中国社区老年人睡眠质量及影响因素调查

Investigation on prevalence and associated factors of poor sleep quality among community-dwelling older people in China

目的分析我国城乡社区60岁及以上老年人睡眠质量及影响因素。方法调查对象来自老年期重点疾病预防和干预项目。该项目采用多阶段分层整群随机抽样的方法,于2019年在辽宁、河南和广东三省12个县区共抽取12369例60岁及以上老年人开展基线调查,调查其人口学基本特征、生活方式、生活自理能力、心理健康状况、常见慢性病患病状况、认知与运动功能状况等信息。2020年继续对该人群开展睡眠质量、听力状况和嗅觉功能的追踪随访,共计10164例调查对象完成追踪随访并纳入本研究分析。睡眠质量评估采用国际公认的匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)。使用χ^(2)检验分析各组间睡眠质量差检出率的差异。采用多因素Logistic回归模型分析影响睡眠质量的因素。结果我国辽宁、河南和广东三省社区老年人PSQI量表总平均分为(6.23±3.57)分,以PSQI>7分为界值,睡眠质量差的老年人有3054例,睡眠质量差检出率为30.0%(95%CI:29.2%~30.9%)。睡眠质量的7项成分中,存在问题的检出率由高到低分别是睡眠效率差(35.7%)、入睡时间≥30min(30.3%)、睡眠时间<6h(21.7%)、睡眠障碍(20.5%)、主观睡眠质量差(16.7%)、日间功能障碍(16.0%)以及使用催眠药物(2.6%)。多因素Logistic回归结果显示女性、≥75岁、居住在农村、从事家庭事务、每天喝茶、共病、存在抑郁情绪、患有糖尿病、消化系统疾病以及肌肉骨骼疾病是睡眠质量差的危险因素,而受教育程度是睡眠质量差的保护因素。结论我国社区老年人睡眠质量差检出率较高,应加强老年人睡眠质量问题的预防和综合干预。

Objective To analyze the prevalence of poor sleep quality and its potential influencing factors among communitydwelling older people in China.Method The subjects were from the Prevention and Intervention on Neurodegenerative Disease for Elderly in China(PINDEC)project.By using the stratified multi-stage cluster random sampling method,a total of 12369 residents aged 60 years and above were selected from 12 urban and rural communities in Liaoning,He􀆳nan and Guangdong provinces.In 2019,a baseline survey was carried out to collect the information on demographic characteristics,lifestyles,ability of daily living,mental health,status of chronic conditions,cognitive and motor function.In 2020,all of the subjects were followed up to investigate their sleep quality,hearing status and olfactory function.A total of 10164 participants were included in this study.Sleep quality was measured by using the Pittsburgh Sleep Quality Index(PSQI).The χ^(2) test was used to analyze the difference of sleep quality between different groups.Multivariate Logistic regression model was applied to assess the factors influencing sleep quality.Result The mean score of PSQI in Liaoning,He􀆳nan and Guangdong provinces was 6.23±3.57 points.A PSQI global score>7 was defined as a cut-off for poor sleep quality,3054 elderly people was detected with poor sleep quality,and the prevalence of poor sleep quality was 30.0%(95%CI:29.2%-30.9%).Among the seven domains of PSQI,the order of detection rate of sleep problems,from high to low,was poor sleep efficiency(35.7%),sleep time≥30 minutes(30.3%),sleep time<6 hours(21.7%),sleep disorder(20.5%),subjective sleep quality(16.7%),daytime dysfunction(16.0%)and use of hypnotic drugs(2.6%).Logistic regression analysis indicated that female,≥75 years old,living in rural areas,engaged in family affairs,drinking tea every day,comorbidity,depression symptoms,diabetes,digestive diseases and musculoskeletal disorders were positively related with poor sleep quality,while non-illiterate was negatively related with poor sleep quality.Conclusion The prevalence of poor sleep quality among community-dwelling older people in China is high.Comprehensive prevention and intervention of sleeping disorders among the elderly should be enhanced.