different characteristics.The effect of sleep quality on HRQoL is different among people in different ages.Taking targeted interventions for people of different ages to improve the sleep quality may be an effective way to improve their HRQoL.