Chen Pan, Sun He-Li, Feng Yuan, Zhang Qinge, Si Tong Leong, Su Zhaohui, Cheung Teris, Ungvari Gabor S, Zhang Erliang, Chen Minzhi, Zhang Jie, Zhang Lin, Ren Bin, Jin Qingqing, Smith Robert D, Xiang Mi, Xiang Yu-Tao
Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
Depress Anxiety. 2024 Nov 23;2024:9920975. doi: 10.1155/da/9920975. eCollection 2024.
Sleep problems are known as risk factors for depression and anxiety, but research on this subject with commercial pilots is limited. This study aimed to explore the effects of sleep problems on depressive and anxiety symptoms among Chinese commercial pilots. Adults who participated in the baseline assessment of the Civil Aviation Health Cohort of China between December 2022 and March 2023 formed the study sample. Depressive and anxiety symptoms and sleep quality were assessed using standardized scales. Sleep duration was measured with standardized questions. Logistic regression and restricted cubic splines (RCSs) were used to analyze the association between sleep problems and depression/anxiety symptoms. A total of 7055 pilots were included in this study. The overall prevalence of depression and anxiety among pilots was 23.3% ( = 1642; 95% confidence interval [CI] = 22.3%-24.3%) and 17.0% ( = 1196; 95% CI = 16.1-17.8%), respectively. Logistic regression analyses revealed that short sleep duration (<7 h) was significantly associated with a higher risk of depression (odds ratio [OR] = 2.491; < 0.001) and anxiety (OR = 2.555; < 0.001), while poor sleep quality was also associated with a higher risk of depression (OR = 7.297; < 0.001) and anxiety (OR = 7.469; < 0.001). After adjusting for confounders, there was an inverse, J-shaped nonlinear relationship between sleep duration and both depression (inflection point: 7.64 h) and anxiety (inflection point: 7.48 h). Similarly, a J-shaped nonlinear relationship was found between sleep quality and depression/anxiety with an inflection point of Pittsburgh Sleep Quality Index (PSQI) = 4 points for both. The major limitation of the study was that causal relationships between variables could not be inferred due to the cross-sectional study design. This study found that depression and anxiety were common among Chinese commercial pilots. Insufficient length and poor quality of sleep were associated with an increased risk of depression and anxiety. Implementing targeted strategies to improve sleep patterns is crucial for reducing the risk of depression and anxiety in this population.
睡眠问题被认为是抑郁和焦虑的风险因素，但针对商业飞行员这一主题的研究有限。本研究旨在探讨睡眠问题对中国商业飞行员抑郁和焦虑症状的影响。2022年12月至2023年3月期间参加中国民航健康队列基线评估的成年人构成了研究样本。使用标准化量表评估抑郁和焦虑症状以及睡眠质量。通过标准化问题测量睡眠时间。采用逻辑回归和受限立方样条（RCS）分析睡眠问题与抑郁/焦虑症状之间的关联。本研究共纳入7055名飞行员。飞行员中抑郁和焦虑的总体患病率分别为23.3%（n = 1642；95%置信区间[CI] = 22.3%-24.3%）和17.0%（n = 1196；95%CI = 16.1-17.8%）。逻辑回归分析显示，睡眠时间短（<7小时）与抑郁风险较高（优势比[OR] = 2.491；P < 0.001）和焦虑风险较高（OR = 2.555；P < 0.001）显著相关，而睡眠质量差也与抑郁风险较高（OR = 7.297；P < 0.001）和焦虑风险较高（OR = 7.469；P < 0.001）相关。在调整混杂因素后，睡眠时间与抑郁（拐点：7.64小时）和焦虑（拐点：7.48小时）之间存在反向的J形非线性关系。同样，睡眠质量与抑郁/焦虑之间也发现了J形非线性关系，两者的匹兹堡睡眠质量指数（PSQI）拐点均为4分。该研究的主要局限性在于，由于横断面研究设计，无法推断变量之间的因果关系。本研究发现，抑郁和焦虑在中国商业飞行员中很常见。睡眠时间不足和睡眠质量差与抑郁和焦虑风险增加有关。实施有针对性的策略来改善睡眠模式对于降低该人群的抑郁和焦虑风险至关重要。
