Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China.
Shandong Provincial Mental Health Center, Jinan City, Shandong, China.
J Affect Disord. 2021 Mar 15;283:147-155. doi: 10.1016/j.jad.2021.01.045. Epub 2021 Jan 27.
Little is known about the variation in sleep quality and its association with coping style and mental health in 21 century China, despite of enormous socioeconomic changes. This study aims to document the variation in sleep quality and its contribution to the association between coping style and mental health in China.
Pooled cross-sectional data of 46,561 adults was obtained from the 2004 and 2015 mental health surveys conducted in Shandong Province, China. A Simplified Coping Style Questionnaire and the Pittsburgh Sleep Quality Index were assessed, with mental health measured by the General Health Questionnaire (GHQ). A mediation regression model was run to test the mediating effect of sleep quality.
Above 10% reported poor sleep quality or median-to-high risk of mental disorders according to GHQ results in year 2015, and a significant but small improvement for sleep quality and mental health came during the studied decade, with the exception of poor sleep quality increasing among males. In 2015, a one-point increase in sleep quality score was associated with an increase of 0.17 (95% CI, 0.16-0.18) and 0.16 (95% CI, 0.14-0.17) points on the GHQ for males and females, respectively. Sleep quality mediated the relationship between negative tendency of coping style and elevated GHQ scores, and the mediating effects grew stronger in 2015 than those in 2004.
The study is a cross-sectional study, and the sample is not nationally representative.
An integrative intervention of mental health promotion is recommended to account for sleep quality and coping strategies..
尽管 21 世纪中国经历了巨大的社会经济变革，但对于睡眠质量的变化及其与应对方式和心理健康的关系，人们知之甚少。本研究旨在记录睡眠质量的变化及其在中国应对方式与心理健康之间的相关性。
本研究采用 2004 年和 2015 年山东省心理健康调查的横断面数据，共纳入 46561 名成年人。使用简化应对方式问卷和匹兹堡睡眠质量指数评估睡眠质量，采用一般健康问卷（GHQ）评估心理健康。采用中介回归模型检验睡眠质量的中介效应。
2015 年，根据 GHQ 结果，超过 10%的人报告睡眠质量差或处于中高度心理健康障碍风险，在研究期间，睡眠质量和心理健康状况有显著但较小的改善，除男性的睡眠质量差有所增加外。2015 年，睡眠质量评分每增加 1 分，男性和女性的 GHQ 评分分别增加 0.17（95%CI：0.16-0.18）和 0.16（95%CI：0.14-0.17）分。睡眠质量中介了应对方式的消极倾向与 GHQ 评分升高之间的关系，并且 2015 年的中介效应强于 2004 年。
本研究为横断面研究，样本不具有全国代表性。
建议综合干预心理健康，考虑睡眠质量和应对策略。
