中国成年人睡眠时长与伴有抑郁和焦虑症状的失眠：一项横断面研究
Sleep Duration and Insomnia with Comorbid Depression and Anxiety Symptoms in Chinese Adults: A Cross-Sectional Study.
作者信息
Hou Zhongxin, Chen Yang, Sun Yunrui, Song Chongwei, Deng Haoyuan, Cheng Nan, Han Xiaoyu, Zhang Jianghui, Wang Qian, Li Yi, Yin Jianzhong, Meng Qiong
机构信息
School of Public Health, Kunming Medical University, Kunming, Yunnan, People's Republic of China.
Institute for Acute Communicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China.
出版信息
Nat Sci Sleep. 2023 Dec 21;15:1079-1091. doi: 10.2147/NSS.S440584. eCollection 2023.
PURPOSE
Depression and anxiety are two highly prevalent mental disorders that commonly coexist. However, little is known about the association between sleep and comorbid depressive and anxiety symptoms (CDAS). Therefore, this study aims to explore the relationship between sleep duration, insomnia and CDAS.
METHODS
This is a cross-sectional study of 22,004 community adults who participated in the China Multi-Ethnic Cohort (CMEC) study. Chinese version of Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 were used to screen CDAS in community adults. A positive score on each scale was considered indicative of CDAS. All participants received face-to-face interviews, medical examinations, and biochemical examinations to assess sleep duration and insomnia and collect covariates. The self-reported sleep duration was divided into three groups: <7 hr, 7-9 hr and >9 hr groups. Logistic regression was used to analyze the association between sleep duration, insomnia and CDAS. A restricted cubic spline (RCS) was used to explore the dose-response relationship between sleep duration and CDAS. Stratified analysis based on gender and age was conducted.
RESULTS
Overall, 2.8% (95% CI 2.6%3.0%) of participants reported having CDAS. After adjusting the potential covariates, sleep duration <7 hr (OR=1.635, 95% =1.3352.004) was significantly associated with CDAS, compared with sleep 7-9 hr. After RCS analysis, there was a nonlinear relationship between sleep duration and CDAS. The increase in the number of types of insomnia, the greater the likelihood of CDAS ( for trend<0.05). In sensitivity analysis, it was found that the results were consistent with those of the main analysis. After stratification by gender and age, the association between sleep duration and CDAS was only observed in female and young and middle-aged adults, not in men and older adults.
CONCLUSION
Both insufficient sleep duration and insomnia are associated with a higher prevalence of CDAS in Chinese adults.
目的
抑郁症和焦虑症是两种高度流行且常共存的精神障碍。然而，关于睡眠与共病抑郁和焦虑症状（CDAS）之间的关联知之甚少。因此，本研究旨在探讨睡眠时间、失眠与CDAS之间的关系。
方法
这是一项对22004名参与中国多民族队列（CMEC）研究的社区成年人进行的横断面研究。采用中文版患者健康问卷-2和广泛性焦虑症-2对社区成年人进行CDAS筛查。每个量表的阳性评分被视为CDAS的指标。所有参与者均接受面对面访谈、医学检查和生化检查，以评估睡眠时间和失眠情况并收集协变量。自我报告的睡眠时间分为三组：<7小时、7-9小时和>9小时组。采用逻辑回归分析睡眠时间、失眠与CDAS之间的关联。使用受限立方样条（RCS）来探索睡眠时间与CDAS之间的剂量反应关系。进行了基于性别和年龄的分层分析。
结果
总体而言，2.8%（95%CI 2.6%3.0%）的参与者报告有CDAS。在调整潜在协变量后，与睡眠时间为7-9小时相比，睡眠时间<7小时（OR=1.635，95%=1.3352.004）与CDAS显著相关。经过RCS分析，睡眠时间与CDAS之间存在非线性关系。失眠类型数量增加，CDAS的可能性越大（趋势P<0.05）。在敏感性分析中，发现结果与主要分析结果一致。按性别和年龄分层后，仅在女性以及中青年成年人中观察到睡眠时间与CDAS之间的关联，在男性和老年人中未观察到。
结论
睡眠时间不足和失眠均与中国成年人中较高的CDAS患病率相关。
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