School of Public Health, Peking University Health Science Center, Beijing, China.
Department of Global Health, Emory University Rollins School of Public Health, Atlanta, USA.
BMC Public Health. 2018 Jun 19;18(1):759. doi: 10.1186/s12889-018-5629-9.
Daytime napping has been postulated as both a protective and a risk factor for depression in previous studies. In addition to these conflicting results, research gaps also exist with regard to controlling confounding bias between daytime napping and depression and examining the potential association within the Chinese population. To facilitate the prevention and diagnosis of depression, this study aims to provide insight into the association of daytime napping and depression in 0.5 million Chinese adults by fully controlling confounders, and further examine the modifying effects of socio-economic status (SES) and age.
Data were drawn from the baseline of a Chinese cohort study of 0.5 million adults. Depressive status was measured by the Composite International Diagnostic Inventory (CIDI). Logistic regression models were used to examine the association between depression and daytime napping adjusted for SES, sleep-related factors, lifestyle factors and related diseases. Further stratified analyses were conducted to identify the modifying effects of socio-economic status and age.
The odds ratio of depression by daytime napping was 1.15 (95% CI: 1.01-1.31) in females and 1.42 (95% CI: 1.18-1.71) in males. Factors including living in a rural area (OR = 1.31, 95% CI: 1.13-1.52), receiving less education (OR = 1.42, 95% CI: 1.22-1.66), getting married (OR = 1.24, 95% CI: 1.10-1.40) and being 45-65 years old (OR = 1.29, 95% CI: 1.12-1.49) had a modifying effect on daytime napping and depression that could strengthen the association.
A significantly positive association was found between depression and daytime napping, as well as daytime dysfunction, snoring and both shorter and longer sleep duration. Lower SES and age could possibly modify the association. Further clinical or epidemiological studies are needed to investigate the mechanism and facilitate the prevention of depression.
此前的研究表明，白天小睡既可以保护人们免受抑郁的影响，也可能增加其患病风险。除了这些相互矛盾的结果，日间小睡与抑郁之间的混杂偏倚的控制以及在中国人群中潜在关联的研究也存在空白。为了促进抑郁的预防和诊断，本研究旨在通过充分控制混杂因素，深入了解 500 万中国成年人中白天小睡与抑郁之间的关联，并进一步研究社会经济地位（SES）和年龄的调节作用。
数据来自于一项 500 万成年人的中国队列研究的基线数据。抑郁状况通过复合国际诊断清单（CIDI）进行测量。使用逻辑回归模型，在校正 SES、睡眠相关因素、生活方式因素和相关疾病后，检验抑郁与日间小睡之间的关联。进一步进行分层分析，以确定社会经济地位和年龄的调节作用。
在女性中，日间小睡与抑郁的比值比为 1.15（95%CI：1.01-1.31），在男性中为 1.42（95%CI：1.18-1.71）。居住在农村地区（OR=1.31，95%CI：1.13-1.52）、受教育程度较低（OR=1.42，95%CI：1.22-1.66）、已婚（OR=1.24，95%CI：1.10-1.40）和 45-65 岁（OR=1.29，95%CI：1.12-1.49）等因素对日间小睡和抑郁之间的关系具有调节作用，可使其关联增强。
日间小睡与抑郁之间存在显著的正相关关系，日间功能障碍、打鼾以及较短和较长的睡眠时间也与抑郁相关。较低的 SES 和年龄可能会改变这种关联。需要进一步的临床或流行病学研究来探讨其机制，以促进抑郁的预防。
