上海市中老年人睡眠问题与高血压的关系研究

Study on the relationship between sleep-related problems and hypertension among middle-aged and elderly peoplein Shanghai

目的 了解上海市中老年人睡眠问题现状,并探讨其与高血压的关系,为制定高血压防控措施提供科学依据。方法 数据来源于2017年上海市慢性病及其危险因素监测调查,采用多阶段抽样方法抽取样本,纳入18 137名≥45岁中老年人作为研究对象。调查方法包括问卷调查、体格检查和实验室检测。采用SAS 9.2软件进行基于复杂抽样设计的Rao-Scottχ2检验。采用基于复杂抽样设计的多因素logistic回归模型分析睡眠问题与高血压的关系。结果 上海市≥45岁中老年人存在睡眠问题的加权比例为61.8%。打鼾、中间觉醒、早醒、入睡困难和服用安眠药的加权比例分别为37.7%、32.5%、22.2%、21.7%和4.8%。打鼾、中间觉醒、早醒、入睡困难和服用安眠药人群的高血压加权患病率(分别为55.8%、56.5%、54.6%、53.8%和60.6%)高于无上述睡眠问题者(45.3%、45.8%、47.7%、48.0%和48.7%),差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,在控制混杂因素后,打鼾(OR=1.308,95%CI:1.174~1.458)和中间觉醒(OR=1.323,95%CI:1.176~1.489)与高血压患病高风险相关。结论 上海市中老年人睡眠问题比较严重,以打鼾和中间觉醒为主,打鼾和中间觉醒与高血压患病有关,是中老年人需要重点关注的睡眠问题。

Objective To understand the current situation of sleep-related problems,explore the relationship between sleeping and hypertension among middle-aged and elderly people in Shanghai,and provide the scientific basis for formulating hypertension prevention and control measures.Methods The data were from“the 2017 Shanghai chronic disease and its risk factors surveillance survey”,the multi-stage sampling method was used to select samples,18137 residents(≥45 years old)were in cluded in the study.The investigation was performed with questionnaire,physical examination and laboratory test.Rao-Scott χ^(2) based on complex sampling design was used to analyze the data.The multivariate logistic regression model based on complex sampling design was used to analyze the relationship between sleeping problems and hypertension.The used software was SAS 9.2.Results The weighted proportion of sleep-related problems among middle-aged and elderly residents(≥45 years old)in Shanghai was 61.8%.The weighted proportions of subjects with sleep-related problems(snoring,intermediate awakening,waking early,difficulty to get into sleep,and taking sleeping pills were 37.7%,32.5%,22.2%,21.7% and 4.8%,respectively.The weighted prevalence of hypertension in subjects with snoring,intermediate awakening,waking early,difficulty to get into sleep,and taking sleeping pills was significantly higher than that of subjects without sleep problems(P<0.05).The multivariate logistic regression model showed that after controlling confound factors,snoring(OR=1.308,95%CI:1.174-1.458)and intermediate awakening(OR=1.323,95%CI:1.176-1.489)were related to the high risk of hypertension.Conclusion Sleep-related problems were serious among the middle-aged and elderly in Shanghai,the main problems were snoring and intermediate awakening,snoring and intermediate awakening were related to hypertension,the middle-aged and elderly people should pay closely attention to the sleeprelated problems.