中国中小学生睡眠状况及其与抑郁症状的关联

Association between sleep and depressive symptoms among primary and secondary school students

目的 了解中国中小学生睡眠状况及其与抑郁症状的关系,为改善中小学生睡眠和降低抑郁症状发生率提供科研证据。方法 利用2018和2020年中国家庭追踪调查(CFPS)中4 232名在校中小学生数据,使用自报方式了解睡眠状况,使用简易流调中心抑郁量表(CES-D8)测量抑郁症状。采用方差分析、χ^(2)检验、多元线性回归分析和限制性立方样条模型分析中小学生睡眠状况及其与抑郁症状的关联。结果 2018—2020年中国中小学生平均学习日、休息日夜晚睡眠时长分别为(7.96±1.38)(9.30±1.51)h,睡眠不足报告率依次是42.75%,11.41%;1 921名(45.39%)中小学生报告有午睡习惯,567名(13.40%)中小学生午睡>1.0 h/d;2 997名(70.82%)中小学生报告周末补觉,595名(14.06%)中小学生补觉>2.0 h/d。多元线性回归分析结果显示,控制其他因素后,学习日夜晚睡眠不足、休息日夜晚睡眠不足、周末补觉>2.0 h/d均与中小学生抑郁症状呈正相关(β值分别为0.40,0.39,0.41,P值均<0.05)。限制性立方样条分析结果显示,调整性别、年龄、城乡、地区、自评健康和体质量指数等因素后,学习日夜晚睡眠时长、休息日夜晚睡眠时长和午睡时长与中小学生抑郁症状均呈非线性剂量反应关系(P总趋势值均<0.05,P非线性值均<0.05),最佳时长分别约为9.0 h, 10.0 h和40 min。结论 中小学生夜晚睡眠不足、午休不科学和周末补觉过长均是抑郁症状的重要风险因素。应积极改变中小学生的不良睡眠行为,降低其抑郁症状发生风险。

Objective To understand the sleep status of primary and secondary school students in China and its relationship with depressive symptoms,so as to provide scientific evidence for improving their sleep status and reducing the incidence of depressive symptoms.Methods Data of 4232 primary and secondary school students come from China Family Panel Studies(CFPS)data of 2018 and 2020.Sleep status was measured by using self-reported questionnaire,and depressive symptoms was measured by using the Center for Epidemiologic Studies Depression Scale-8 Items(CES-D8).Variance analysis,χ^(2 )test,multiple linear regression analysis(MLR)and restricted cubic spline models(RCS)were conducted to analysis the association of sleep status and depressive symptoms among primary and secondary school students.Results From 2018 to 2020,the average sleep duration on weekdays and on weekends among primary and secondary school students was(7.96±1.38)and(9.30±1.51)h,respectively.The prevalence of insufficient sleep was 42.75%,11.41%.A total of 1921 students(45.39%)had a nap,567(13.40%)students napped>1.0 h/d.A total of 2997 students(70.82%)caught up sleep on weekends,595(14.06%)caught up sleep>2.0 h/d.MLR showed that insufficient sleep on weekdays,insufficient sleep on weekends,catching up>2.0 h/d on weekends were risk factors for depressive symptoms of primary and secondary school students(β=0.40,0.39,0.41,P<0.05).RCS showed that sleep duration at night,and napping duration had nonlinear dose-response relationships with depressive symptoms(Ptrend<0.05,Pnon-linear<0.05),with optimal durations of 9.0 h,10.0 h,and 40 min.Conclusions Insufficient sleep at night,inappropriate napping duration and inappropriate weekend catch-up sleep duration are risk factors for depressive symptoms of primary and secondary school students.It is necessary to actively change bad sleep behaviors to reduce the risk of depressive symptoms.