Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.

Wild Nutrition’s Food-Grown® Magnesium Supplementation Increases Sleep Quality and Sleep Duration and Reduces Stress in a Healthy Adult Population: A Double-Blind, Randomised, Placebo-Controlled Study

Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhancing sleep quality and duration, as well as overall well-being. Methods: Eighty participants were randomly assigned to receive either 80 mg of Food-Grown® magnesium or a placebo (microcrystalline cellulose) daily for 8 weeks. Participants completed questionnaires assessing sleep quality, daytime drowsiness, quality of life, anxiety, and stress levels. Additionally, participants maintained daily sleep diaries and wore wrist-worn actigraphy devices. The primary outcome measured was the change in sleep quality and duration. Results: Seventy-one participants fulfilled all study requirements (35 in the active group and 36 in the placebo group). Magnesium supplementation significantly improved reported sleep quality, with the active group showing a 32% increase compared to 16% in the placebo group (p = 0.034). Moreover, magnesium supplementation led to a decrease in reported stress scores at week 8 compared to the placebo group (3.7 ± 2.6 vs. 5.5 ± 3.1, respectively). Both the magnesium and placebo groups exhibited significant increases in reported sleep duration and reductions in time to fall asleep, sleep disturbance, sleep latency, sleep medication usage, and total Pittsburgh Sleep Quality Index score at week 8 compared to baseline. Conclusion: Magnesium supplementation notably enhanced sleep quality and reduced stress levels compared to the placebo group. These findings highlight the potential of magnesium as a beneficial supplement for improving sleep quality and overall well-being.

A Proposal on the Novel Method to Estimate Optimal Sleep Duration Based on Self-Reported Survey Data

Background: Many adolescents have a sleep debt. Individuals sleeping for their optimal sleep duration are expected to experience no sleepiness. Then, it is important to recognize one’s optimal sleep duration to reduce sleep debt. However, there is no simple method to determine this value. Since body mass index and sleep duration exhibit a U-shaped association, it is expected that a person taking optimal sleep duration would show no marked deviation from the mean body mass index value for the population evaluated. By using self-reported sleepiness and standardized body mass index, this study aimed to estimate individual optimal sleep duration. Methods: Data from 2540 grade 5 - 11 students were used. Students who declared no sleepiness during class and also had a gender- and grade-standardized body mass index of ±1.5 were termed ideal students. The average sleep durations of ideal students were compared with those of non-ideal students. The differences of sleep duration between ideal and no-ideal students were added to habitual sleep duration of each non-ideal student to obtain assumed optimal sleep duration. A multiple regression line to predict assumed optimal sleep duration was calculated using the least squares method. Results: The mean sleep duration of 666 ideal students exceeded the lower limit of daily sleep duration proposed as “may be appropriate” for children aged 6 - 17 years by National Sleep Foundation of the USA, being longer than those of non-ideal students. Significant regression formula for assumed optimal sleep duration was obtained (adjusted R2 = 0.996, p Conclusions: No contradiction was identified in the sleep duration obtained from ideal students as with optimal sleep duration. Although further studies to confirm the current estimation are needed, a simple formula to estimate individual optimal sleep duration through easily obtainable parameters was proposed.

Night Sleep Duration and Risk of Cognitive Impairment in a Chinese Population： A Cross-sectional Study

Objective Although sleep is one of the most important health-related behavioral factors, the association between night sleep duration and cognitive impairment has not been fully understood. A cross-sectional study was conducted with a random sample of 2,514 participants （≥ 40 years of age; 46.6% women） in China to examine the association between night sleep duration and cognitive impairment. Methods Night sleep duration was categorized as ≤ 5, 6, 7, 8, or ≥ 9 h per night. Cognitive function was measured using the Mini-Mental State Examination. A multivariate regression analysis was used to analyze the association of night sleep duration with cognitive impairment. A total of 122 participants were diagnosed with cognitive impairment. Results A U-shaped association between night sleep duration and cognitive impairment was found. The odds ratios （95% confidence intervals） of cognitive impairment （with 7 h of daily sleep being considered as the reference） for individuals reporting ≤ 5, 6, 8, and ≥ 9 h were 2.14 （1.20-3.83）, 1.13 （0.67-1.89）, 1.51 （0.82-2.79）, and 5.37 （1.62-17.80）, respectively （P ≤ 0.01）. Conclusion Short or long night sleep duration was an important sleep-related factor independently associated with cognitive impairment and may be a useful marker for increased risk of cognitive impairment.

Non-alcoholic fatty liver disease and sleep disorders

Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.

Report on Childhood Obesity in China (10): Association of Sleep Duration with Obesity

Objectives To explore the association of sleep duration with obesity among children in urban areas of China.Methods A total of 6 576 children（3 293 boys and 3 283 girls） aged 7-11 years were randomly selected from 36 primary schools in 6 metropolitan cities in China.A 7-day Physical Activity Recall was used to assess the sleep duration and physical activity level.The height,weight,waist circumference（WC） and percentage of body fat（%BF,as determined by bioelectrical impedance analysis technique） were measured by following the standardized operation procedures.The information on demography,lifestyle and eating habits was collected with a self-administered questionnaire from participants and their parents.Results The average sleep duration per night in the children was 9.7 h with the decreasing trends along with the increase of age（P0.05）.The sleep duration was negatively associated with body mass index（BMI） and WC in both boys and girls after adjustment for confounders（β value-0.23 and-0.82 for boys,-0.24 and-0.91 for girls,respectively,P0.01）.However,no significant association of sleep duration with %BF was found.Children who slept less than 9.0 h per night had a higher risk for overweight and obesity（OR=1.29,95% CI：1.01,1.64） and abdominal obesity（OR=1.38,95% CI：1.04,1.83） as compared with those who slept for 10.0-10.9 h.Conclusions Short sleep duration is associated with obesity.It is important to ensure adequate sleep duration of children and foster their healthy lifestyle at an early stage of life.

Gender-specific Association of Sleep Duration with Body Mass Index,Waist Circumference,and Body Fat in Chinese Adults

Objective To examine the association between habitual sleep duration and obesity among Chinese adults. Methods The association of sleep duration and obesity was investigated among 7,094 community-dwelling Chinese adults. Sleep duration was self-reported. In this study, obesity was defined as follows： body mass index （BMI） ≥ 28 kg/m^2, waist circumference （WC） ≥ 85 cm in men and ≥ 80 cm in women, and percent body fat （%BF） ≥ 25 in men and ≥ 35 in women. Logistic and quantile regressions were employed to examine relationships of interest. Results Overall, 6.42% of the participants reported short sleep durations （〈 6 h/d） while 14.71% reported long （≥ 9 h/d） sleep durations. Long sleepers （≥ 9 h/d） represented a greater frequency of women with obesity [odds ratio （OR）： 1.30; 95% confidence interval （CI）, 1.02-1.67] and high body fat （1.43, 1.04-1.96） than those who slept 7-8 h/d. An association between long sleep times and higher BMI estimations was found across the 10th-75th percentile of the BMI distribution. Among men, long sleepers （≥ 9 h/d） presented lower risks of developing abdominal obesity compared with individuals who slept 7-8 h/d （OR = 0.79, 95% CI： 0.44-0.99）. Conclusion Our study suggests that long sleep durations are associated with general obesity in Chinese women but reduced waist circumferences in men. Confirmatory studies are needed to determine the heterogeneous association of sleep time and obesity by gender.

Daily Activities and Sleep Durations of Patients with Ischemic Heart Disease Who Were Discharged to Their Homes after Elective Percutaneous Coronary Intervention

The purpose of this study was to examine the relationship between daily activities and sleep durations for patients following elective percutaneous coronary intervention (ePCI) and diagnosed with ischemic heart disease (IHD) after discharge to their homes. The actigraph data were used to collect data from twenty five patients. The duration of night-time sleep (minutes from the start to end of night-time) and actual night-time sleep duration (total sleep duration excluding wake-up durations of night-time) on the seventh day after discharge were divided into three groups;less than 360, 360 to 480, and more than 480 minutes (short, optimal and long respectively). Subsequently, among the three groups of patients, the data were analyzed by Kruskal Wallis H-test with multiple comparison procedures using the Scheffé-test in order to compare differences in daytime activity items at seven days after discharge from the hospital. Total daytime nap duration (p p p p < 0.05). However, the duration of night-time sleep and daytime activity did not significantly differ. If actual night-time sleep duration is improved from 360 to 480 minutes, daytime nap could potentially be decreased. Determining objective sleep conditions for patients and treating sleep disorders may improve overall patient health, facilitating appropriate sleep and wake rhythms.

Comparison of exogenous melatonin versus placebo on sleep efficiency in emergency medicine residents working night shifts： A randomized trial

BACKGROUND: Sleep deprivation resulting from night shifts, is a major cause of burnout among physicians. Exogenous melatonin may improve sleep quality in night-shift workers. The study aims to compare the effectiveness of melatonin versus placebo on sleep effi ciency in emergency medicine(EM) residents. METHODS: A randomized, double-blind, replicated crossover trial was performed on EM residents. This study consisted of 4 phases within a month with intervention periods of 2 nights and washouts of 6 days. In our study, EM residents had nine-hour shifts on 6 consecutive days, 2 mornings, 2 evenings and 2 nights and then 2 days off. At the end of shifts' cycle, 24 EM residents were given 3 mg melatonin or placebo(12 in each arm of the study) for 2 consecutive nights after the second night shift with crossover to the other arm after a six-day off drug. This crossover intervention was repeated for two more another time. Finally, we created 48 cases and comparisons in each arm. Different items related to sleep quality were assessed and compared both within the same group and between the two groups. RESULTS: In the melatonin group, daytime sleepiness(calculated by Karolinska Sleep Scale) had a signifi cant reduction after taking the second dose of drug(P=0.003) but the same result was not observed when comparing the 2 groups. Mood status(calculated by Profile of Mood States) showed no remarkable difference between the 2 groups. CONCLUSION: Melatonin might have a limited benefi t on sleep quality in EM residents working night shifts.

Predicted 10-year Cardiovascular Disease Risk and Its Association with Sleep Duration among Adults in Beijing-Tianjin-Hebei Region,China

Objective The study aims to predict 10-year cardiovascular disease(CVD)risk and explore its association with sleep duration among Chinese urban adults.Methods We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling.The simplified Pittsburgh Sleep Quality Index(PSQI)and Framingham 10-year risk score(FRS)were used to measure sleep duration and CVD risk.Demographic characteristics,personal history of chronic diseases,lifestyle factors were collected using a questionnaire.Height,weight,total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C)were also measured.Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.Results We included 31,135 participants(median age 44 years,53.02%males)free of CVD,cerebral stroke,and not taking lipid-lowering agents.Overall,14.05%,and 25.55%of participants were at medium and high predicted CVD risk,respectively.Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males(OR=1.10;95%CI:1.01–1.19)and increased odds of medium to high and high risk of predicted 10-year CVD among females(OR=1.23;95%CI:1.08–1.40;OR=1.27;95%CI:1.11–1.44).In contrast,long sleep had no association with cardiovascular risk.Conclusion A substantial number of adults free of CVD were at high 10-year CVD risk.Short sleep was associated with increased odds of predicted CVD risk.

Hospital Night Shift and Its Effects on the Quality of Sleep, the Quality of Life, and Vigilance Troubles among Nurses

Introduction: The exposure to shift works, and especially to night shift, goes against the circadian rythmicity of the social man, which brings about a multitude of disruptive effects on health. In a hospital environment, such night shift is necessary so as to ensure the continuity of care. Sleep and vigilance disorders related to this work mode are frequent and often pose adaptation problems. The objective of this study is to detect the harmful effects of night shift on sleep, vigilance and the quality of life of nurses in Farhat Hached Teaching Hospital in Sousse. Material and Methods: It is a cross-sectional study carried out among two groups of nurses: one group performing a fixed night work and the other one working permanently during the day at Farhat Hached Teaching Hospital in Sousse. Data collection is mainly based on validated questionnaires evaluating sleep quality (Pittsburg sleep quality index), daytime sleepiness (Epworth sleepiness scale), sleep typology (Horne and Ostberg questionnaire), and the quality of life (SF-12). An objective evaluation of vigilance was realized by the study of reaction time and error rates to different tasks of “Super lab” software. Results: 50 night and 50 day nurses have been colligated. Both groups were age- and gender-matched. Sleep quality mean index was significantly higher among night nurses in comparison with day nurses (10.2 ± 5.9 versus 6.76 ± 5.16). After multivariate analysis, sleep quality was significantly correlated to age, department, schedule and the choice of schedule. Night shift was not related to daytime sleepiness. The objective analysis of vigilance showed that the reaction time to different tasks exploring the attentional mechanisms, as well as errors rate, were significantly more important among the night group. The mental score of the quality of life was significantly higher among day nurses. However, such difference was not significant with regard to physical score. Conclusion: The findings of our study highlight not only the alteration of the health and the well being of paramedical staff secondary to night shift, but also a possible threat to safety care lavished by these teams, which involves the necessity to undertake preventive measures on an individual and collective scale.

Associations of sleep duration with childhood obesity: findings from a national cohort study in China

Objective:Examine effect of sleep duration on children’s risk of overweight and obesity;and study associations between activities in the last hour before bedtime and sleep outcomes(sleep duration,sleep quality,and sleep onset latency).Methods:Children’s data were recruited using a questionnaire survey from a nationally representative sample of children(n=10279)in China in 2013‒2016.Mixed-effects models were used to test associations among variables stratified by sex.Results:Sleep duration was positively associated with BMI in boys(β=0.04,P=0.021).Girls with short sleep durations(<8 h/d)tended to have higher BMI values than those with normal sleep durations(8‒9 h/d)(β=0.12,P=0.063).The top three activities were playing electronic devices(Factor 1),doing homework,and reading(combined as Factor 2).Factors 1 and 2 were both significantly associated with sleep duration(β=0.17,P<0.001;β=−0.26,P<0.001,respectively).Conclusion:Sleep duration seems to affect BMI in Chinese children.Using electronic devices and reading before bedtime influenced sleep duration.Good bedtime habits and sleep duration can help weight management in children.

Unhealthy eating habits around sleep and sleep duration: To eat or fast?

Traditionally, breakfast skipping(BS), and recently latenight dinner eating(LNDE), have attracted attention in public health because they can predispose to cardiometabolic conditions such as obesity and type 2 diabetes. Intriguingly, it has become evident that short duration of sleep elicits similar health risks. As LNDE, BS, and short sleep can be closely related and can aggravate each other, these three should not be considered separately. In this context, LNDE(or its equivalents, snacking or heavy alcohol consumption after dinner) and BS may be representative unhealthy eating habits around sleep(UEHAS). While it is important to take energy in the early morning for physical and intellectual activities, attaining a fasting state is essential for metabolic homeostasis. Our previous UEHAS studies have shown that BS without LNDE, i.e., BS alone, is not associated with obesity and diabetes, suggesting the possibility that BS or taking a very low energy breakfast, which could yield fasting for a while, may prevent obesity and diabetes in people with inevitable LNDE. Further studies considering UEHAS and short sleep simultaneously are needed to elucidate the effects of these unhealthy lifestyles on cardiometabolic diseases.

Association between drinking behavior and sleep duration in Chinese adults: findings from the China Health and Nutrition Survey

Background:To examine the association between alcohol drinking and short sleep duration among Chinese adults.Methods:Based on inclusion and exclusion criteria,28,167 records of 15,074 adults longitudinal data were obtained from the China Health and Nutrition Survey for the period from 2004 to 2011.A multilevel logistic regression model was employed to explore the association between alcohol drinking and sleep duration.Results:Compared with nondrinking participants,a high drinking frequency was positively correlated with a short sleep duration in both the males(odds ratio(OR)=1.33,95%confidence interval(CI)=1.20–1.48,P<0.001)and females(OR=1.60,95%CI=1.18–2.18,P=0.003)before the covariates were adjusted.After adjusting for age,residence area,education level,marital status,smoking,coffee consumption,tea consumption,and activity level,this association remained significant in the males(OR=1.31,95%CI=1.17–1.46,P<0.001)but not in the females(OR=1.16,95%CI=0.85–1.59,P=0.340).Conclusion:The present results suggest that a high drinking frequency was positively correlated with a short sleep duration in male population.Comprehensive measures therefore need to be implemented to improve sleep duration,especially to increase awareness of the dangers of drinking alcohol.

Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents

Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.

Insomnia Symptoms and Sleep Duration Are Associated with Impaired Cardiac Autonomic Modulation in Children

Limited population-based data from children are available to investigate the associations between insomnia and sleep duration in relationship to impaired cardiac autonomic modulation (CAM). Therefore, the objective of this study is to examine the cross-sectional associations between insomnia symptoms, sleep duration, and CAM in a population-based sample of children. All 616 children were randomly selected from Central Pennsylvania to participate in a one-night polysomnography (PSG) study in a sleep laboratory. The Pediatric Behavior Scale was used to assess parent-reported insomnia. Sleep duration was assessed objectively by PSG. CAM was measured by heart rate variability (HRV) analysis of 9-hour-beat-to-beat RR intervals. Multivariate linear regression models were used to assess the association between insomnia, sleep duration and HRV. The mean (SD) age was 9.2 (1.7) years, with 25.5% non-white and 48.9% male. After adjusting for age, race, gender, BMI percentile, %REM sleep, apnea-hypopnea-index, sleep latency, and sleep efficiency, the means(SE) of HRV indices were lower in children with insomnia than in children without: 6.56 (0.07) vs. 6.78 (0.04) m2 on logHF, respectively;and 6.47 (0.06) vs. 6.61 (0.03) m2 on logLF, respectively (all P < 0.05). There is a trend towards a significant lower time domain HRV indices, faster HR, and higher LF/HF ratio in children with insomnia symptoms. There is a similar pattern of association between shorter objective sleep duration and HRV. Insomnia symptoms and shorter objective sleep duration are associated with lower HRV and higher HR and LF/HF ratio, indicative of disturbance of CAM towards more sympathetic and lower parasympathetic modulation. These data provide supporting evidence of physiological activation associated with insomnia and short sleep duration even in very young children.

Association between sleep duration and overweight/obesity among Chinese children and adolescents:a longitudinal study

Background:To determine the associations between sleep duration and overweight/obesity in Chinese children and adolescents.Methods:This longitudinal study analyzed 3,126 children and adolescents aged 7 to 18 years who had participated in the China Health and Nutrition Survey during 2004-2011.Sleep duration was classified into<9 h,9-10 h,and>10 h for children aged 7-12 years,and<8 h,8-9 h,and>9 h for adolescents aged 13-18 years.Results:After adjusting for confounder,short sleep duration was associated with overweight/obesity for girls aged 7-12 years(β=4.32,95%confidence interval=1.27 to 7.37,P=0.006)and boys aged 13-18 years(β=3.38,95%confidence interval=2.01 to 4.74,P<0.001).No statistically significant association was found among the other 2 groups.Meanwhile,long sleep duration was not statistically significant at any age.Conclusion:The association between short sleep duration and overweight/obesity to be dependent on both age and gender.

中国老年人午睡时长和夜间睡眠与抑郁症状的关联:基于2020年CHARLS数据的实证分析

背景随着我国进入中度老龄化社会,老年人心理健康问题逐年增加,而生活习惯与老年人的心理健康密切相关。目的探讨我国老年人午睡时长、夜间睡眠与抑郁症状的关系,基于生活习惯角度推荐睡眠时间,为老年人抑郁早期防控提供科学依据。方法基于2023-11-16公开发布第五轮(2020年)中国健康与养老追踪调查项目(CHARLS),纳入符合研究标准的8233名为研究对象。采用抑郁评定量表(CSE-D10)评估老年人抑郁症状,午睡时长划分5级:不午睡、<30 min、30~59 min、60~89 min、≥90 min,夜间睡眠分为5级:≥8 h、7~<8 h、6~<7 h、5~<6 h、<5 h。采用多因素Logistic回归分析探究影响老年人发生抑郁症状的因素,随机森林模型分析午睡时长、夜间睡眠在老年人发生抑郁症状中的重要程度,限制性立方样条曲线进一步探索午睡时长、夜间睡眠时长与抑郁症状发生风险之间的剂量-反应关系。结果2020年调查期间,中国老年人抑郁症状的发生率为24.84%(2045/8233)。多因素Logistic回归分析结果显示,午睡时长30~59 min是老年人发生抑郁症状的保护因素(OR=0.814,95%CI=0.673~0.985,P=0.034),夜间睡眠时间<5 h是老年人发生抑郁症状的危险因素(OR=1.705,95%CI=1.435~2.027,P<0.001)。女性、未婚/分居/离异/丧偶、失能、身体疼痛、强度体力活动、自评健康状况下降、生活满意度下降、卒中、帕金森病会增加老年人发生抑郁症状的风险(P<0.05)。随机森林模型显示,午睡时长、夜间睡眠时间对抑郁症状影响的重要性较高。午睡时长与发生抑郁症状之间存在非线性关系(P_(nonlinear)<0.05),老年人发生抑郁症的风险在午睡时长30 min后随着时间的增加而持续降低,最低水平约为50 min,午睡时长超过75 min后抑郁症状的发生风险会增加。老年人患抑郁症状的发生风险在夜间睡眠6 h后随着时间的增加而持续降低,最低水平约为7 h,睡眠时间超过9 h后抑郁的风险会增加(Poverall<0.05)。结论中国老年人群抑郁症的患病率较高(24.84%),午睡时长、夜间睡眠的持续时间与抑郁症之间呈J型关系,建议老年人每天午睡30~75 min,适度的午睡时长有效降低老年人发生抑郁症状的风险,同时夜间睡眠6~9 h降低抑郁症状的发生风险,对老年人群抑郁症的早期防控具有一定的意义。

腰椎融合术后患者急性疼痛发展轨迹及影响因素

目的探讨开放性腰椎融合术患者急性术后疼痛轨迹的潜在类别,分析不同潜在类别的影响因素,为不同类别患者制定针对性镇痛措施提供依据。方法使用便利抽样法,选取择期开放性腰椎融合术患者251例,在术前1 d收集患者一般资料、疼痛评分及睡眠质量资料。术后分别于全麻清醒并拔除气管导管的0 h、6 h、12 h、1 d、2 d、3 d、4 d、5 d、6 d 9个时间点评估患者疼痛程度。采用潜类别增长模型识别急性术后疼痛轨迹的潜在类别,采用无序多分类logistic回归分析急性术后疼痛轨迹潜在类别的影响因素。结果识别出3种急性术后疼痛轨迹,分别为疼痛加剧后缓解组(83例,33.0%),疼痛加剧稳定后反弹组(30例,12.0%),轻度疼痛组(138例,55.0%)。回归分析显示,相对于轻度疼痛组,病程≥10年、高中以下文化程度、手术时间>240 min的患者更容易进入疼痛加剧稳定后反弹组;年龄≤50岁、存在睡眠障碍、术后未使用镇痛泵的患者更容易进入疼痛加剧后缓解组(均P<0.05)。结论开放性腰椎融合手术患者急性术后疼痛呈现不同的发展轨迹,医护人员应根据不同发展轨迹重视年龄≤50岁、病程≥10年、高中以下文化程度、术前有睡眠障碍、手术时间>240 min、术后未使用镇痛泵的患者,给予及时的疼痛评估及针对性干预措施,改善患者术后疼痛程度。

上海市虹口区中学生睡眠时长现状及其影响因素分析

目的了解上海市虹口区中学生睡眠时长现状并分析影响因素。方法采用分层整群随机抽样方法,抽取虹口区5所中学(包括2所初中、2所高中和1所职校),每所学校按年级分层,并从每个年级随机抽取至少80名学生,以整班为单位进行调查,共抽取1309名学生参与体格检查和问卷调查。对相关数据进行统计学分析。结果虹口区中学生每日平均睡眠时间为7.33 h,75.3%的学生存在睡眠不足问题。男生的睡眠不足率(71.9%)显著低于女生(79.2%)(χ^(2)=9.293,P<0.01);初中、高中、职高学生的睡眠不足率分别为77.4%、83.0%、55.2%,差异有统计学意义(χ^(2)=74.796,P<0.001)。多因素分析结果显示:有抑郁症状、每天使用移动设备、放学后每天做作业或读书写字时间≥3 h,以及过去1周参加文化类补习班时间≥3 h的学生,睡眠不足的风险较高;职高生和每天看电视(≥1 h,<2 h)的学生,睡眠不足的风险相对较低。结论虹口区中学生睡眠不足问题较为突出,需加强睡眠健康教育,特别关注有抑郁症状及移动设备使用过度的学生,并减轻学生课业和课外补习负担。