Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
JAMA Netw Open. 2022 May 2;5(5):e2213247. doi: 10.1001/jamanetworkopen.2022.13247.
Healthy sleep has an important role in the physical and mental health of children. However, few studies have investigated the association between outdoor artificial light at night (ALAN) and sleep disorders in children.
To explore the associations between outdoor ALAN exposure and sleep disorders in children.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study, part of the National Chinese Children Health Study, was conducted from April 1, 2012, to June 30, 2013, in the first stage and from May 1, 2016, to May 31, 2018, in the second stage in 55 districts of 14 cities in China. This analysis included 201 994 children and adolescents aged 2 to 18 years. Data were analyzed from February 20 to March 21, 2022.
Outdoor ALAN exposure (in nanowatts per centimeters squared per steradian) within 500 m of each participant's residential address obtained from the satellite imagery data, with a resolution of approximately 500 m.
Sleep disorders were measured by the Chinese version of the Sleep Disturbance Scale for Children. Generalized linear mixed models were used to estimate the associations of outdoor ALAN with sleep scores and sleep disorders.
The study included 201 994 children and adolescents (mean [SD] age, 11.3 [3.2] years; 106 378 boys [52.7%]), 7166 (3.5%) of whom had sleep disorder symptoms. Outdoor ALAN exposure of study participants ranged from 0.02 to 113.48 nW/cm2/sr. Compared with the lowest quintile (Q1) of outdoor ALAN exposure, higher quintiles of exposure (Q2-Q5) were associated with an increase in total sleep scores of 0.81 (95% CI, 0.66-0.96) in Q2, 0.83 (95% CI, 0.68-0.97) in Q3, 0.62 (95% CI, 0.46-0.77) in Q4, and 0.53 (95% CI, 0.36-0.70) in Q5. Higher quintiles of exposure were also associated with odds ratios for sleep disorder of 1.34 (95% CI, 1.23-1.45) in Q2, 1.43 (95% CI, 1.32-1.55) in Q3, 1.31 (95% CI, 1.21-1.43) in Q4, and 1.25 (95% CI, 1.14-1.38) in Q5. Similar associations were observed for sleep disorder subtypes. In addition, greater effect estimates were found among children younger than 12 years.
The findings of this cross-sectional study suggest that sleep disorders are more prevalent among children residing in areas with high levels of outdoor ALAN and the associations are generally stronger in children younger than 12 years. These findings further suggest that effective control of outdoor ALAN may be an important measure for improving the quality of children's sleep.
健康的睡眠对儿童的身心健康有重要作用。然而，很少有研究调查夜间户外人工光（ALAN）与儿童睡眠障碍之间的关系。
探索户外 ALAN 暴露与儿童睡眠障碍之间的关系。
设计、地点和参与者：这是一项基于人群的横断面研究，是中国国家儿童健康研究的一部分，于 2012 年 4 月 1 日至 6 月 30 日在第一阶段和 2016 年 5 月 1 日至 2018 年 5 月 31 日在第二阶段在中国 14 个城市的 55 个区进行。本分析包括 201994 名 2 至 18 岁的儿童和青少年。数据于 2022 年 2 月 20 日至 3 月 21 日进行分析。
从卫星图像数据中获取每个参与者居住地址周围 500 米范围内的户外 ALAN 暴露（以每平方厘米每立体弧度的毫微瓦特为单位），分辨率约为 500 米。
使用儿童睡眠障碍量表的中文版测量睡眠障碍。使用广义线性混合模型估计户外 ALAN 与睡眠评分和睡眠障碍之间的关联。
研究纳入了 201994 名儿童和青少年（平均[标准差]年龄为 11.3[3.2]岁；106378 名男孩[52.7%]），其中 7166 名（3.5%）有睡眠障碍症状。研究参与者的户外 ALAN 暴露范围为 0.02 至 113.48 毫微瓦/平方厘米/秒。与户外 ALAN 暴露最低五分位（Q1）相比，较高的五分位（Q2-Q5）与总睡眠评分增加有关，在 Q2 中增加 0.81（95%CI，0.66-0.96），在 Q3 中增加 0.83（95%CI，0.68-0.97），在 Q4 中增加 0.62（95%CI，0.46-0.77），在 Q5 中增加 0.53（95%CI，0.36-0.70）。较高的五分位暴露还与睡眠障碍的比值比相关，在 Q2 中为 1.34（95%CI，1.23-1.45），在 Q3 中为 1.43（95%CI，1.32-1.55），在 Q4 中为 1.31（95%CI，1.21-1.43），在 Q5 中为 1.25（95%CI，1.14-1.38）。睡眠障碍亚型也存在类似的关联。此外，在年龄小于 12 岁的儿童中发现了更大的效应估计值。
这项横断面研究的结果表明，居住在户外 ALAN 水平较高地区的儿童睡眠障碍更为普遍，且这些关联在年龄小于 12 岁的儿童中通常更强。这些发现进一步表明，有效控制户外 ALAN 可能是改善儿童睡眠质量的重要措施。
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