Guan Hongyu, Chen Xiangzhe, Liu Wenting, Zhang Lidong, Ding Yuxiu
Center for Experimental Economics for Education, Faculty of Education, Shaanxi Normal University, Xi'an 710119, China.
Prev Med Rep. 2025 Aug 22;58:103217. doi: 10.1016/j.pmedr.2025.103217. eCollection 2025 Oct.
To examine the association between weekday sleep duration and visual health among adolescents in low-resource rural settings, and to explore potential behavioral mechanisms.
We used cross-sectional data from 36,139 rural primary and junior high school students in northwestern China (2012, 2019). Visual acuity was assessed via standardized LogMAR tests. To address potential endogeneity in self-reported sleep, we applied two-stage least squares regression with sunset time as an instrumental variable.
Students averaged 8.65 weekday sleep hours, and 58.3 % slept fewer than 9 h-below age-specific recommendations. Instrumental variable estimates indicated that each additional weekday sleep hour reduced the LogMAR score by 0.070 ( < 0.05), indicating better vision. Mechanism analysis suggested that shorter sleep was linked to greater late-night screen use and near work.
Insufficient weekday sleep is associated with poorer vision among rural adolescents, potentially mediated by digital screen exposure. School-based programs that promote adequate sleep and reduce nighttime screen use may offer a low-cost, scalable approach to support visual health in under-resourced areas.
研究资源匮乏的农村地区青少年平日睡眠时间与视觉健康之间的关联，并探索潜在的行为机制。
我们使用了来自中国西北部36139名农村中小学生的横断面数据（2012年、2019年）。通过标准化的LogMAR测试评估视力。为解决自我报告睡眠中的潜在内生性问题，我们采用以日落时间为工具变量的两阶段最小二乘法回归。
学生平日平均睡眠时间为8.65小时，58.3%的学生睡眠时间少于9小时，低于特定年龄的建议睡眠时间。工具变量估计表明，平日睡眠时间每增加1小时，LogMAR评分降低0.070（P<0.05），表明视力更好。机制分析表明，睡眠时间较短与夜间更多使用电子屏幕和近距离工作有关。
农村青少年平日睡眠不足与视力较差有关，可能是由数字屏幕暴露介导的。促进充足睡眠和减少夜间屏幕使用的校本项目可能为资源匮乏地区支持视觉健康提供一种低成本、可扩展的方法。
