童年时期不良经历聚集性与中老年睡眠质量的关联研究

Association between the clustering of adverse childhood experiences and sleep quality in middle-aged and older Chinese adults

目的探讨童年不良经历(ACEs)聚集性与中老年睡眠质量的关联。方法数据来自于中国健康与养老追踪调查项目(CHARLS)2014年的生命历程调查和2015年的第3次全国随访调查,共纳入10824名45岁及以上的中老年人,根据其童年时期不良经历的数量,研究对象被分为0、1、2~3和≥4项ACEs四组。采用多因素logistic回归模型分析童年不良经历聚集性与中老年时期不良睡眠时长和睡眠质量差的关联。结果在10824名研究对象中,男性5211名(48.14%),年龄(60.83±9.06)岁;睡眠时长不良者6131名(56.64%),睡眠质量较差者3640名(33.63%)。多因素logistic回归模型分析结果显示,调整性别、年龄、现居住地、婚姻状况、教育水平、家庭年消费和成年期BMI、吸烟、饮酒和抑郁症状等混杂因素后,与0项ACE组相比,有2~3项ACEs和≥4项ACEs的研究对象在中老年时期出现不良睡眠时长的风险显著增加,OR(95%CI)值分别为1.26(1.12~1.41)和1.43(1.23~1.66);出现睡眠质量差的风险显著增加,OR(95%CI)值分别为1.28(1.12~1.46)和1.53(1.29~1.80)。结论童年时期的不良经历的聚集性可能会对中老年时期的睡眠时长和质量产生负面影响。

Objective To examine the association between the clustering of adverse childhood experiences(ACEs)and sleep quality in middle-aged and older Chinese adults.Methods Data were from the Life History Survey in 2014 and the third wave follow-up survey in 2015 of China Health and Retirement Longitudinal Study(CHARLS).A total of 10824 participants aged 45 years and above were included in this study.According to the number of ACEs,the participants were divided into four groups:0,1,2-3 and≥4 ACEs.The multivariate logistic regression model was used to analyze the association of ACEs clustering with inappropriate sleep duration and poor sleep quality in middle-aged and older adults.Results Among the 10824 participants with an average age of(60.83±9.06)years,5211(48.14%)were males.About 6111 participants(56.64%)had inappropriate sleep duration,and 3640 participants(33.63%)had poor sleep quality.After adjusting for covariates including gender,age,residence,marital status,education,household consumption,BMI,smoking,drinking,and depression in adulthood,compared with the 0 ACE group,the risk of inappropriate sleep duration was significantly increased in the 2-3 ACEs group and≥4 ACEs group,while ORs(95%CIs)were 1.26(1.12-1.41)and 1.43(1.23-1.66),respectively.The risk of poor sleep quality in the 2-3 ACEs group and≥4 ACEs group was also significantly higher than that in the 0 ACE group,while ORs(95%CIs)were 1.28(1.12-1.46)and 1.53(1.29-1.80),respectively.Conclusion ACEs clustering in childhood could negatively affect sleep duration and quality in middle-aged and older Chinese adults.