Sleep status of Chinese fourth-grade primary school students and its physical and psychological factors
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摘要:
目的 了解我国四年级学生睡眠量与质的状况及群体差异,探索影响学生睡眠时长和质量的身心因素。 方法 选取2018年中国教育追踪调查(China education panel survey, CEPS)数据库中重要变量完整的23 717名年龄为10~11岁的学生作为研究对象,分别采用多元线性回归模型和多因素logistic回归分析模型分析具体睡眠时长和自评睡眠质量的身心影响因素。 结果 我国四年级学生的睡眠时长均值为9.26 h,自评睡眠质量为好的学生占88.56%。BMI分类、生病频率、抑郁程度、吸烟、饮酒、食用烧烤/膨化/西式快餐食品、饮用含糖/碳酸饮料和吃早饭频率会影响睡眠时长(均P < 0.05)。而性别、自评健康等级、生病频率、饮酒、饮用含糖/碳酸饮料和吃早饭是影响学生睡眠质量的因素(均P < 0.05)。 结论 我国学生中有一部分睡眠平均时长<10 h,但大部分自评睡眠质量良好,不同的身心因素与健康行为对睡眠时长和睡眠质量的影响效应存在差异化。 Abstract:Objective To understand the status and group differences in sleep quantity and quality among fourth-grade primary school students in China, and to explore its physical and psychological factors. Methods Total of 23 717 school students between the ages of 10 and 11 with complete important variables in the 2018 China Education Panel Survey (CEPS) data were selected as research subjects. A multiple linear regression model was used to analyze factors affecting their sleep duration, and a multifactor logistic regression model was used to analyze factors affecting their sleep quality. Results The average sleep duration of fourth-grade school students nationwide was 9.26 hours, and the proportion of subjects with self-rated good sleep quality was 88.56%. BMI classification, frequency of illness, depression score, smoking, alcohol consumption, consumption of barbecued/puffed/and western fast food, consumption of sugary/carbonated beverages, and the frequency of not eating breakfast were the factors affecting their sleep duration (all P < 0.05). Gender, self-rated health rating, frequency of illness, depressed psychology, alcohol consumption, consumption of barbecued, puffed, and western fast food, and consumption of sugary or carbonated beverages and habits of not eating breakfast were the factors affecting their sleep quality (all P < 0.05). Conclusions The average length of sleep of Chinese fourth-grade primary school students has not reached 10 hours, but the self-assessed sleep quality is good. Different physical and mental factors and health behaviors have different effects on the duration and quality of sleep. -
表 1 不同一般情况的学生自评睡眠质量的比较
Table 1. Comparison of self-rated sleep quality among school students with different general conditions
变量 Variable 睡眠质量好 ① Students of good sleep ① 睡眠质量差 ① Students of bad sleep ① χ2值 value P值 value 日均睡眠时间/h ① Average daily sleep duration /h t/F值 value P值 value 性别 Gender 92.377 < 0.001 10.28 0.001 男 Male 10 712(86.65) 1 650(13.35) 9.29±1.06 女 Female 10 291(90.63) 1 064(9.37) 9.24±1.17 BMI分类 Classify/(kg·m-2) 13.749 < 0.001 3.03 0.048 正常 Normal 15 948(88.99) 1 973(11.01) 9.27±1.10 超重 Overweight 29 75(87.09) 441(12.91) 9.23±1.17 肥胖 Obesity 20 80(87.39) 300(12.61) 9.23±1.20 吸烟 Smoking 83.287 < 0.001 0.35 0.555 有 Yes 2 620(96.54) 94(3.46) 9.30±1.78 无 No 20 747(98.78) 256(1.22) 9.26±1.11 饮酒 Drinking 295.824 < 0.001 89.03 < 0.001 有 Yes 3 875(81.46) 882(18.54) 9.13±1.29 无 No 17 128(90.34) 1 832(9.66) 9.30±1.07 自评健康等级 Self-rated health rating 1 100.000 < 0.001 17.90 < 0.001 很不好 Very poor 197(63.96) 111(36.04) 9.13±1.65 不太好 Poor 879(68.56) 403(31.44) 9.07±1.36 一般 Not so good 3 474(82.19) 753(17.81) 9.22±1.17 比较好 Good 6 213(90.34) 664(9.66) 9.25±1.05 很好 Very good 10 077(93.05) 753(6.95) 9.32±1.09 生病频率 Frequency of illness 771.677 < 0.001 41.77 < 0.001 从不 Never 3 013(92.03) 261(7.97) 9.32±1.13 很少 Seldom 12 060(91.29) 1 151(8.71) 9.31±1.07 有时 Sometimes 4 617(86.93) 782(13.07) 9.20±1.12 经常 Often 908(80.04) 339(19.96) 9.06±1.32 总是 Always 259(70.30) 156(29.70) 8.76±1.54 食用烧烤/膨化/西式快餐食品频率 Frequency of eating barbecue/puffing/western food 258.664 < 0.001 72.28 < 0.001 从不 Never 3 435(90.59) 357(9.41) 9.44±1.13 很少 Seldom 11 173(90.02) 1 239(9.98) 9.30±1.07 有时 Sometimes 5 175(86.93) 778(13.07) 9.15±1.11 经常 Often 802(80.04) 200(19.96) 8.99±1.25 总是 Always 277(70.30) 117(29.70) 8.80±1.57 饮用含糖/碳酸饮料频率 Frequency of drinking consumption of sugar/carbonated beverages 354.428 < 0.001 91.67 < 0.001 从不 Never 2 707(90.87) 272(9.13) 9.46±1.10 很少 Seldom 10 438(90.66) 1 075(9.34) 9.32±1.06 有时 Sometimes 5 876(87.51) 839(12.49) 9.17±1.12 经常 Often 1 300(80.85) 308(19.15) 9.03±1.24 总是 Always 418(70.73) 173(29.27) 8.75±1.58 抑郁得分 Depression score -0.063 < 0.001 9.26±1.12 14.08 < 0.001 注:①以人数(占比/%)或x±s表示。
Note: ① Number of people (proportion/%) or x±s.).表 2 学生睡眠时间影响因素的多元线性回归分析
Table 2. Multivariate regression analysis on sleep time among school students
自变量 Independent variable 非标准化β值 value (95% CI) sx 标准化β值 value t值 value P值 value 性别 Gender 男 Male -0.001(-0.032~0.030) 0.016 0 -0.06 0.950 女 Female 0 BMI分类 Classify/(kg·m-2) 正常 Normal 0 超重 Overweight -0.044(-0.087~-0.001) 0.022 -0.014 -2.00 0.046 肥胖 Obesity -0.059(-0.109~-0.008) 0.026 -0.016 -2.26 0.024 自评健康等级 Self-rated health rating 很不好 Very poor 0 不太好 Poor -0.033(-0.181~0.115) 0.075 -0.007 -0.44 0.663 一般 Not so good -0.010(-0.150~0.129) 0.071 -0.004 -0.15 0.885 比较好 Good 0.008(-0.131~0.147) 0.071 0.003 0.12 0.908 很好 Very good 0.032(-0.107~0.170) 0.071 0.014 0.45 0.655 生病频率 Frequency of illness 从不 Never 0 很少 Seldom 0.030(-0.016~0.076) 0.023 0.014 1.29 0.196 有时 Sometimes -0.004(-0.058~0.050) 0.028 -0.002 -0.15 0.878 经常 Often -0.087(-0.168~-0.006) 0.041 -0.018 -2.11 0.035 总是 Always -0.321(-0.448~-0.193) 0.065 -0.037 -4.94 < 0.001 抑郁得分 Depression score -0.004(-0.005~-0.003) 0.000 -0.072 -9.56 < 0.001 吸烟 Smoking 否 No 0 是 Yes 0.176(0.037~0.316) 0.071 0.018 2.48 0.013 饮酒 Drinking 否 No 0 是 Yes -0.111(-0.150~-0.072) 0.020 -0.039 -5.61 < 0.001 食用烧烤/膨化/西式快餐食品频率 Frequency of eating barbecue/puffing/western food 从不 Never 0 很少 Seldom -0.020(-0.065~0.025) 0.023 -0.009 -0.86 0.389 有时 Sometimes -0.063(-0.116~-0.009) 0.027 -0.025 -2.30 0.021 经常 Often -0.134(-0.223~-0.045) 0.046 -0.024 -2.95 0.003 总是 Always -0.183(-0.318~-0.047) 0.069 -0.021 -2.65 0.008 饮用含糖/碳酸饮料频率 Frequency of drinking consumption of sugar/carbonated beverages 从不 Never 0 很少 Seldom -0.092(-0.142~-0.043) 0.025 -0.042 -3.66 < 0.001 有时 Sometimes -0.195(-0.251~-0.139) 0.028 -0.080 -6.86 < 0.001 经常 Often -0.264(-0.342~-0.187) 0.040 -0.060 -6.67 < 0.001 总是 Always -0.524(-0.642~-0.407) 0.060 -0.072 -8.74 < 0.001 吃早饭频率 Frequency of having breakfast 每天都吃 Everyday 0 偶尔不吃 Often -0.137(-0.180~-0.094) 0.022 -0.044 -6.20 < 0.001 有时不吃 Sometimes -0.008(-0.066~0.050) 0.030 -0.002 -0.27 0.787 经常不吃 Seldom -0.155(-0.253~-0.057) 0.050 -0.022 -3.11 0.002 几乎从来不吃 Never -0.025(-0.131~0.080) 0.054 -0.003 -0.47 0.638 表 3 学生睡眠质量影响因素的多因素logistic回归分析模型
Table 3. Multivariate logistic regression analysis on sleep time among school students
变量 Variable OR值 value (95% CI) P值 value 性别 Gender 女 Female 1.000 男 Male 1.329(1.203~1.467) < 0.001 BMI分类 Classify/(kg·m-2) 正常 Normal 1.000 超重 Overweight 1.092(0.956~1.248) 0.194 肥胖 Obesity 0.986(0.841~1.155) 0.858 自评健康等级 Self-rated health rating 很不好 Very poor 1.000 不太好 Poor 1.006(0.726~1.393) 0.971 一般 Not so good 0.662(0.484~0.903) 0.009 比较好 Good 0.436(0.318~0.597) < 0.001 很好 Very good 0.361(0.264~0.495) < 0.001 生病频率 Frequency of illness 从不 Never 1.000 很少 Seldom 0.961(0.813~1.136) 0.639 有时 Sometimes 1.148(0.956~1.379) 0.138 经常 Often 1.635(1.306~2.047) < 0.001 总是 Always 2.012(1.485~2.726) < 0.001 抑郁得分 Depression score 1.024(1.022~1.026) < 0.001 吸烟 Smoking 否 No 1.000 是 Yes 1.026(0.722~1.457) 0.887 饮酒 Drinking 否 No 1.000 是 Yes 1.429(1.281~1.595) < 0.001 食用烧烤/膨化/西式快餐食品频率 Frequency of eating barbecue/puffing/western food 从不 Never 1.000 很少 Seldom 1.023(0.875~1.197) 0.776 有时 Sometimes 1.048(0.879~1.249) 0.600 经常 Often 1.141(0.885~1.469) 0.309 总是 Always 1.412(1.012~1.970) 0.042 饮用含糖/碳酸饮料频率 Frequency of drinking consumption of sugar/carbonated beverages 从不 Never 1.000 很少 Seldom 0.860(0.725~1.020) 0.084 有时 Sometimes 0.944(0.785~1.135) 0.540 经常 Often 1.136(0.902~1.430) 0.278 总是 Always 1.623(1.205~2.185) 0.001 吃早饭频率 Frequency of having breakfast 每天都吃 Everyday 1.000 偶尔不吃 Often 1.532(1.354~1.734) < 0.001 有时不吃 Sometimes 1.620(1.387~1.893) < 0.001 经常不吃 Seldom 1.662(1.292~2.137) < 0.001 几乎从来不吃 Never 1.744(1.326~2.294) < 0.001 -
[1] 颜有萱, 陈俊财, 林柳婷, 等. 基于海南省队列BMI与睡眠时长和睡眠质量关系的横断面研究[J]. 中华疾病控制杂志, 2022, 26(4): 406-411. DOI: 10.16462/j.cnki.zhjbkz.2022.04.008.Yan YX, Chen JC, Lin LT, et al. A cross-section study of the correlations between BMI and sleep duration or sleep quality based on Hainan cohort study [J]. Chin J Dis Control Prev, 2022, 26(4): 406-411. DOI: 10.16462/j.cnki.zhjbkz.2022.04.008. [2] 刘连启, 穆朝娟, 王汝展, 等. 小学生睡眠问题及其相关因素[J]. 中国心理卫生杂志, 2004, 18(9): 613-616. DOI: 10.3321/j.issn:1000-6729.2004.09.004.Liu LQ, Mu ZJ, Wang RZ, et al. Sleep problems and related factors of primary school students [J]. Chinese Mental Health Journal, 2004, 18(9): 613-616. DOI: 10.3321/j.issn:1000-6729.2004.09.004. [3] 臧艳, 刘业海, 马云霞. 合肥市7~12岁学龄儿童睡眠呼吸障碍及其影响因素调查[J]. 中华疾病控制杂志, 2011, 15(5): 409-411. https://zhjbkz.ahmu.edu.cn/article/id/JBKZ201105016Zang Y, Liu YH, Ma YX. A study on the situation of sleep-disordered breathing and its influencing factors in children aged 7-12 years in Hefei City [J]. Chin J Dis Control Prev, 2011, 15(5): 409-411. https://zhjbkz.ahmu.edu.cn/article/id/JBKZ201105016 [4] 王一然, 黄晓培, 严惠, 等. 河南省7~18岁儿童青少年睡眠时长与超重肥胖的关联[J]. 中华疾病控制杂志, 2021, 25(3): 306-358. DOI: 10.16462/j.cnki.zhjbkz.2021.03.011.Wang YR, Huang XP, Yan H, et al. Correlation between sleep duration and overweight/obesity among children and adolescents aged 7-18 in Henan Province [J]. Chin J Dis Control Prev, 2021, 25(3): 306-358. DOI: 10.16462/j.cnki.zhjbkz.2021.03.011. [5] 雷晓梅, 李少闻, 杨媛媛. 小学生睡眠障碍危险因素及其行为问题调查研究[J]. 陕西医学杂志, 2014, 43(1): 109-111. DOI: 10.3969/j.issn.1000-7377.2014.01.041.Lei XM, Li SW, Yang YY. On risk factors for sleep disorders and their behavioral problems in primary school students [J]. Shaanxi Medical Journal, 2014, 43(1): 109-111. DOI: 10.3969/j.issn.1000-7377.2014.01.041. [6] 秦玉友, 赵忠平. 营养好不好?睡眠足不足?锻炼够不够?——我国中小学生身体发展条件调查研究[J]. 四川师范大学学报(社会科学版), 2014, 41(2): 5-12.Qin YY, Zhao ZP. The survey research on physical development condition of primary and middle school students in country [J]. Journal of Sichuan Normal University(Social Sciences Edition). 2014, 41(2): 5-12. [7] 成刚, 周鹤洋, 朱庆环. 青少年为什么睡眠不足?——基于中国教育追踪调查数据的研究[J]. 教育科学研究, 2022(3): 42-50. DOI: 10.3969/j.issn.1009-718X.2022.03.007.Cheng G, Zhou HY, Zhu QH. Why adolescents do not get enough sleep? [J]. Education Science Research, 2022(3): 42-50. DOI: 10.3969/j.issn.1009-718X.2022.03.007. [8] 赵青矣, 吴英发. "望子成龙"与青少年的睡眠剥夺——基于CEPS2014—2015的实证研究[J]. 中国青年研究, 2023, (7): 15-25. DOI: 10.19633/j.cnki.11-2579/d.2023.0087.Zhao QY, Wu YF. Hope for success and sleep deprivation of adolescents: an empirical study based on CEPS2014-2015 [J]. China Youth Study, 2023, (7): 15-25. DOI: 10.19633/j.cnki.11-2579/d.2023.0087. [9] 曾详宇, 黄彦, 刘斯博, 等. 睡眠时长、饮食习惯与学龄儿童肥胖的关系[J]. 中华疾病控制杂志, 2021, 25(5): 600-611. DOI: 10.16462/j.cnki.zhjbkz.2021.05.019.Zeng XY, Huang Y, Liu SB, et al. The association between sleep duration, eating habits and obesity of school-aged children [J]. Chin J Dis Control Prev, 2021, 25(5): 600-611. DOI: 10.16462/j.cnki.zhjbkz.2021.05.019. [10] 王一然, 黄晓培, 严惠, 等. 河南省7~18岁儿童青少年睡眠时长与超重肥胖的关联[J]. 中华疾病控制杂志, 2021, 25(3): 306-310, 358. DOI: 10.16462/j.cnki.zhjbkz.2021.03.011.Wang YR, Huang XP, Yan H, et al. Correlation between sleep duration and overweight/obesity among children and adolescents aged 7-18 in Henan Province [J]. Chin J Dis Control Prev, 2021, 25(3): 306-310, 358. DOI: 10.16462/j.cnki.zhjbkz.2021.03.011. [11] 曾祥宇, 黄彦, 刘斯博, 等. 睡眠时长、饮食习惯与学龄儿童肥胖的关系[J]. 中华疾病控制杂志, 2021, 25(5): 600-604, 611. DOI: 10.16462/j.cnki.zhjbkz.2021.05.019.Zeng XY, Huang Y, Liu SB, et al. The association between sleepduration, eating habits and obesity of school-aged children [J]. Chin J Dis Control Prev, 2021, 25(5): 600-604, 611. DOI: 10.16462/j.cnki.zhjbkz.2021.05.019. [12] Park GR, Kim J. The gendered health consequences of persistent exposure to short sleep duration during adolescence [J]. J Adolesc, 2023, 95(7): 1311-1320. DOI: 10.1002/jad.12203. [13] Yuan W, Chen L, Wu Y, et al. Sleep time and quality associated with depression and social anxiety among children and adolescents aged 6-18 years, stratified by body composition [J]. J Affect Disord, 2023, 338: 321-328. DOI: 10.1016/j.jad.2023.06.029. [14] Orchard F, Gregory AM, Gradisar M, et al. Self-reported sleep patterns and quality amongst adolescents: cross-sectional and prospective associations with anxiety and depression [J]. J Child Psychol Psychiatry, 2020, 61(10): 1126-1137. DOI: 10.1111/jcpp.13288. [15] O′Dean S, Sunderland M, Newton N, et al. The Health4Life e-health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled trial [J]. Med J Aust, 2024, 220(8): 417-424. DOI: 10.5694/mja2.52279.