Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.
Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, People's Republic of China.
Eur Child Adolesc Psychiatry. 2019 Sep;28(9):1265-1275. doi: 10.1007/s00787-019-01294-9. Epub 2019 Feb 18.
Nonmedical use of prescription drug (NMUPD) among adolescents has increased substantially over the last 2 decades, and evidence suggests that sleep duration may impact upon drug use and academic performance. This study aimed to estimate the prevalence of sleep duration, NMUPD, and academic performance among Chinese adolescents, to test the independent associations of sleep duration with NMUPD, and to investigate whether these associations vary by academic performance. Data were from the 2015 School-based Chinese Adolescents Health Survey using a multi-stage, stratified-cluster, random-sampling method to collect information from 162,601 high school students [mean age (SD) =15.2 (1.9) years; 47.4% were male] from 42 cities in China. The weighted prevalence of sleeping ≤ 5 h/weekday was 1.1% (95% CI, 1.0-1.1%), and the weighted prevalence of sleeping > 9 h/weekday was 7.6% (95% CI 7.4-7.7%). After adjusting for significant covariates and academic performance, the results showed that compared with those with 7-9 h/weekday sleep duration, students reporting ≤5 h/weekday were more likely to misuse opioids (AOR = 2.12, 95% CI 1.73-2.59), sedatives (AOR = 2.00, 95% CI 1.65-2.42), and any prescription drug use (AOR = 1.89, 95% CI 1.60-2.23); students with>9 h/weekday sleep duration were also at a higher risk of opioids use, sedative use, and any prescription drug misuse; the U-shaped association of sleep duration with NMUPD was found. Moreover, there exist significant associations between weekday sleep duration and NMUPD among Chinese adolescents, and academic performance plays a moderating role in the aforementioned associations. The efforts to prevent NMUPD should be focused on adolescents who report abnormal sleep duration or poor academic performance.
青少年非医疗目的使用处方药物（NMUPD）在过去 20 年中大幅增加，有证据表明睡眠时长可能会影响药物使用和学业表现。本研究旨在估计中国青少年的睡眠时长、NMUPD 和学业表现的流行率，检验睡眠时长与 NMUPD 的独立相关性，并探讨这些相关性是否因学业表现而有所不同。数据来自 2015 年的中国青少年健康调查，采用多阶段、分层聚类、随机抽样方法，从中国 42 个城市的 162601 名高中生（平均年龄（SD）=15.2（1.9）岁；47.4%为男性）收集信息。每周工作日睡眠时长≤5 小时的加权患病率为 1.1%（95%CI，1.0-1.1%），每周工作日睡眠时长>9 小时的加权患病率为 7.6%（95%CI，7.4-7.7%）。在调整了显著的协变量和学业表现后，结果表明，与每周工作日睡眠时长为 7-9 小时的学生相比，报告每周工作日睡眠时长≤5 小时的学生更有可能滥用阿片类药物（AOR=2.12，95%CI 1.73-2.59）、镇静剂（AOR=2.00，95%CI 1.65-2.42）和任何处方药物（AOR=1.89，95%CI 1.60-2.23）；每周工作日睡眠时长>9 小时的学生也更有可能滥用阿片类药物、镇静剂和任何处方药物；睡眠时间与 NMUPD 之间呈 U 型关联。此外，中国青少年的周内睡眠时长与 NMUPD 之间存在显著关联，学业表现在上述关联中起调节作用。预防 NMUPD 的努力应集中在报告异常睡眠时长或学业表现不佳的青少年上。
