KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.
Sleep Med. 2019 Jun;58:19-26. doi: 10.1016/j.sleep.2019.01.048. Epub 2019 Mar 5.
Sleep problems are burdensome in adolescents. Understanding modifiable environmental risk factors is essential. There is evidence that physical activity is protective against sleep problems in adolescents. However, the association between sedentary behavior (SB) and anxiety-induced sleep disturbance has not been investigated.
Using cross-sectional data from the Global school-based Student Health Survey, we explored the association between SB and anxiety-induced sleep disturbance in 181,093 adolescents [mean (standard deviation, SD) age 13.7 (1.0) years; 48.4% girls] from 67 countries, controlling for confounders (including physical activity). Adolescents reported anxiety-induced sleep disturbance during the past 12 months, and SB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework. Multivariable logistic regression analysis was conducted and a countrywide meta-analysis undertaken.
Overall, 7.8% of adolescents had anxiety-induced sleep disturbance. The prevalence of SB was: <1 h/day 39.9%; 1-2 h/day 33.8%; 3-4 h/day 15.4%; 5-8 h/day 7.4%; and >8 h/day 3.6%. Compared to <1 h/day of SB, >8 h/day was associated with a 2.27 [95% confidence interval (CI) = 1.98-2.62] times higher odds for anxiety-induced sleep disturbance. The association was similar among both sexes. The pooled odds ratio for anxiety-induced sleep disturbance when being sedentary ≥3 h/day was 1.42 (95% CI = 1.36-1.48) with only a small degree of between-country heterogeneity (I = 41.4%).
Future longitudinal data are required to confirm/refute the findings to inform public interventions which aim to reduce anxiety and sleep disturbance in adolescents.
睡眠问题在青少年中是一个负担。了解可改变的环境风险因素至关重要。有证据表明，身体活动对青少年的睡眠问题有保护作用。然而，久坐行为（SB）与焦虑引起的睡眠障碍之间的关联尚未得到调查。
使用来自全球学校学生健康调查的横断面数据，我们在 67 个国家的 181093 名青少年（平均[标准差，SD]年龄 13.7[1.0]岁；48.4%为女孩）中探讨了 SB 与焦虑引起的睡眠障碍之间的关系，控制了混杂因素（包括身体活动）。青少年报告了过去 12 个月中因焦虑引起的睡眠障碍，以及 SB，这是一个综合变量，评估了典型一天中坐着和看电视、玩电脑游戏、与朋友交谈的时间，不包括在学校和做作业时坐着的时间。进行了多变量逻辑回归分析，并进行了全国范围内的荟萃分析。
总体而言，7.8%的青少年有焦虑引起的睡眠障碍。SB 的发生率为：<1 小时/天 39.9%；1-2 小时/天 33.8%；3-4 小时/天 15.4%；5-8 小时/天 7.4%；>8 小时/天 3.6%。与 SB<1 小时/天相比，>8 小时/天与焦虑引起的睡眠障碍的几率增加 2.27 倍（95%置信区间[CI]为 1.98-2.62）。这种关联在两性中相似。当每天久坐≥3 小时时，焦虑引起的睡眠障碍的合并优势比为 1.42（95%CI 为 1.36-1.48），且仅存在较小程度的国家间异质性（I=41.4%）。
需要未来的纵向数据来证实/反驳这些发现，以为旨在减少青少年焦虑和睡眠障碍的公共干预措施提供信息。
