Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash.
Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash.
Acad Pediatr. 2023 Aug;23(6):1242-1246. doi: 10.1016/j.acap.2023.02.013. Epub 2023 Mar 9.
The purpose of this paper was to understand associations between low sleep duration (<8.ßhours) and positive mental health screens among adolescents (ages 13...18) seen for preventive visits in primary care.
Data were from two randomized controlled trials testing the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. Participants (n.ß=.ß601) completed screeners at baseline, 3 months, and 6 months which included sleep duration in hours and the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 screeners for depression and anxiety, respectively. Main analyses included adjusted logistic regressions testing associations between low sleep duration and positive mental health screens.
Adjusted models showed that low sleep duration was associated with significantly greater odds of a positive depression screen (OR.ß=.ß1.58, 95% CI: 1.06...2.37) but not with a positive anxiety screen or co-occurring positive depression and anxiety screens. However, follow-up analyses indicated an interaction between sleep duration and anxiety in the association with a positive depression screen, such that the association between low sleep and a positive depression screen was driven by those who did not screen positive for anxiety.
As pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are warranted to ensure effective early intervention for sleep and mental health problems during adolescence.
本文旨在了解青少年在初级保健中接受预防就诊时，睡眠时长较短（<8 小时）与心理健康筛查呈阳性之间的关联。
数据来自两项随机对照试验，这些试验测试了电子健康风险行为筛查和反馈工具在青少年预防就诊中的功效。参与者（n=.601）在基线、3 个月和 6 个月时完成了筛查，其中包括睡眠时间（以小时为单位）以及患者健康问卷 9 项和广泛性焦虑障碍 7 项筛查，分别用于筛查抑郁和焦虑。主要分析包括调整后的逻辑回归分析，用于测试睡眠时长较短与心理健康筛查呈阳性之间的关联。
调整后的模型表明，睡眠时长较短与出现抑郁阳性筛查的几率显著增加相关（OR=.158，95%CI：1.06...2.37），但与焦虑阳性筛查或同时出现的抑郁和焦虑阳性筛查无关。然而，后续分析表明，在与抑郁阳性筛查的关联中，睡眠时长和焦虑之间存在交互作用，即睡眠时长较短与抑郁阳性筛查之间的关联是由那些没有焦虑阳性筛查的人驱动的。
随着儿科初级保健中睡眠指南的不断发展，需要进一步研究、培训和支持睡眠筛查，以确保在青少年时期有效进行睡眠和心理健康问题的早期干预。
